National Integrated Health Services Information (NIHSI)

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Collection frequency
Annual 


The National Integrated Health Services Information (NIHSI) Version 3.0 was used to populate the measures. This version contains data from 2010–11 up to and including 2020–21 and was available for analysis approximately 2 years after the end of the reference period.

Baseline data
1 January – 31 December 2018
Latest data
1 January – 31 December 2020
Description of data source
The NIHSI, managed under the custodianship of the AIHW, is an enduring linked data asset that brings together state/territory hospitals data with national health administrative datasets using probabilistic linkage. Participation in and contribution to the NIHSI by states and territories is voluntary. NIHSI V3.0 includes data from various sources including:


  • the National Death Index (NDI)
  • Hospital admitted patient care (APC) services in all public hospitals for participating states and territories (excludes NT and WA) and private hospital data from Qld only (for 2019–2021) 
  • Hospital emergency department (ED) services in public hospitals for all participating states and territories (excludes NT and WA)
  • Outpatient non-admitted patient (NAP) services in public hospitals for all participating states and territories (excludes SA, NT, and WA) 
  • Medicare Benefits Schedule (MBS) 
  • Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) 
  • Residential Aged Care (RAC) – includes permanent residential aged care and/or respite care. 

The NIHSI can be used to inform health service planning, for monitoring and evaluation purposes and policy development for Australians. It includes records of services provided to people who are usual residents of Australia. It may capture some people who live in Australia but are not eligible for Medicare (for example, international students, visitors to Australia from countries with reciprocal healthcare agreements). As such, both under coverage and over coverage of different groups within the Australian resident population need to be considered in the analysis and interpretation of the NIHSI.
Measures reported
2.1 Proportion of people with life-limiting illnesses who received potentially non-beneficial treatments at the end of life.


4.1 Proportion of people with life-limiting illnesses with a potentially preventable hospitalisation in their last 3 months of life.


4.2a Proportion of people who received specialist palliative care in the last year of life with first receipt at least 3 months before death.
Age group
Refers to person’s age at death according to the NDI. 


Disaggregation categories (years): 0–14, 15–24, 25–34, 35–44, 45–54, 55–64, 65–74, 75–84, 85 or over. 

Sex
The sex at death according to the categories 'Male’, 'Female’, ‘Indeterminate’, and ‘Not stated/inadequately described’, as per the NDI. Only individuals with sex recorded as 'Male’ or 'Female’ in the NDI were included in analyses.

Disaggregation categories: Males, Females.
State/territory
The unique state/territory in which a person’s death was registered according to the NDI. This is not necessarily the state/territory where a service was received nor necessarily the state/territory of usual residence. Differences in health service delivery or data recording may warrant caution in the interpretation of outcomes disaggregated by state/territory. Only deaths registered in New South Wales, Victoria, Queensland, South Australia, Tasmania, or the Australian Capital Territory were included in the analyses as no hospital data were available for the Northern Territory and Western Australia.

Disaggregation categories: New South Wales, Victoria, Queensland, South Australia, Tasmania, and the Australian Capital Territory. 
Remoteness area
The Remoteness Area (RA) of a person’s usual residence at the time of death as per the NDI based on Statistical Area Level 2 (SA2). The Australian Statistical Geography Standard (ASGS) 2016 was used to assign RAs for all people whose death was registered prior to 2021 and ASGS 2021 was used for people whose death was registered in 2021. Where more than one RA category was associated with a specific SA2, the RA category accounting for the highest proportion by area was assigned to that SA2. 

Disaggregation categories: Major Cities, Inner Regional, Outer Regional, and Remote and Very Remote (combined). 

Source: Australian Bureau of Statistics (ABS) (METEOR Identifier 697105)
Socioeconomic area
The socioeconomic area of a person’s usual residence at the time of death as per the NDI based on Statistical Area Level 2 and according to the ABS Socio-Economic Indexes for Areas (SEIFA) Index of Relative Socio-economic Disadvantage (IRSD). ABS SEIFA 2016 was used to assign SEIFA IRSD quintiles for all people whose death was registered prior to 2021 and SEIFA 2021 was used for people whose death was registered in 2021.

Disaggregation categories: SEIFA IRSD quintiles (1–5 or lowest/most disadvantaged to highest/least disadvantaged socioeconomic area).

Source: Australian Bureau of Statistics (METEOR Identifier 695778).
Cause of death
Based on the underlying cause of death according to the NDI.

Disaggregation categories: Malignant neoplasm (C00–C97), Heart disease (I00–I52), Cerebrovascular disease (I60–I69), Renal disease (N17, N18, N28), Liver disease (K70–K77), Respiratory disease and HIV/AIDS (J06-J18, J20-J22, J40-J47, J96, B20-B24), Neurodegenerative disease (G10, G20, G35, G122, G903, G231), Dementia/Alzheimer’s disease/Senility (G30, F01, F03, R54).
Potentially non-beneficial
treatment/intervention
Based on any record from the hospitals data in the reference period. No hospital data from the private hospital sector were accessed. 
Disaggregation categories: chemotherapy, cardiopulmonary resuscitation, intravenous feeding, mechanical ventilation, dialysis, blood transfusion.

See Data dictionary for more information.
Hospitalisation condition
group (for potentially
preventable hospitalisation)

Based on any record from the hospitals data in the reference period. No hospital data from the private hospital sector were accessed. 

Each potentially preventable hospitalisation admission is associated with at least 1 of the specified condition-groups (acute, chronic and/or vaccine-preventable). If an admission was associated with more than 1 condition-group, it was assigned to a single condition-group according to the following highest-to-lowest priority order, acute > chronic > vaccine-preventable, to allow unambiguous categorisation in the 'Hospitalisation condition group' analysis.  

Disaggregation categories: Acute conditions, Chronic conditions, Vaccine-preventable conditions. 

See Data dictionary for more information.

Length of stay

The total length of stay of an inpatient measured in days. This is the length of time between the hospital admission date and separation date, minus any leave days. 

Disaggregation categories: Same-day admission, 1-2 days, 3 or more days.
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