scholarly journals Funding Victoria's public hospitals: The casemix policy of 2000-2001

2002 ◽  
Vol 25 (1) ◽  
pp. 72 ◽  
Author(s):  
Peter McNair ◽  
Stephen Duckett
Keyword(s):  
Public Hospitals ◽  
Rehabilitation Services ◽  
Inpatient Services ◽  
Australian State ◽  
Casemix Funding

On 1 July 1993 Victoria became the first Australian state to use casemix information to set budgets for its public hospitals commencing with casemix funding for inpatient services. Victoria's casemix funding approach now embracesinpatient, outpatient and rehabilitation services.

Using a public hospital funding model to strengthen a case for improved nutritional care in a cancer setting

2013 ◽  
Vol 37 (3) ◽  
pp. 286 ◽  
Author(s):  
Anna G. Boltong ◽  
Jenelle M. Loeliger ◽  
Belinda L. Steer
Keyword(s):  
At Risk ◽  
Public Hospital ◽  
Business Case ◽  
Public Hospitals ◽  
Nutritional Care ◽  
Hospital Funding ◽  
Hospitalised Patients ◽  
Casemix Funding ◽  
Icd 10 ◽  
Successful Business

Objective. This study aimed to measure the prevalence of malnutrition risk and assessed malnutrition in patients admitted to a cancer-specific public hospital, and to model the potential hospital funding opportunity associated with implementing routine malnutrition screening. Methods. A point-prevalence audit of malnutrition risk and diagnosable malnutrition was conducted. A retrospective audit of hospital funding associated with documented cases of malnutrition was conducted. Audit results were used to estimate annual malnutrition prevalence, associated casemix-based reimbursement potential and the clinical support resources required to adequately identify and treat malnutrition. Results. Sixty-four percent of inpatients were at risk of malnutrition. Of these, 90% were assessed as malnourished. Twelve percent of malnourished patients produced a positive change in the diagnosis-related group (DRG) and increased allocated financial reimbursement. Identifying and diagnosing all cases of malnutrition could contribute an additional AU$413644 reimbursement funding annually. Conclusions. Early identification of malnutrition may expedite appropriate nutritional management and improve patient outcomes in addition to contributing to casemix-based reimbursement funding for health services. A successful business case for additional clinical resources to improve nutritional care was aided by demonstrating the link between malnutrition screening, hospital reimbursements and improved nutritional care. What is known about the topic? It is known that between 20 and 50% of hospital patients are malnourished and oncology patients are 1.7 times more likely to be malnourished than are other hospitalised patients. Despite the existence of practice guidelines for malnutrition screening of at-risk oncology patients, these are not routinely implemented. Identification of malnutrition in hospitalised patients is linked to casemix funding via DRG. Casemix reimbursement for malnutrition can be enhanced if: (1) malnutrition risk is identified; (2) malnutrition is diagnosed; (3) the word ‘malnutrition’ and an associated action plan is documented in the medical record; and (4) malnutrition is recognised and recorded by the clinical coder. Amendments to the ICD-10-AM in 2008 allowing malnutrition to be recognised as a complication for coding when it is documented by a dietitian in the medical history has hospital reimbursement implications for dietetic practice. Reimbursement potential for malnutrition has been calculated in public hospitals in Australia with varying results. What does this paper add? This paper reports the components of a successful business case made to enhance resources for identification and treatment of malnutrition on the basis of improved treatment as well as enhanced reimbursement potential resulting from changes to the ICD-10-AM. The present study adds to the body of literature showing that malnutrition coding contributes to casemix funding in Australian public hospitals, as well as internationally, and highlights the previously unreported opportunity for a cancer-specific health service. This work demonstrated that reassignment of a DRG based on a diagnosis of malnutrition altered the overall casemix funding value for 12% of audited patients. This compares with the findings of other authors who demonstrated hypothetical DRG changes and financial reallocation. What are the implications for practitioners? This paper highlights that practitioner-centred strategies are needed to enhance malnutrition identification, diagnosis, documentation and coding to maximise casemix reimbursement and better treat malnutrition in hospitals. Strategies include education of the dietetics, medical and health-information workforce. This manuscript provides a description of the conduct of quality-improvement activities that may support successful business cases for increased dietetic resources in future.

scholarly journals Socio-demographic and Clinical Correlates of Community Reintegration of Stroke Survivors in Nigeria

2020 ◽  
pp. 1-7
Author(s):  
Muhammad Usman Ali ◽  
Auwal Yahaya Garba ◽  
Adewale Luqman Oyeyemi ◽  
Mamman Ali Masta ◽  
Fatima Kachallah Gujba ◽  
...  
Keyword(s):  
Clinical Characteristics ◽  
Sampling Technique ◽  
Haemorrhagic Stroke ◽  
Public Hospitals ◽  
Rehabilitation Services ◽  
Stroke Survivors ◽  
Community Reintegration ◽  
Post Discharge ◽  
Post Stroke ◽  
The Impact

Background: Low level of community reintegration among stroke survivors is a major obstacle to rehabilitation services post discharge from acute care. Few studies have assessed the impact of community reintegration on stroke survivors in Nigeria. This study investigates community reintegration and associated factors among stroke survivors in Maiduguri, Nigeria. Methodology: Purposive sampling technique was used to recruit 55 stroke survivors attending rehabilitation services from two public hospitals in Maiduguri. Community reintegration was assessed with the Reintegration to Normal Living Index (RNLI) questionnaire, while information on sociodemographics (e.g., age group, gender, employment status, educational status) and clinical characteristics (e.g., post stroke duration, types of stroke, side of affectation) was obtained using the data form. Logistic regression analyses with odd ratios were used to test the associations between community reintegration and sociodemographic and clinical characteristics. Results: The mean age and post stroke duration of the participants were 44.69±13.06 years and 17.25±24.90 months respectively. The participants’ community reintegration scores showed that 60%, 38.2% and 1.8% have no integration, mild to moderate reintegration and complete reintegration respectively. The results indicated that stroke survivors with a stroke duration greater than 8 months (OR=3.32, C.I=1.08-10.27) and those with haemorrhagic stroke (OR=4.67, C.I=1.05-20.66) were more likely to be reintegrated into the community than their counterparts with 6-8 months post stroke duration and ischaemic stroke, respectively. There was significant association between community reintegration and sociodemographic characteristics such as post stroke duration and type of stroke. Conclusions: Rehabilitation strategies should focus on clinical characteristics of the stroke survivors when planning and delivering effective community reintegration interventions.

scholarly journals The indirect impact of COVID-19 pandemic on inpatient admissions in 204 Kenyan hospitals: An interrupted time series analysis

2021 ◽  
Vol 1 (11) ◽  
pp. e0000029
Author(s):  
Steven Wambua ◽  
Lucas Malla ◽  
George Mbevi ◽  
Amen-Patrick Nwosu ◽  
Timothy Tuti ◽  
...  
Keyword(s):  
Time Series ◽  
Negative Binomial ◽  
Interrupted Time Series ◽  
Public Hospitals ◽  
Hospital Ownership ◽  
Private Hospitals ◽  
Live Births ◽  
Inpatient Services ◽  
First Case ◽  
The Impact

The first case of severe acute respiratory coronavirus 2 (SARS-CoV-2) was identified in March 2020 in Kenya resulting in the implementation of public health measures (PHM) to prevent large-scale epidemics. We aimed to quantify the impact of COVID-19 confinement measures on access to inpatient services using data from 204 Kenyan hospitals. Data on monthly admissions and deliveries from the District Health Information Software version 2 (DHIS 2) were extracted for the period January 2018 to March 2021 stratified by hospital ownership (public or private) and adjusting for missing data using multiple imputation (MI). We used the COVID-19 event as a natural experiment to examine the impact of COVID-19 and associated PHM on use of health services by hospital ownership. We estimated the impact of COVID-19 using two approaches; Statistical process control (SPC) charts to visualize and detect changes and Interrupted time series (ITS) analysis using negative-binomial segmented regression models to quantify the changes after March 2020. Sensitivity analysis was undertaken to test robustness of estimates using Generalised Estimating Equations (GEE) and impact of national health workers strike on observed trends. SPC charts showed reductions in most inpatient services starting April 2020. ITS modelling showed significant drops in April 2020 in monthly volumes of live-births (11%), over-fives admissions for medical (29%) and surgical care (25%) with the greatest declines in the under-five’s admissions (59%) in public hospitals. Similar declines were apparent in private hospitals. Health worker strikes had a significant impact on post-COVID-19 trends for total deliveries, live-births and caesarean section rate in private hospitals. COVID-19 has disrupted utilization of inpatient services in Kenyan hospitals. This might have increased avoidable morbidity and mortality due to non-COVID-19-related illnesses. The declines have been sustained. Recent data suggests a reversal in trends with services appearing to be going back to pre- COVID levels.

scholarly journals The extent to which off-patent registered prescription medicines are used for off-label indications in Australia: A scoping review

PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261022
Author(s):  
Katrina Howe ◽  
Siobhan Bourke ◽  
Lloyd Sansom
Keyword(s):  
Scoping Review ◽  
South Australia ◽  
Community Setting ◽  
Public Hospitals ◽  
Clinical Settings ◽  
Off Label ◽  
Australian State ◽  
Scoping Reviews ◽  
Prescription Medicines ◽  
Label Indication

Aim The aim of this scoping review was to determine the extent of off-patent prescription medicine use beyond registered indications in various Australian clinical settings. Method The review followed the Joanna Briggs Institute approach and reported using PRISMA Extension for Scoping Reviews. Online databases were used to identify published literature about off-patent registered prescription medicines used for off-label indications in Australian public hospital, community and primary healthcare settings. In addition, empirical data from the Queensland and the South Australian state-wide medicine formularies were screened for the same medication/off-label indication dyads identified in the literature, and other locally approved uses. Results Overall, fourteen studies were included, conducted in public hospitals (n = 11), palliative care units (n = 2) and the community setting (n = 1). There were 213 reports extracted from the literature describing off-patent registered prescription medicines used for off-label indications, representing 128 unique medication/off-label indication dyads and 32 different medicines. Of these, just five medication/off-label indication dyads were approved for use on both the Queensland and South Australian state-wide medicine formularies, with 12 others only approved for use in Queensland and 16 others only approved for use in South Australia. Further examination of these state-wide formularies demonstrated that the use of off-patent registered prescription medicines beyond registered indications is more extensive than has been reported to date in the literature. There were 28 additional medication/off-label indication dyads approved on the Queensland state-wide medicine formulary and 14 such examples approved for use in South Australia. Of these, just two medication/off-label indication dyads were approved for use on both formularies. Conclusion The extent to which off-patent registered prescription medicines have been repurposed in clinical settings for off-label indications in Australia is greater than previously reported in the literature. Usage and funded availability of certain medication/off-label indication dyads, varies across Australia. These results further expose the two tiered system of medicines regulation in Australia, and its impact on equity of access to medicines. Further research is required to support policy change to encourage submission of registration updates for off-patent prescription medicines.

scholarly journals Blue Ocean Strategy in the private hospital sector

2020 ◽  
Vol 3 ◽  
pp. 42-46
Author(s):  
Kanan Heydarov ◽  
Keyword(s):  
Private Hospital ◽  
Rapid Development ◽  
Medical Services ◽  
Rehabilitation Services ◽  
Private Hospitals ◽  
Hospital Sector ◽  
Intense Competition ◽  
Inpatient Services ◽  
Short Period

The rapidly growing number of private hospitals in a short period of time has led to intense competition. Thanks to the rapid development of technology and the rapid imitation of institutions, private hospitals are similar to each other and resort to many different strategies to get rid of the same pressure. Private hospitals offer preventative medical services, outpatient or inpatient services, and rehabilitation services for individuals. However, private hospitals do not pay enough attention to healthcare development. It is assumed that private hospitals that provide services that others do not provide, establish fitness and sports centers in their structures, avoid competition and open up to the Blue Ocean, expand medical services by creating a new client segment and contribute to the image of the hospital.

scholarly journals Designing a funding system for rehabilitation services Part 2 achieving efficiency and quality of care

1995 ◽  
Vol 18 (4) ◽  
pp. 62 ◽  
Author(s):  
Stephen Duckett ◽  
Len Gray ◽  
Anna Howe
Keyword(s):  
Quality Of Care ◽  
Payment System ◽  
Rehabilitation Services ◽  
Funding Policy ◽  
Information Base ◽  
Funding System ◽  
Casemix Funding ◽  
Policy Objectives ◽  
Functional Gain

This paper examines the objectives of a funding policy for rehabilitation services.A casemix funding system comprises two sets of instruments: a classification systemand a payment system. Attention is given to identifying which policy objectives arebest pursued through each of these instruments. The paper then analyses the effectof various instruments on creating incentives for efficiency and quality, and assessespolicy options with regard to their capacity for dealing with the heterogeneity ofrehabilitation patients and controlling various forms of gaming. In conclusion, thepaper canvasses four major areas warranting consideration in advancing policy: theuse of a blended payment system; dealing with functional gain; the developmentof an information base; and the focus on designated rehabilitation units.

scholarly journals Construction, Factor Structure, and Internal Consistency Reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS)

2020 ◽  
Vol 17 (16) ◽  
pp. 5857
Author(s):  
Manuel Albornoz-Cabello ◽  
José Manuel Pérez-Mármol ◽  
Mª de los Ángeles Cardero-Durán ◽  
Cristo Jesús Barrios-Quinta ◽  
Luis Espejo-Antúnez
Keyword(s):  
Patient Satisfaction ◽  
Physical Therapy ◽  
Factor Structure ◽  
Internal Consistency ◽  
Internal Consistency Reliability ◽  
Public Hospitals ◽  
Rehabilitation Services ◽  
Satisfaction Questionnaire ◽  
Perceived Satisfaction ◽  
Hospital Rehabilitation

Patient satisfaction is a crucial aspect in the evaluation of the quality of health care provided by health services and units, especially in patients that require physical rehabilitation. This study aims to design and analyze the factor structure and internal consistency reliability of the Hospital Physical Therapy Perceived Satisfaction Questionnaire (H-PTPS) measuring the level of physical therapy patient satisfaction in hospital rehabilitation services. This study has a multicenter cross-sectional survey design. This study used the structural validity and internal consistency domains from COSMIN (consensus-based standards for the selection of health status measurement instruments) guideline. The H-PTPS questionnaire consists of 20 closed questions. A sample of 384 adult patients from physical therapy units from three Spanish public hospitals completed this questionnaire. A factor structure and internal consistency reliability analysis were performed. The factor analysis including the 20 items of the H-PTPS showed an adequacy index of 0.922 according to the Kaiser–Meyer–Olkin measure and the Barlett test allowed us to reject the null hypothesis (p < 0.001). In the rotated component matrix, four specific factors were obtained, explaining 66.75% of the accumulated variance. All factors present satisfactory internal reliability, achieving Cronbach’s alpha indices and Omega coefficients higher than 0.74. The H-PTPS questionnaire has shown a four-factor solution with satisfactory reliability evaluating the satisfaction of Spanish patients treated in physical therapy units in the hospital rehabilitation services.

scholarly journals Sleep Faster! (Somebody else needs your blanket...)

2012 ◽  
Vol 36 (3) ◽  
pp. 244 ◽  
Author(s):  
Matthew H. R. Anstey ◽  
Stephen P. Gildfind ◽  
Eugene Litvak
Keyword(s):  
Emergency Department ◽  
Health Reform ◽  
Waiting Times ◽  
Alternative Solution ◽  
Inpatient Services ◽  
Reform Plan ◽  
Australian State ◽  
The Uk

One of the elements of the health reform plan, as agreed to by Australian state and federal governments, is to introduce a 4-h National Access Target, to reduce emergency department (ED) waiting times. This article highlights the flawed rationale behind the 4-h rule, the UK experience of this rule and discusses the potential dangers it poses to Australian patients. An alternative solution proposed is the separation of elective and emergency surgical streams to reduce the variability in demand for inpatient services.

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