Casemix: challenges for nursing care

Abstract

Synopsis An Australia‐wide patient classification system for nursing is urgently needed as the health system attempts to develop benchmarks against which to measure and compare services. Standardised measures of demand for nursing care must be developed to allow appropriate reimbursement and to act as proxies for illness severity. Nurses need to identify the outcomes that measure the nursing contribution to episodes of care, and assist in developing outcome goals reflecting the efficacy of treatment and the quality of care. A system of measuring nursing requirements and costs of early discharge and coordinated care programs is required. It must be consistent with nursing classifications and hospital costing systems.

Virtual reality or real virtuality: the space of flows and nursing practice

“…Lawler emphasises how endeavours to measure nursing effort are framed similarly. Urgent calls are made to validate nursing work through input measurement, outcome measurement, nursing sensitive outcome measures and the development of international classification systems of practice taxonomies (Lawler 1997; Long and Mann 1998; Aitken et al 2003).…”

Difficult hospital discharges in internal medicine wards

“…Cognitive dysfunction was evaluated by the "Short Portable Mental Status Questionnaire" [13]. Nursing complexity score was evaluated according to the need for care, with a range measurement from 1 to 3 [14]. Social determinants were evaluated by exploring patient's and his/her family characteristics.…”

Determining caseloads in the community care of frail older people with chronic illnesses

“…Diverse models of community care have been developed based on different types of health insurance and healthcare policy in Western countries, and more recently, Singapore and Hong Kong. Some countries claim to be shifting towards a longitudinal disease management style of care, although current reimbursement funding models are disincentives for home‐based care (Long & Mann 1998, Marek et al. 2005).…”

“…2003). A consistent problem in measuring care is the difficulty of measuring the contribution of nursing to patient care (Long & Mann 1998, Diwan 1999, Diwan et al. 2001).…”

“…Diverse models of community care have been developed based on different types of health insurance and healthcare policy in Western countries, and more recently, Singapore and Hong Kong. Some countries claim to be shifting towards a longitudinal disease management style of care, although current reimbursement funding models are disincentives for home-based care (Long & Mann 1998, Marek et al 2005. Coordinating aged home care has been problematic, and reflects the necessity for an efficient healthcare delivery system, with coordination both at the level of direct-service provision and government policy (Fine 1999, Alcock et al 2002, Schwab et al 2003, Weissert et al 2003.…”