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Sub-acute modelling in Victoria

Dr Connie Spinoso 7 April 2011. Sub-acute modelling in Victoria. Victoria’s subacute service system. Diverse range of admitted and ambulatory services that: Support patients to maximise independence and functioning and minimise long term health and community care needs

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Sub-acute modelling in Victoria

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  1. Dr Connie Spinoso 7 April 2011 Sub-acute modelling in Victoria

  2. Victoria’s subacute service system • Diverse range of admitted and ambulatory services that: • Support patients to maximise independence and functioning and minimise long term health and community care needs • Promote seamless services across the care continuum from acute to community care • Improve outcomes and avoid functional decline in frail elderly and those with multiple co-morbidities and complex care issues • Services that can provide alternative to hospital care

  3. The subacute service system • Subacute bed based services • Rehabilitation (adult and paediatric) • Geriatric Evaluation and Management • Palliative Care Services 34,000 separations (2009-10) Subacute ambulatory services • Subacute Ambulatory Care Services • Community Palliative Care services 63,000 clients (2009-10)

  4. Subacute Services Planning Framework • Planning the future of Victoria’s subacute service system: A capability and access planning framework (2009) • To establish a process to guide planning towards equity of access and consistency of service quality in sub-acute services across Victoria. • consistent and comparable information on types and location of services • Identify service gaps at sub-regional, regional and state level • Develop explicit standards of service provision and support benchmarking of like services • Establish expectations around referral and clinical support

  5. Subacute demand

  6. Growth in subacute separations SACS

  7. Average length of stay

  8. Modelling subacute activity Clinical Related Groups Level 1 rehabilitation Level 2-3 rehabilitation GEM – stroke GEM – rehabilitation GEM – other VAED is divided according to the forecast variables shown on right.

  9. Modelling subacute activity Traditional forecast Calculate utilisation rate for each group (separations per 1,000 population) Linear projection of utilisation rate as shown below

  10. Modelling subacute activity Traditional forecast (ALOS) Group length of stay as per sub-groups shown previously Calculate Average Length of Stay (length of stay / separations) Forecast ALOS using log, linear/exponential smoothing model

  11. A new approach

  12. A new approach • public acute to public sub-acute flow • private acute to public sub-acute flow • admissions direct from community and other non-acute care • Expected demand = A + B + C

  13. Modelling subacute activity New method Uses transfer rates from acute so that the volume of acute activity determines future subacute activity Uses linked VAED Transfer rates by MCRG

  14. A new approach • adjust for net regional flow • adjust for interstate flow • Adjusted demand = D + E + F

  15. A new approach • Calculate utilisation of current supply • Gap= H - G

  16. Gap between supply and demand (catchments)

  17. Forecasting outcomes Rehabilitation level 2-3

  18. Forecasting outcomes GEM rehabilitation

  19. Forecasting outcomes Average length of stay

  20. National Partnership Agreements • National Partnership Agreement on Hospital and Health Workforce Reform (2008) and Improving Public Hospital Services (2011) • Increase subacute services across Victoria by 20% over the four years of the agreement • Commit to provide an additional 326 subacute beds (or bed equivalent) The framework underpins our planning to ensure that Victoria meets its commitments under these agreements.

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