Welcome to the Hospital Demand Management Project

This is a 3 year research project that is funded by the South Australian Department of Health. The aim is to quantify the contribution of alternative causes of new demand for hospital bed day use, and to consider which policies may be targeted to feasibly and most efficiently manage new demand.

Demand for public hospital-based health care is a multi-faceted concept that incorporates clinical need, technological availability, hospital capacity, and relationships with the private health care sector. This project is concerned with the effects of met or satisfied demand, as reflected in hospital utilisation.

The general approach proposed involves identifying areas of increased utilisation (by DRG); analysing patient-level data within increased utilisation DRGs to jointly estimate the contributions of different factors to the observed increase in utilisation; and investigating the equity and efficiency implications of policy options for potentially ameliorable factors.

The methodology suggests that it is necessary to work backwards from utilisation to quantify the contribution of potentially ameliorable factors to observed increases in demand for bed days (by DRG and ICD-10 codes). Potentially ameliorable categories (i.e. where policy could be focussed to improve equity and efficiency) include demand and supply factors (changing thresholds for admission, changing quality of care, and Specialty-based capacity protection). Thus, the potential impact of policy aimed at improving health service activity can be quantified, whilst also quantifying the contributions of less ameliorable factors (technological advancement, changing patterns of private public transfers, and changing disease incidence/clinical presentation)

Specific questions and objectives include:

• Question 1: What are the key factors creating new demand/need in the health system?
  
  Objectives: to describe the frequency of public hospital separations and bed day use across South Australia, by severity weighted Diagnosis Related Groupings (DRG) codes.
  
  
• Question 2: What are the most important variables at play which are contributing to this bed filling phenomenon?
  
  Objectives: to identify attributable causes to DRGs with observed increases in frequency of separations and/or LoS.
  
  
• Question 3: What could be done to improve use of hospital beds in the health care system in response to increased demand?
  
  Objectives: to quantify the redistribution of hospital resources between patient groups; to assess the relative efficiency of alternative management strategies and methods of service delivery for new demand patients.