Identifying and definitional attributes | |
Metadata item type: | Data Element |
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Short name: | Medicare eligibility status |
METEOR identifier: | 270093 |
Registration status: | Health!, Superseded 29/11/2006 |
Definition: | An indicator of a person's eligibility for Medicare services as specified under the Commonwealth Health Insurance Act 1973, as represented by a code. |
Context: | Admitted patient care: To facilitate analyses of hospital utilisation and policy relating to health care financing. |
Data element concept attributes | |
Identifying and definitional attributes | |
Data element concept: | Person—eligibility status |
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METEOR identifier: | 304534 |
Registration status: | Health!, Standard 04/01/2006 Community Services (retired), Standard 04/01/2006 Tasmanian Health, Standard 27/06/2017 |
Definition: | An indicator of a person's eligibility to receive a service as determined by an assessment. |
Object class: | Person |
Property: | Eligibility status |
Source and reference attributes | |
Submitting organisation: | Australian Institute of Health and Welfare |
Value domain attributes | |
Identifying and definitional attributes | |
Value domain: | Medicare eligibility status code N |
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METEOR identifier: | 270689 |
Registration status: | Health!, Superseded 29/11/2006 |
Definition: | A code set representing eligibility for Medicare services. |
Representational attributes | ||
Representation class: | Code | |
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Data type: | Number | |
Format: | N | |
Maximum character length: | 1 | |
Value | Meaning | |
Permissible values: | 1 | Eligible |
2 | Not eligible | |
Supplementary values: | 9 | Not stated/unknown |
Data element attributes | |
Collection and usage attributes | |
Guide for use: | An eligible person includes a person who resides in Australia and is one of the following:
Other persons, as temporary residents, who are fully eligible for Medicare include:
Other persons, as visitors or temporary residents, who are eligible for Medicare, in certain circumstances, include:
With respect to hospital services, persons covered by an RHCA (except RHCA diplomats as they have full Medicare eligibility) are eligible only as public patients in a public hospital and are ineligible persons if they are admitted as a private patient in either a public or a private hospital; It should also be noted that some patients can be both an 'eligible person' and either personally or a third party liable for the payment of charges for hospital services received; for example:
Newborn babies take the eligibility status of the mother. |
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Comments: | Commencing with Version 9.0 of the National Health Data Dictionary, three separate metadata items are recorded in the Dictionary:
This is because each metadata item relates to a separate concept and requires separate information to be reported. These three items replace the previous metadata items Patient accommodation eligibility status and Compensable status. |
Relational attributes | |
Related metadata references: | Has been superseded by Person—eligibility status, Medicare code N Health!, Superseded 04/07/2007 Is re-engineered from Medicare eligibility status, version 1, DE, NHDD, NHIMG, Superseded 01/03/2005.pdf (18.2 KB) No registration status |
Implementation in Data Set Specifications: | Admitted patient care NMDS Health!, Superseded 07/12/2005 Implementation start date: 01/07/2005 Implementation end date: 30/06/2006 Admitted patient care NMDS 2006-07 Health!, Superseded 23/10/2006 Implementation start date: 01/07/2006 Implementation end date: 30/06/2007 |