Defining an episode of care: a study of five case types.

This is the first study in Australia to test definitions of various types of 'episodes of care'. The definitions reported here are those used in the 1996 National Sub-Acute and Non-Acute Patient (SNAP) Casemix Classification Study. The study collected data on a total of 683 patients at 10 hospitals and 2 community health services providing a range of rehabilitation, aged care and community care services. The kappa statistic (kappa) was used to determine the significance of the level of agreement between raters. The value of kappa was 0.838 with a 95 per cent confidence interval of 0.801 to 0.975. The results of this study are encouraging and support the use of the five Case Types - Palliative Care, Rehabilitation, Psychogeriatric, Geriatric Evaluation and Management, and Maintenance Care. All five Case Types proved to have good interrater reliability, there was a good fit for most patients, and staff found the definitions easy to use.