Status of costing hospital nursing work within Australian casemix activity‐based funding policy

Heslop, Liza

doi:10.1111/j.1440-172x.2011.01992.x

Cited by 7 publications

(5 citation statements)

References 24 publications

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“…This study indicated that the drugs and supplies made the highest component of the pharmacy cost. These findings come in line with other international and local studies considering the pharmacy services as ancillary services [ 27 ] and among the highest components of cost in the hospital [ 28 , 29 , 32 ]. To our knowledge, the pharmacy services and its related weights are commonly studied within the general hospital level costing and are rarely to be evaluated as an independent subject [ 27 , 33 ].…”

Section: Discussionsupporting

confidence: 90%

“…The best way to calculate service weights is to use actual cost per inpatient case by assigning each DRG a relative value that reflects the cost of any one, or all, of the resources consumed (e.g. bed-days, theatre time, drugs, diagnostic procedures, physiotherapy and nursing treatment) in that respective DRG when compared with all DRGs [ 28 , 29 ]. In order to estimate the pharmacy service weight we need first to calculate the average pharmacy cost for all MY-DRGs.…”

Section: Methodsmentioning

confidence: 99%

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Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia

et al. 2015

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BackgroundThe service weight is among several issues and challenges in the implementation of case-mix in developing countries, including Malaysia. The aim of this study is to develop the Malaysian Diagnosis Related Group (MY-DRG) case-mix pharmacy service weight in University Kebangsaan Malaysia-Medical Center (UKMMC) by identifying the actual cost of pharmacy services by MY-DRG groups in the hospital.MethodsAll patients admitted to UKMMC in 2011 were recruited in this study. Combination of Step-down and Bottom-up costing methodology has been used in this study. The drug and supplies cost; the cost of staff; the overhead cost; and the equipment cost make up the four components of pharmacy. Direct costing approach has been employed to calculate Drugs and supplies cost from electronic-prescription system; and the inpatient pharmacy staff cost, while the overhead cost and the pharmacy equipments cost have been calculated indirectly from MY-DRG data base. The total pharmacy cost was obtained by summing the four pharmacy components’ cost per each MY-DRG. The Pharmacy service weight of a MY-DRG was estimated by dividing the average pharmacy cost of the investigated MY-DRG on the average of a specified MY-DRG (which usually the average pharmacy cost of all MY-DRGs).ResultsDrugs and supplies were the main component (86.0%) of pharmacy cost compared o overhead cost centers (7.3%), staff cost (6.5%) and pharmacy equipments (0.2%) respectively. Out of 789 inpatient MY-DRGs case-mix groups, 450 (57.0%) groups were utilized by the UKMMC. Pharmacy service weight has been calculated for each of these 450 MY-DRGs groups. MY-DRG case-mix group of Lymphoma & Chronic Leukemia group with severity level three (C-4-11-III) has the highest pharmacy service weight of 11.8 equivalents to average pharmacy cost of RM 5383.90. While the MY-DRG case-mix group for Circumcision with severity level one (V-1-15-I) has the lowest pharmacy service weight of 0.04 equivalents to average pharmacy cost of RM 17.83.ConclusionA mixed approach which is based partly on top-down and partly on bottom up costing methodology has been recruited to develop MY-DRG case-mix pharmacy service weight for 450 groups utilized by the UKMMC in 2011.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia

et al. 2015

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“…However, it has previously been identified that reduced LOS alone may be insufficient financial incentive for hospitals to invest in increasing registered nurse staffing [ 22 ]. In our study, ward nursing accounted for over one-third of patient costs for the older in-patient population, but it remains unclear whether the DRG or case-mix funding systems appropriately estimate nursing care needs of patients more likely to get complications – that is, patients with dementia [ 26 , 27 ]. Further research could focus on administrative data and the accuracy of cost allocations via DRG for variable costs such as nursing, and may be able to explore workplace variations and efficiencies in hospital work environments that contribute to the hospital estimations of DRG costs.…”

Section: Discussionmentioning

confidence: 99%

The cost of hospital-acquired complications for older people with and without dementia; a retrospective cohort study

Bail

Goss

Draper

et al. 2015

BMC Health Serv Res

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BackgroundIncreased length of stay and high rates of adverse clinical events in hospitalised patients with dementia is stimulating interest and debate about which costs may be associated and potentially avoided within this population.MethodsA retrospective cohort study was designed to identify and compare estimated costs for older people in relation to hospital-acquired complications and dementia. Australia’s most populous state provided a census sample of 426,276 discharged overnight public hospital episodes for patients aged 50+ in the 2006–07 financial year. Four common hospital-acquired complications (urinary tract infections, pressure areas, pneumonia, and delirium) were risk-adjusted at the episode level. Extra costs were attributed to patient length of stay above the average for each patient’s Diagnosis Related Group, with separate identification of fixed and variable costs (all in Australian dollars).ResultsThese four complications were found to be associated with 6.4% of the total estimated cost of hospital episodes for people over 50 (A$226million/A$3.5billion), and 24.7% of the estimated extra cost of above-average length of stay spent in hospital for older patients (A$226million/A$914million). Dementia patients were more likely than non-dementia patients to have complications (RR 2.5, p <0.001) and these complications comprised 22.0% of the extra costs (A$49million/A$226million), despite only accounting for 10.4% of the hospital episodes (44,488/426,276). For both dementia and non-dementia patients, the complications were associated with an eightfold increase in length of stay (813%, or 3.6 days/0.4 days) and doubled the increased estimated mean episode cost (199%, or A$16,403/A$8,240).ConclusionUrinary tract infections, pressure areas, pneumonia and delirium are potentially preventable hospital-acquired complications. This study shows that they produce a burdensome financial cost and reveals that they are very important in understanding length of stay and costs in older and complex patients. Once a complication occurs, the cost is similar for people with and without dementia. However, they occur more often among dementia patients. Advances in models of care, nurse skill-mix and healthy work environments show promise in prevention of these complications for dementia and non-dementia patients.

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“…Korėjoje stengiamasi, kad slaugytojų darbo užmokestis būtų vertinamas ne tik pagal dirbtą laiką, bet ir už turimas žinias [8]. Taip yra daroma ir Australijoje, kur stengiamasi, kad slaugytojos dirbtų pa-gal žinomus standartus, o lėšos, skirtos slaugytojų žinių ir įgūdžių tobulinimui, grįžtų sveikatos priežiūros įstaigai dėl geresnio žinių panaudojimo [9].…”

Section: Rezultatų Aptarimasunclassified

Slaugos Politikos Formavimas Ir Įgyvendinimas Lietuvoje

Urbanavičė¹,

Rozenbergaitė²,

Kairys³

et al. 2020

Health Sciences

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Slaugos politika yra svarbi kiekvienos valstybės tikslingos sveikatos sistemos funkcionavimo dalis. Dėl kintančios socialinės, ekonominės ir demografinės padėties yra svarbus nuoseklus slaugos politikos formavimas ir kryptingas jos įgyvendinimas, o slaugos politikos vertinimas turi būti nuolatinis. Tyrimo tikslas – identifikuoti ir ištirti slaugos politikos formavimo ir jos įgyvendinimo trukdžius Lietuvoje. Atliktas kokybinis tyrimas – pusiau struktūruotas slaugos ekspertų interviu, kuris vyko 2016 metų sausio mėnesį. Duomenų rinkimas truko tris savaites. Tyrime dalyvavo aštuoni informantai: keturi slaugos politikos formuotojai ir keturi slaugos politikos įgyvendintojai. Gavus tyrimo dalyvių leidimus, interviu duomenys buvo įrašomi diktofonu, vėliau transkribuojami ir perkeliami į atskiras dokumentų bylas. Tyrimo duomenys apdoroti kokybinės – kontentinės analizės metodu. Tyrimui naudota lentelė, sudaryta iš kategorijų ir subkategorijų bei jas patvirtinančių teiginių. Slaugos ekspertai, dalyvavę kokybiniame tyrime, atskleidė pagrindinius slaugos politikos formavimo ir įgyvendinimo trukdžius. Išvados. Pagrindiniai slaugos politikos formavimo ir įgyvendinimo trukdžiai yra raidos kryptingumo nebuvimas, reformų nesuderinamumas, fragmentiškas slaugos politikos formavimas, ilgą laiką atsakingų asmenų už slaugos politikos plėtrą nebuvimas, finansavimo trūkumas, menkas visuomenės slaugos profesijos vertinimas. Netinkama socialinė ir darbo aplinka, slaugytojų su aukštuoju universitetiniu išsilavinimu kompetencijų panaudojimo praktikoje problemos, kurias lemia teisinio reglamentavimo spragos, norminių dokumentų įgyvendinimas, sveikatos sektoriaus finansavimas, žemas slaugos profesijos prestižas, skatina slaugytojų migraciją į užsienio šalis.

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Status of costing hospital nursing work within Australian casemix activity‐based funding policy

Cited by 7 publications

References 24 publications

Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia

Development of MY-DRG casemix pharmacy service weights in UKM Medical Centre in Malaysia

The cost of hospital-acquired complications for older people with and without dementia; a retrospective cohort study

Slaugos Politikos Formavimas Ir Įgyvendinimas Lietuvoje

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