Webster Samuel B G, Neville Sarah E, Nobbs Jennifer, Ching Jada, van Gool Kees
Independent Health and Aged Care Pricing Authority, Darlinghurst, NSW, Australia.
Beamtree, London, UK.
Health Serv Insights. 2023 Jul 25;16:11786329231187891. doi: 10.1177/11786329231187891. eCollection 2023.
In a bid to improve quality of care, numerous countries have incorporated rewards and penalties into the funding and pricing of hospital services. This paper outlines recent advances in Australia to incorporate financial penalties for hospital acquired complications (HACs) and avoidable hospital readmissions (AHRs) adjustments into the funding of public hospital services. It describes the work in the development of suitable measures to identify episodes, the design of the analytical approach used for risk adjustment and the calculation of the funding implications including dampening effects to account for the level of risk. Using the 2019 to 20 round of data collection, this paper reports on the risk adjustment analysis, incremental costs of HACs and AHRs, and the funding dampening effects, the paper further discusses the implementation strategies undertaken by the Independent Health and Aged Care Pricing Authority (IHACPA) to ensure transparency, stakeholder consultation and engagement. The paper argues that both the technical development and its implementation strategies have been central to making safety and quality an integral and accepted part of Australia's public hospital funding arrangements.
为提高医疗服务质量，许多国家已将奖惩措施纳入医院服务的资金投入和定价之中。本文概述了澳大利亚最近的进展，即将针对医院获得性并发症（HACs）和可避免的医院再入院（AHRs）调整的经济处罚纳入公立医院服务的资金投入。它描述了在制定识别事件的合适措施、用于风险调整的分析方法设计以及资金影响计算（包括考虑风险水平的抑制效应）方面所做的工作。利用2019至20轮数据收集，本文报告了风险调整分析、HACs和AHRs的增量成本以及资金抑制效应，还进一步讨论了独立卫生与老年护理定价局（IHACPA）为确保透明度、利益相关者咨询和参与而采取的实施策略。本文认为，技术发展及其实施策略对于使安全和质量成为澳大利亚公立医院资金安排中不可或缺且被接受的一部分至关重要。
