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.
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