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PbR for Renal Services Trust Dialysis Reference Cost Comparisons Project – Workshop 2

This workshop discusses the need for more robust costing data for renal services, focusing on dialysis costs and their construction. The project examines cost components and categories using a standard cost template based on 2006/07 Reference Costs. Issues such as service labels, activity data, and allocation of costs are addressed.

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PbR for Renal Services Trust Dialysis Reference Cost Comparisons Project – Workshop 2

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  1. Renal Clinical Directors Forum – 7th March 2008 PbR for Renal ServicesTrust Dialysis Reference Cost Comparisons Project – Workshop 2 Chris Newton University Hospital Birmingham NHS Foundation Trust

  2. Project Background • RAG response to the DoH consultation on “The Future of Payment by Results” • More robust costing data required for renal services – wide variation appears to exist • Project group established to examine dialysis costs and their construction

  3. Dialysis Project Summary • 16 participant Trusts representing 41% of adult HD and 35% of adult PD nationally • A standard cost template to identify cost components and categories for dialysis • Based on 2006/07 Reference Costs (June 2007) using HRG Version 4 definitions • Data based on second cut incorporating costing and activity adjustments from some Trusts

  4. HRG Version 4 – Adult Dialysis LC01A Haemodialysis/Filtration on patient with Hepatitis B 19 years and over LC02A Haemodialysis/Filtration 19 years and over LC03A Peritoneal Dialysis on patient with Hepatitis B 19 years and over LC04A Peritoneal Dialysis 19 years and over

  5. Project Issues • Reconciliation with June 2007 Ref Cost data • Service labels – HD/PD with/without HepB • Activity data, particularly PD therapy days vs exchanges • Allocation of costs to service components • Limitations of costing models • Primary cost data collection • IS satellite costs

  6. £24k per year therapy cost

  7. £29k per year therapy cost

  8. £22k per year therapy cost

  9. £17k per year therapy cost

  10. £21k per year therapy cost

  11. £19k per year therapy cost

  12. £22k per year therapy cost

  13. Issues for Consideration • Improving 2008 Reference Cost collection • Activity measures • Costing models • Tariff exclusions • HRGV4 Tariff Structure • Hospital/Satellite/Home vs HepB/non-HepB? • PD with HepB? • Links with other Renal tariff development

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