non-admittedandsubacutecostingstudyfinalreportx - ihpa

1、National Non-admitted and Subacute admitted Costing Study30 September, 2014Executive SummaryThe Independent Hospital Pricing Authority (IHPA) is an independent government agency established by the Commonwealth as part

2、of the National Health Reform Act 2011. IHPA was established to contribute to significant reforms to improve Australian public hospitals. A major component of these reforms is the implementation of national Activity Ba

3、sed Funding (ABF). The implementation of ABF provides incentives for efficiency and increases transparency in the delivery and funding of public hospital services across Australia.IHPA's primary function is to calc

4、ulate and deliver an annual National Efficient Price (NEP). The NEP is a major determinant of the level of Australian Government funding for public hospital services and provides a price signal or benchmark for the eff

5、icient cost of providing public hospital services. IHPA undertakes several major areas of work designed to inform the annual determination of the NEP, including ongoing consultation with all Australian health departmen

6、ts, expert advisory committees and key stakeholders. In determining the 2012-13 and 2013-14 NEP, it became apparent that the reliability and representativeness of non-admitted costing data was less than ideal. This was

7、 demonstrated by the lack of cost data from some jurisdictions and highly variable costs from others. IHPA also lacked enough robust cost data for subacute services to inform the calculation of price weight for AN-SNAP

8、 classified patients. As a result, the Pricing Authority determined that a prospective costing study should be carried out to inform the 2014-15 NEP. IHPA commissioned Ernst and Young (EY) to undertake this study in co

9、llaboration with jurisdictions between 1 June 2013 and 30 November 2013. This report describes the processes adopted in the conduct of this study. Study Overview In this study, EY worked collaboratively with IHPA and th

10、e project steering committee (which included nominated representatives from each jurisdiction) to develop and deploy a methodology to collect a definitive baseline dataset of patient level cost data that can be used by

11、 IHPA for multiple purposes including:? producing costs, price and service weights, ? informing the development of current and future classifications, and ? informing the refinement of national costing standards.Data co

12、llection across the two services types of non-admitted and subacute admitted was undertaken at 43 sites across Australia, capturing over 500,000 patient service events and involving direct time data collection by over

13、2,000 clinicians. Appendix C lists the participating sites by jurisdiction and Table 1.2 Part B lists hospital participation by service area. The study objective was the construction of a costed dataset that could be us

14、ed by IHPA to set national prices, improve the classification of patients and the national pricing framework. Analysis of cost data and derivation of the national efficient price for non-admitted and subacute admitted

15、 services was outside the scope of the study. To gauge the reliability of the costed dataset constructed, some preliminary time based data are presented in the report to provide insight into the datasets. In addition q

16、uality checks were undertaken with the processes and associated results being found within Part A, Section 4. This report presents the outcomes of the study in two distinct parts. Part A of the report relates to the dat