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Change of transfer rules in PRIMHD for the HoNOS family of measures

Since the introduction of the HoNOS family of measures in July 2008, there have been transfer rules for tāngata whai ora moving from community to inpatient settings in PRIMHD. The original rationale for having these transfer rules was to develop a case-mix methodology. However, as we no longer use a case-mix approach, it makes sense to remove these transfer rules.

The HoNOS family of measures refers to the suite of Health of the Nation Outcome Scale (HoNOS) measures mandated in New Zealand: HoNOS, HoNOS65+, HoNOSCA, HoNOS-LD and HoNOS-Secure.

Collaboration between the PRIMHD National Stakeholders group (represented by all 20 DHBs), the Ministry of Health (MOH) and Te Pou has resulted in changes to the transfer rules to align with clinical practice. Community episodes will now be the primary HoNOS episode setting. These new transfer rules apply to all the HoNOS family of measures.

These new transfer rules will require you to keep a community HoNOS episode open while simultaneously still collecting admission and discharge collections for all inpatient admissions. This change is effective from July 2021.

Revised transfer rules

This section shows what needs to be checked and possibly changed in systems with this new rule.

Revised HoNOS transfer rules diagram  showing community episode and inpatient admissions

As the diagram above shows, the new transfer rules mean that the community episode, following the community admission collection, remains open. Where an inpatient event occurs, inpatient HoNOS collection at admission and discharge continues as normal. However, the inpatient admission will not affect the timing of the community collections.

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