Data and Business Rules – Alcohol DES
Author / HSCIC - SDS team / Version No / 2.1 / Version Date / 22/05/2013

New GMS Contract Implementation

Dataset and Business Rules

-

Alcohol DES

Alcohol DES_v2 1_Quarterly_Reporting_Annual_Payment / Version Date: 22/05/2013

Amendment History:

Version / Date / Amendment History
0.1 / 21st January 2013 / First draft by HSCIC
0.2 / 25th January 2013 / Second draft by HSCIC following more detailed requirements
0.3 / 1st February 2013 / Third draft by HSCIC
0.4 / 28th February 2013 / Fourth draft by HSCIC
0.5 / 28th March 2013 / Fifth draft by HSCIC updated following confirmation around indicators to be included
1.0 / 2nd April 2013 / Final version by HSCIC updated following discussion around additional counts
1.1 / 5th April 2013 / Updated to amend AUDIT screening code
1.2 / 8th April 2013 / Specification updated following discussion around use of date criteria
1.3 / 23rd April 2013 / Specification updated following meeting
1.4 / 3rd May 2013 / Specification updated following teleconference
1.5 / 8th May 2013 / Specification updated following discussions
2.0 / 8th May 2013 / Tracked changes accepted
2.1 / 22nd May 2013 / Updated for publication

Dataset and business rules – Alcohol DES

Notes

1)  Dates used:

  1. ACHIEVEMENT_DAT: The date up to which patient information is considered when determining the output for each extraction.
  2. PAYMENTPERIODEND_DAT: The end date of the period for which payments are made for a given Quality Service. For any given Quality Service there will be one or more payment periods.
  3. QUALITY_SERVICE_START_DAT (QSSD): The start of the period during which a GP Practice provides the Quality Service
  4. QUALITY_SERVICE_END_DAT (QSED): The end of the period during which a GP Practice provides the Quality Service

The QUALITY_SERVICE_START_DAT (QSSD) for this DES is 01.04.2013

The QUALITY_SERVICE_END_DAT (QSED) for this DES is 01.04.2014

2)  Clinical codes quoted are (where known) from the April 2013 release of Read codes version 2 and clinical terms version 3 (CTV3). The codes are shown within the document as a 5 character value to show that the Read Code is for a 5-Byte system.

i)  Where a ‘%’ wildcard is displayed, the Read Code is filled to 5 characters with full-stops. When implementing a search for the Read Code, only the non full-stop values should be used in the search, For example, a displayed Read Code of c1...% should be implemented as a search for c1%, i.e. should find c1 and any of it’s children.

ii)  Where a range of read codes are displayed, the Read Code is filled to 5 characters with full-stops. When implementing the search, only the non full-stop values should be used in the search, For example, a displayed Read Code range of G342. – G3z.. should find all codes between G342 and G3z (including any children where applicable).

3)  Where Rulesets are specified as multiple rules they are to be processed sequentially. Processing of rules should terminate as soon as a ‘Reject’ or ‘Select’ condition is encountered. A count should be returned for each Select statement. Unless explicitly stated there is no need to return a count for the Reject statements.

4)  Rules are expressed as logical statements that evaluate as either ‘true’ or ‘false’. The following operators are required to be supported:

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Alcohol DES_v2 1_Quarterly_Reporting_Annual_Payment / Version Date: 22/05/2013

a)  > (greater than)

b)  < (less than)

c)  = (equal to)

d)  ≠ (not equal to)

e)  AND

f)  OR

g)  NOT

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Alcohol DES_v2 1_Quarterly_Reporting_Annual_Payment / Version Date: 22/05/2013

5)  Where date criteria are specified with intervals of multiples of months or years these should be interpreted as calendar months or calendar years.

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Alcohol DES_v2 1_Quarterly_Reporting_Annual_Payment / Version Date: 22/05/2013

Dataset Specification

1)  Patient selection criteria:

a)  Registration status

Current registration status / Qualifying criteria
Currently registered for GMS / Most recent registration date < (ACHIEVEMENT_DAT)
Previously registered for GMS / Any sequential pairing of registration date and deregistration date where both of the following conditions are met:
registration date < (ACHIEVEMENT_DAT); and
deregistration date >= (ACHIEVEMENT_DAT)

b)  Diagnostic code status

Action / Qualifying criterion

Included

/ Age >= 16 yrs at QSED

2)  Clinical data extraction criteria

Field Number / Field name / Data item / Qualifying criteria
1  / pat_id / Patient ID number / Unconditional
2  / reg_dat / Date of patient registration / Latest < ACHIEVEMENT_DAT
3  / PAT_AGE / Patients age (in years) at QSED / Unconditional
4  / FAST_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT)
388u. / XaNO9
(FAST alcohol screening test codes)
5  / FAST_DAT / Date of FAST_COD / Chosen record
6  / AUDITC_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT)
38D4. / XaORP
(AUDIT C alcohol screening test codes)
7  / AUDITC_DAT / Date of AUDITC_COD / Chosen record
8  / FASTPOS_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT) where FASTPOS_VAL >= 3
388u. / XaNO9
(Positive FAST alcohol screening test codes)
9  / FASTPOS_DAT / Date of FASTPOS_COD / Chosen record
10  / FASTPOS_VAL / Value of FASTPOS_COD / Chosen record
11  / AUDITCPOS_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT) where AUDITCPOS_VAL >= 5
38D4. / XaORP
(Positive AUDIT C alcohol screening test codes)
12  / AUDITCPOS_DAT / Date of AUDITCPOS_COD / Chosen record
13  / AUDITCPOS_VAL / Value of AUDITCPOS_COD / Chosen record
14  / AUDIT_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT)
38D3. / XM0aD
(Audit alcohol screening test codes)
15  / AUDIT_DAT / Date of AUDIT_COD / Chosen record
16  / AUDIT1_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT) where
AUDIT1_VAL >=0 and <8
38D3. / XM0aD
(Audit alcohol screening test codes)
17  / AUDIT1_DAT / Date of AUDIT1_COD / Chosen record
18  / AUDIT1_VAL / Value of AUDIT1_COD / Chosen record
19  / AUDIT2_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT) where
AUDIT2_VAL >=8 and <16
38D3. / XM0aD
(Audit alcohol screening test codes)
20  / AUDIT2_DAT / Date of AUDIT2_COD / Chosen record
21  / AUDIT2_VAL / Value of AUDIT2_COD / Chosen record
22  / AUDIT3_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT) where
AUDIT3_VAL >=16 and <20
38D3. / XM0aD
(Audit alcohol screening test codes)
23  / AUDIT3_DAT / Date of AUDIT3_COD / Chosen record
24  / AUDIT3_VAL / Value of AUDIT3_COD / Chosen record
25  / AUDIT4_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT) where
AUDIT4_VAL >= 20
38D3. / XM0aD
(Audit alcohol screening test codes)
26  / AUDIT4_DAT / Date of AUDIT4_COD / Chosen record
27  / AUDIT4_VAL / Value of AUDIT4_COD / Chosen record
28  / ALCBRFINT_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT)
9k1A. / XaPPv
(Brief intervention for excessive alcohol consumption codes)
29  / ALCBRFINT_DAT / Date of ALCBRFINT_COD / Chosen record
30  / ALCEXTINT_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT)
9k1B. / XaPPy
(Extended intervention for excessive alcohol consumption codes)
31  / ALCEXTINT_DAT / Date of ALCEXTINT_COD / Chosen record
32  / ALCRFRL_COD / Read codes v2 / CTV3 / Earliest >= QSSD AND
< (ACHIEVEMENT_DAT)
8HkG. / XaORR
(Referral for specialist advice codes)
33  / ALCRFRL_DAT / Date of ALCRFRL_COD / Chosen record

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Alcohol DES_v2 1_Quarterly_Reporting_Annual_Payment / Version Date: 22/05/2013

DES Count rulesets

The following section shows how the Cohorts and Counts used within this DES are defined. In some instances the Cohorts are used to derive multiple Counts. For example, Cohort 1 forms the cohort for the derived counts of PaymentCount ALCDES1.1 and AdditionalCounts ALCDES1.2, ALCDES1.3 and ALCDES2.1. Where a Count is to be used for payment it is listed as a PaymentCount i.e. PaymentCount ALCDES1.1 and where a Count is used to support additional reporting it will be listed as an AdditionalCount i.e. AdditionalCount_ALCDES1.2.

For an explanation of the dates in this section used please refer to Point 1 of the Notes section above.

Cohort 1

Count ALCDES0.1: The number of newly registered patients aged 16 and over within the financial year.

Rule number / Rule / Action if true / Action if false
1  / If REG_DAT >= QSSD / Select / Reject

Rule 1: The aim of this rule is to identify newly registered patients (aged 16 and over) i.e. those who registered on or after the QUALITY_SERVICE_START_DAT(QSSD). If the patient meets this criteria then they are added to the Cohort count, otherwise they are rejected and not included in the Cohort count.

Cohort 2

Count ALCDES0.2: The number of newly registered patients aged 16 and over within the financial year who have had a positive FAST (3+) or a positive AUDIT-C (5+) score within the period.

Rule number / Rule / Action if true / Action if false
1  / If REG_DAT >= QSSD
AND
(If FASTPOS_DAT < ACHIEVEMENT_DAT
OR
If AUDITCPOS_DAT < ACHIEVEMENT_DAT) / Select / Reject

Rule 1: The aim of this rule is to identify newly registered patients (aged 16 and over) who registered on or after the QUALITY_SERVICE_START_DAT and who have a positive FAST or AUDIT-C score within the period i.e. on or after the QUALITY_SERVICE_START_DAT and before the ACHIEVEMENT_DAT. If the patient meets this criteria then they are added to the Cohort count, otherwise they are rejected and not included in the Cohort count.

Cohort 3

Count ALCDES0.3: The number of newly registered patients aged 16 and over within the financial year with a positive FAST (3+) or a positive AUDIT-C (5+) score who have an AUDIT score of 8-15 within the period.

Rule number / Rule / Action if true / Action if false
1  / If REG_DAT >= QSSD
AND
(If FASTPOS_DAT < ACHIEVEMENT_DAT
OR
If AUDITCPOS_DAT < ACHIEVEMENT_DAT)
AND
If AUDIT2_DAT < ACHIEVEMENT_DAT / Select / Reject

Rule 1: The aim of this rule is to identify newly registered patients (aged 16 and over) who:

-  were registered on or after the QUALITY_SERVICE_START_DAT and

-  who have a positive FAST or AUDIT-C score within the period i.e. on or after the QUALITY_SERVICE_START_DAT and before the ACHIEVEMENT_DAT and

-  who have an AUDIT score of 8-15 within the period i.e. on or after the QUALITY_SERVICE_START_DAT and before the ACHIEVEMENT_DAT

If the patient meets all of the above criteria then they are added to the Cohort count, otherwise they are rejected and not included in the Cohort count.

Cohort 4

Count ALCDES0.4: The number of newly registered patients aged 16 and over within the financial year with a positive FAST (3+) or a positive AUDIT-C (5+) score who have an AUDIT score of 16-19 within the period.

Rule number / Rule / Action if true / Action if false
1  / If REG_DAT >= QSSD
AND
(If FASTPOS_DAT < ACHIEVEMENT_DAT
OR
If AUDITCPOS_DAT < ACHIEVEMENT_DAT)
AND
If AUDIT3_DAT < ACHIEVEMENT_DAT / Select / Reject

Rule 1: The aim of this rule is to identify newly registered patients (aged 16 and over) who:

-  were registered on or after the QUALITY_SERVICE_START_DAT and

-  who have a positive FAST or AUDIT-C score within the period i.e. on or after the QUALITY_SERVICE_START_DAT and before the ACHIEVEMENT_DAT and

-  who have an AUDIT score of 16-19 within the period i.e. on or after the QUALITY_SERVICE_START_DAT and before the ACHIEVEMENT_DAT

If the patient meets all of the above criteria then they are added to the Cohort count, otherwise they are rejected and not included in the Cohort count.

Cohort 5

Count ALCDES0.5: The number of newly registered patients aged 16 and over within the financial year with a positive FAST (3+) or a positive AUDIT-C (5+) score who have an AUDIT score of 20 or over within the period.

Rule number / Rule / Action if true / Action if false
1  / If REG_DAT >= QSSD
AND
(If FASTPOS_DAT < ACHIEVEMENT_DAT
OR
If AUDITCPOS_DAT < ACHIEVEMENT_DAT)
AND
If AUDIT4_DAT < ACHIEVEMENT_DAT / Select / Reject

Rule 1: The aim of this rule is to identify newly registered patients (aged 16 and over) who:

-  were registered on or after the QUALITY_SERVICE_START_DAT and

-  who have a positive FAST or AUDIT-C score within the period i.e. on or after the QUALITY_SERVICE_START_DAT and before the ACHIEVEMENT_DAT and

-  who have an AUDIT score of 20 or over within the period i.e. on or after the QUALITY_SERVICE_START_DAT and before the ACHIEVEMENT_DAT

If the patient meets all of the above criteria then they are added to the Cohort count, otherwise they are rejected and not included in the Cohort count.

PaymentCount ALCDES1.1: The number of newly registered patients aged 16 and over within the financial year who have had the short standard case finding test (FAST or AUDIT-C).

PaymentCount ruleset: To be applied to the above Cohort 1 population

Rule number / Rule / Action if true / Action if false
1  / If FAST_DAT < PAYMENTPERIODEND_DAT
OR
If AUDITC_DAT < PAYMENTPERIODEND_DAT / Select / Reject

Rule 1: This count will be used to determine payment

The aim of this rule is to identify patients included in Cohort 1 who have had either the FAST or AUDIT-C screening test before the PAYMENTPERIODEND_DAT. If a patient meets this criteria they are added to the count, otherwise they are rejected and not included in the Payment count.

AdditionalCount_ALCDES1.2: The number of newly registered patients aged 16 and over within the financial year who have had the FAST short standard case finding test within the period.

AdditionalCount ruleset: To be applied to the above Cohort 1 population

Rule number / Rule / Action if true / Action if false
1  / If FAST_DAT < ACHIEVEMENT_DAT / Select / Reject

Rule 1: The aim of this rule is to identify patients included in Cohort 1 who have received the FAST screening test within the period i.e. on or after the QUALITY_SERVICE_START_DAT and before the ACHIEVEMENT_DAT. If a patient meets this criteria they are added to the count, otherwise they are rejected and not included in this count.