Presentations by Victorians Rhonda Carroll from Alfred Health and Carly Uzkuraitis and Karen Hastings from Eastern Health Victoria (see Uzkuraitis, Hastings & Torney 2010, in this issue) related to the auditing of hospital coding by the hospitals themselves and highlighted the importance of accurate coding in a casemix
or activity based funding environment.
Unrecognized Structural Implications of Casemix
The emergence of national classification systems, for example, casemix
groups (CMGS) in Canada and diagnosis-related groups (DRGS) in the United States, have provided a basis for government reimbursement of hospital costs for patient care (Botz, 1991).
The effects of cost containment and ownership on nursing home costs, casemix
, and staffing.
funding optimization: working together to make the most of every episode.
I: Context, Methods, Casemix
, Population, Patient and Hospital Characteristics.
HIPE is being used increasingly by the HSE; for example, for Healthstat, the monthly published measurement of hospitals' performance (8) attention is once again on the coders' work, as happened previously in 1989 when Casemix
was first introduced as a funding mechanism in Ireland.
Cardiac surgery, trauma services, transplantation and neurosurgery are frequent users of intensive care services so a hospital's casemix
will strongly influence its intensive care requirements.
This was a challenging position but very rewarding and once again I learnt a lot, particularly about the implementation of casemix
in South Australia.
If, for example, facilities with relatively long wait times attract fewer severely ill patients (because they choose to go elsewhere rather than wait), then long wait times could be associated with relatively favorable outcomes because of unobserved and uncontrolled casemix
Again, I was in the right place at the right time as this was when casemix
was being introduced in various states and territories and the HIMAA was contracted by the then Commonwealth Department of Human Services and Health to run the National Coder Workforce Issues Project (NCWIP).
2005) describe the casemix
variable selection criteria; see also Hargraves, Hays, and Cleary (2001).