National palliative care measures

This section describes the classification systems and methodology used in the National Palliative Care Measures web report. More detailed information is available under Data dictionary and Data sources, and in the accompanying data tables. 

National Health Data Hub (NHDH)

The National Health Data Hub (NHDH), formerly the National Integrated Health Services Information (NIHSI), is a major national health data linkage system for health and welfare research and analysis.  It comprises de-identified and enduring health and welfare data from state and territory, Commonwealth and non-government data sources.

Access granted to the NHDH data does not constitute endorsement by the data custodians of the methodology used or related findings. 

For more information on the NHDH, see National Health Data Hub.

International Statistical Classification of Diseases and Related Health Problems

The International Statistical Classification of Diseases and Related Health Problems (ICD), which was developed by the World Health Organization (WHO), is the international standard for coding morbidity and mortality statistics. It was designed to promote international comparability in collecting, processing, classifying and presenting these statistics. The ICD is periodically reviewed to reflect changes in clinical and research settings (WHO 2022).

The version currently used in Australia to code causes of death, ICD-10 (WHO 1992), was endorsed in May 1990 and officially came into use in WHO member states from 1994. The 11th revision of the ICD-10 was released in June 2018. Further information on the ICD is available from the WHO website.

ICD-10-AM

Admitted patient care data in the NHDH are drawn from the National Hospital Morbidity Database (NHMD). Diagnosis, procedure and external cause hospital data for 2023–24 were reported to the NHMD by all states and territories using the 11th edition of the Australian Modification of ICD-10, referred to as the ICD-10-AM. ICD-10-AM, is based on ICD-10 (NCCH 2013). ICD-10 was modified for the Australian setting by the National Centre for Classification in Health (NCCH) to make it more relevant to Australian clinical practice. Compatibility with ICD-10 at the higher levels (that is, up to 4-character codes) of the classification has been maintained. ICD-10-AM has been used to classify diagnoses in admitted patient hospital records in all Australian states and territories since 1999–2000 (AIHW 2000).

The ICD-10-AM disease classification is hierarchical; a small number of summary disease chapters are divided into a large number of more specific disease groupings (represented by 3-character codes). Most of the 3-character disease groupings can be divided into an even larger number of very specific disease categories represented by 4- character and 5-character codes (see Measures 2.1, 4.1 and 4.2a in the Data Dictionary).

Methodology for reporting on the progress of measures over time

To determine the ‘progress status’ of each measure, statistical testing was used to understand if the measure had significantly changed over time. Weighted linear regression was used to test the direction and statistical significance (p<0.05) of the change in each measure from baseline to the latest available data. Statistical testing was performed on summary data only for measures 1.1, 1.2, 3.2, 4.2b and 5.1a. 

The 'Status key' for the relevant icon in the report can be summarised as follows: 

• Progress: The change in the measure from baseline to latest available data was statistically significant (p<0.05) and moving in the desired direction.
• Nochange: Any change in the measure from baseline to latest available data was not statistically significant (p<0.05).
• Regress: The change in the measure from baseline to latest available data was statistically significant (p<0.05) and moving in the opposite direction to what is desired.
• Status not yet known: Insufficient data currently available.