Fisher D A, Murray J M, Cleary M I, Brewerton R E
Royal Darwin Hospital, NT.
Med J Aust. 1998 Oct 19;169(S1):S11-6. doi: 10.5694/j.1326-5377.1998.tb123469.x.
With increasing implementation of casemix-based funding for hospitals, quantitative data were needed to confirm the clinical impression that treating Aboriginal (compared with non-Aboriginal) inpatients consumes significantly more resources. Utilisation data, collected over a three-month period in 10 hospitals, were used to determine a cost per inpatient episode, which was grouped according to AN-DRG-3 to give a cost per AN-DRG for Aboriginal and Torres Strait Islander (ATSI) patients and non-ATSI patients. ATSI patients had consistently longer average length of stay and significant variation in relative frequency of admissions, compared with non-ATSI patients, with higher prevalences of infectious diseases. Degenerative and neoplastic conditions were more common in non-ATSI patients. There were significant differences in casemix-adjusted costs per patient episode (ATSI, $1856; non-ATSI, $1558; P < 0.001). Our study has quantified differential resource consumption between two Australian populations, and highlights the need for recognition of some hospitals' atypical populations and special funding requirements.
随着基于病例组合的医院资金投入方式的日益普及，需要定量数据来证实临床印象，即治疗原住民（与非原住民相比）住院患者消耗的资源要多得多。利用在10家医院三个月期间收集的使用数据来确定每位住院患者的费用，该费用根据澳大利亚疾病相关分组-3（AN-DRG-3）进行分组，以得出原住民和托雷斯海峡岛民（ATSI）患者以及非ATSI患者的每个AN-DRG的费用。与非ATSI患者相比，ATSI患者的平均住院时间始终更长，入院相对频率存在显著差异，传染病患病率更高。退行性和肿瘤性疾病在非ATSI患者中更为常见。每位患者住院期间经病例组合调整后的费用存在显著差异（ATSI为1856澳元；非ATSI为1558澳元；P<0.001）。我们的研究量化了澳大利亚两个群体之间资源消耗的差异，并强调需要认识到一些医院的非典型人群和特殊资金需求。
