Case Mix Based Funding For Patients

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(A) Statements:-1
• Firstly case mix distributes a fixed state budget based on the type and number of patients treated and the average of patients treated and the average cost of treating patients as reported by hospitals.
• Case mix based funding is used to purchase an agreed services at an agreed patients.
• It is based on the average cost of treating patients.
• Case mix provides incentive to treat patients for the fewest inputs.
• This type of funding helps determine hospital budgets and hospital management allocate resources within organization.
• Case mix influences each hospitals fair share of a fixed state budget.
• Case mix allocates funds in way that promotes health funding objectives particular hospital.
Example:
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• WIES (weighted inliers equivalent separation) co payments are in addition to base allocation determined by the patients DRG and length of stay.
• Cost data supplied to director of health is accurate as possible.
• Various block funding used to support hospital activity such as incentive schemes, teaching and research, new technology patient complexity, compensation grants. (B) Statements: - 2
• Australian Institute of health and welfare
ARDRG modifications to the preferred option that outperformed their inclusion would not be consistent with decisions made about other ADRGs across the classification.
It should be noted that, for two of these ADRGs, the vote was very nearly equally divided between two option For two ADRGs the statistical criteria for splitting were not adequately satisfied in the preferred option.
In addition,, a modification to the preferred option that out-performed those presented to the DTG was found after the meeting. In both cases, this involved adding a same day split to the preferred patient complication and co morbidity level (PCCL) split.
This was consistent with suggestions that were made by DTG members for other ADRGs. In these cases, further analysis had been circulated after the meeting and the suggested modification accepted by the members.

(C) Statements: - 3
• ICD is vital for the correct coding & interoperation of cause of death information by codes and statisticians.
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