Emergency care includes care provided by emergency departments and emergency services. For the purposes of activity based funding, emergency departments and emergency services are categorised into seven emergency care categories based on service provision, staffing and location.
Emergency departments, often referred to as EDs, are dedicated hospital-based facilities specifically designed and staffed to provide 24-hour emergency care. The role of an emergency department is to diagnose and treat acute and urgent illnesses and injuries. Patients are seen in order of medical urgency with non-urgent patients being seen after more acute patients.
Emergency services are small facilities designed and staffed for 24-hour nursing care and access to medical practitioners. The role of an emergency service is to provide first aid and treatment for non-life-threatening injuries and illnesses. Patients are treated at an emergency service prior to being referred to a higher level of service if required.
Public hospitals in Australia group emergency department patient presentations to the Australian Emergency Care Classification (AECC), while emergency service patient presentations are grouped to the Urgency Disposition Groups (UDG) classification.
Data collected at the emergency department or the emergency service is reported to the Independent Health and Aged Care Pricing Authority (IHACPA) to ensure each emergency presentation is assigned an AECC or UDG class. The data collected includes:
- the type of visit for the presentation (that is, whether it is an emergency presentation; a planned return visit; or a pre-arranged admission)
- what happens to the patient once the emergency presentation is complete (for example, the patient may be admitted to hospital; be discharged or transferred to another hospital; or may choose to leave before treatment is completed)
- how urgently the patient needs to receive treatment, based on the triage score given to the patient upon initial assessment
- how the patient arrived (for example, did the patient travel by ambulance or helicopter)
- the diagnosis given for the presentation.
Emergency Care ICD-10-AM Principal Diagnosis Short List
The Emergency Care International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) Principal Diagnosis Short List (EPD Short List) is a set of terms used for reporting emergency care principal diagnoses to national activity data sets. A principal diagnosis is the diagnosis established at the conclusion of an emergency care episode, which is mainly responsible for occasioning the patients attendance following consideration of clinical assessment.
The EPD Short List and resources, including the user guide, can be found on the Emergency Care ICD-10-AM Principal Diagnosis Short List webpage.
Australian Emergency Care Classification
From 1 July 2021, emergency department presentations have been classified and priced using the AECC. The AECC replaces the Urgency Related Groups classification and has three hierarchical levels which represent how the classification groups emergency department episodes of care into end classes. The complexity level of each episode of care is based on a score calculated using the patient’s type of visit, episode end status, triage category, principal diagnosis, transport mode and age.
The AECC has a statistically strong performance, provides scope for further refinement, and can be used for purposes other than funding, including health service planning and research.
Resources relating to the AECC, including groupers, specifications and fact sheets, can be found on the Australian Emergency Care Classification webpage.
Urgency Disposition Groups
From 1 July 2012, IHACPA implemented the UDG classification to classify emergency services. UDGs group patient presentations on the basis of the type of visit, episode end status and triage.
IHACPA is currently working with states and territories to determine the feasibility of transitioning emergency services to the AECC in the future.
Resources relating to the UDG classification can be found on the Urgency Disposition Groups webpage.