1 / 8

Admission Rates – an example of ‘Intelligent Information’

Admission Rates – an example of ‘Intelligent Information’. Dr Rod Jones (ACMA) Healthcare Analysis & Forecasting hcaf_rod@yahoo.co.uk. Aims. Often we need to know, ‘how many do we expect’ versus ‘how many are there’ Illustrate some of the issues using acute data

levi
Download Presentation

Admission Rates – an example of ‘Intelligent Information’

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. Admission Rates – an example of ‘Intelligent Information’ Dr Rod Jones (ACMA) Healthcare Analysis & Forecasting hcaf_rod@yahoo.co.uk

  2. Aims • Often we need to know, ‘how many do we expect’ versus ‘how many are there’ • Illustrate some of the issues using acute data • Suggest an approach to clinically meaningful comparisons for wider healthcare data sets

  3. From experience • The benchmarks are flawed • Supposed differences are often artefacts of the benchmark! • Capitation formula allocation to PCT and subsequent PBR payment to Trusts rely on different assumptions financial asymmetry • Serious problems with the Data Definitions • NHS site-based processes of counting & coding are different • Each site has a unique signature (especially small PCT run units!) • Analyse zero day admissions separately • Greater effect on the ‘diagnosis-based’ HRG and on specific ‘procedure-based’ HRG • What works? • Adjust for age, sex, deprivation (IMD), ethnicity & students • Analyse using both HRG and OPCS procedure code • HRG are composites & the language of finance

  4. From experience (contd) • Look at the trend over time • Step changes & trends • Use FCE (not Spell) especially for procedures • Add EL + EM for final analysis • EL/EM boundary is not the same in all hospitals • Use persons if fundamental disease incidence is the issue

  5. Zero day stay ‘elective’ >30% above expected Acute site No I is a high PbR cost site. The real surgical day case rate at this site is low yet it counts very high volumes of events as a ‘day case’.

  6. Index of Multiple Deprivation Intervention rates are only as good as the adjustment used to account for deprivation IMD is very important and is highly non-linear

  7. The danger of averaging (Modifiable Areal Unit Property) The average IMD for this LSOA is 29.9 The HRG described by red line has an apparent rate of 3 but a real rate of 3.7 for the benchmark

  8. OPCS Procedure – excess as SD

More Related