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Patient Level SNAP Costing

Patient Level SNAP Costing. Melita Howes. Patient Costing. uses “measures of resources consumption by individual patients … to estimate costs” PowerHealth Solutions tool implemented early 2006 4 Hospitals (2 private, 2 public) St Vincents Hospital – costing an acute episode

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Patient Level SNAP Costing

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  1. Patient Level SNAP Costing Melita Howes

  2. Patient Costing uses “measures of resources consumption by individual patients … to estimate costs” • PowerHealth Solutions tool implemented early 2006 • 4 Hospitals (2 private, 2 public) • St Vincents Hospital – costing an acute episode • Sacred Heart Hospital - costing nonacute phase(s) or classes within an episode

  3. Sacred Heart Hospital St Vincents & Mater Health service Public Hospital - 3rd Schedule status Funded by NSW Health within SESIAHS Palliative & Rehabilitation Care 71 beds; 21,120 beddays; 945 separations $17.6 m Expenditure (2005-2006)

  4. What’s AN SNAP • Sub & Non Acute Patients Classification 5 Case Types: Palliative; Rehabilitation; Psychogeriatric; Geriatric Evaluation and Management and Maintenance care. 134 Classes based on patient characteristics and intervention goals • Developed in 1997 • Based on 99 Australian and 5 New Zealand sites

  5. Schema

  6. Costing Data Sources • HIE – patient detail; ward utilisation; morbidity data • Local – pathology; imaging; allied health • SNAP service weights • SNAP feed • takes the HIE sub-acute data patient episode, matches it to SNAPshot data and attaches a snap class – there may be multiple SNAP Classes to a single patient episode • General Ledger

  7. SNAP feed – examples of issues

  8. Issues • Linkage to HIE • (stay number unique; SNAP class not) • Unnecessary records created for the same SNAP class • 90 day rule ? Other? • Long stays extending over financial periods • Too many beddays & cost to exclude • End date same as start date • Costing duplicated ? • No SNAP class • no SNAP service weight; no cost allocation

  9. Implications & Adjustments • $2.3m (17% of total inpatient cost) for inpatients at financial year change • Admission or Separation date adjusted • Subtract 1 day at SNAP class end date • ? Which is appropriate SNAP class • PHS contracted to create extract and report in format required (file 6b) • Perfect alignment with UAR possible • More accurate and complete costing

  10. Results - extract 0506

  11. Results 0506 Summary

  12. Summary • Resolution of Issues to facilitate benchmarking • More refinement and business rules required • New Version released !!!

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