National Ambulatory Care Reporting System data set

Description

The National Ambulatory Care Reporting System (NACRS) is a tool for collecting data and reporting on all levels of ambulatory care within Canada including emergency departments (EDs), day surgery, and medical and surgical day clinics within hospitals, the community and private clinics. NACRS facilitates comparisons and benchmarking across jurisdictions provincially and nationally through the use of standardized definitions and coding standards that adhere to national and international standards. 

In September 2010 the BC Ministry of Health (the Ministry) mandated the health authorities to work with Canadian Institute for Health Information (CIHI) to implement the NACRS Level 2 at fifteen high volume emergency departments across the province. NACRS Level 2 will provide patient level, demographic and wait time information and clinical data including presenting complaint and discharge diagnosis. Presently there are a total of twenty-nine hospital EDs  in the province reporting to NACRS and no ambulatory care facility is reporting in BC.

Inclusions

More information coming soon.

Exclusions

More information coming soon.

Data changes over time

• 2012/13 – Twenty facilities were submitting data on emergency visits to NACRS
• By the end of 2013/14, twenty nine facilities were submitting data on emergency visits to NACRS
• 2014/15 - The CDU flag and in/out times became mandatory reporting on April 1, 2014.

Quality/accuracy of information/field coding source

The centralized data processing of the NACRS records, done by the Canadian Institute of Health Information (CIHI), results in increased efficiency and standardization among the participating provinces.

Fields available

Field Name	Description
Personal Health Number – Replaced by project-specific identification number	BC Personal Health Number
Health Care Number – Replaced by project-specific identification number	Patient's medical number as assigned by the province of the patient's home residence. Note: This will be the same as the PHN for BC residents.
Province	Identifies the province in which the hospital is located
Institution Number – Replaced by project-specific identification number OR Institution Number (unencrypted) – Research rationale describing why this field is required must be supplied before it will be considered for release:	Facility identification number unique to each province/territory
Unique Record Number – Replaced by project-specific identification number	A unique number for each record generated by the Ministry of Health
Hospital Number – Replaced by project-specific identification number OR Hospital Number (unencrypted) – Research rationale describing why this field is required must be supplied before it will be considered for release:	3 digit BC Hospital Number
Fiscal Year	Fiscal Year of encounter
Fiscal Period	This is the period of the patient s visits as determined by the Date of Registration (data element 27). The period submitted follows the submission period dates defined by the reporting jurisdiction, so BC s 13 fiscal periods do not apply to out of province records.
Province Issuing Health Care Number	The provincial/territorial or federal government from which the health care number was issued
Gender	Patient's Gender
Birth Date	Birth Date of Patient (MMYYYY)
Birth Date is Estimated	Flag to indicate that all or part of the patient's date of birth is estimated
Age in Years	A Patient's age in years at the time of discharge
Age Group 1	Detailed age grouping for age under 18 (i.e., <1, 1-5, 6-12, 13-18, >18)
Age Group 10	5 year age groups (i.e., <1, 1-4, 5-9, 10-14,…, 90-94, 95+)
Age Group 12	Detailed age grouping for age under 1 year (days) (i.e., 0 (newborn), <1 , 1, 2-6, 7-13, 14-27, 28-90, 91-182, 183-274, 275-365)
Postal Code – 3-digit (i.e., FSA)	Postal code to identify patient’s place of residence. Note: Only the first three digits of the postal code (i.e., FSA) will be provided.
Mini Postal Code	This is a two-digit province or state code for the patient residence assigned when postal code is not available (e.g., BC, AB, SK), as defined in the CIHI NACRS Manual.
Local Health Area	Local Health Area from TMF based on translation of valid BC postal codes only
Triage date/time	Date and time when the patient is triaged in the ED
Triage Level	Scale to categorize patients according to the type and severity of their initial presenting signs and symptoms
Registration Date/Time	Date and time when the patient is officially registered as a patient
Physician Initial Assessment Date/Time	Date and time when the patient was first assessed by a physician
Disposition Date/Time	Date and time when the main service provider makes the decision about the patient's disposition
Visit Disposition	The patient's type of separation from the ambulatory care service after registration to that service
Date/Time Patient Left ED	Date patient was discharged from ER to inpatient unit
Provider Type	A code which identifies the role of the Provider responsible for the care of the Patient during hospitalization
Provider Service	A code which identifies the Training or Specialty of the Provider responsible for the Patient's care
Provider Number – Replaced by project-specific identification number	Provider 1 Number. MSP billing number to identify the Provider who was most responsible for the Patient's care
Presenting Complaint 1	The primary symptom, complaint, problem or reason for seeking emergency medical care as identified by the patient expressed in terms as close as possible to those used by the patient or responsible informant.
Presenting Complaint 2	The secondary symptom, complaint, problem or reason for seeking emergency medical care as identified by the patient expressed in terms as close as possible to those used by the patient or responsible informant.
Presenting Complaint 3	The tertiary symptom, complaint, problem or reason for seeking emergency medical care as identified by the patient expressed in terms as close as possible to those used by the patient or responsible informant.
ED Discharge Diagnosis 1	The physician's diagnosis of the patient at the time of discharge from ED 1
ED Discharge Diagnosis 2	The physician's diagnosis of the patient at the time of discharge from ED 2
ED Discharge Diagnosis 3	The physician's diagnosis of the patient at the time of discharge from ED 3
ED Visit Indicator	Indicates whether a visit reported under the emergency MIS functional centre account code is a "true" ED visit or an arranged day surgery or clinic visit taking place in the emergency department.
Clinical Decision Unit Flag	Indicates if the patient was placed in a Clinical Decision Unit during their emergency visit
Clinical Decision Unit In Date/Time	Date and time when the patient arrived in the Clinical Decision Unit
Clinical Decision Unit Out Date/Time	Date and time when the patient leaves the Clinical Decision Unit
Admit via Ambulance	Ambulance code which is used to indicate if the patient was brought to the facility by ambulance
Responsibility for Payment	The body responsible for payment of the patient's hospitalization