Education Policy | Post Primary | Preschool | Primary | Tertiary | Search

 


Hospital reforms have changed transfer behaviour

April 30, 2014

Hospital reforms have changed transfer behaviour

People with more complicated health conditions are being transferred from smaller regional hospitals to the larger tertiary hospitals less often since the health reforms of 2003, according to research from Massey University’s School of Economics & Finance.

The research also finds tertiary and teaching hospitals are under-funded for their level of expertise and workload.

Dr Somi Shin’s doctoral research examines the impact of the health system reforms of 2003.

One aspect of her work looked at data around the transferral of patients between hospitals.

Dr Shin found that where smaller hospitals once routinely transferred the most complex cases to specialists at tertiary hospitals, since the system reforms that introduced the population-based funding formula smaller hospitals were more likely to keep their complex cases.

“What this means is that sicker patients are less likely to be transferred since the health system reform in 2003,” says Dr Shin.

“We think that is because the new system gives non-tertiary district health boards incentives to keep patients in their districts to retain the funds. If you transfer patients, you have to pay the other provider for the treatment from the funds you received.”

The research also found, however, that even though more complex cases were less likely to be transferred, the more fatal cases – that is, those people with higher mortality rates - were still transferred to the tertiary hospitals – “so non-tertiary district health boards seem to selectively treat severe but non-fatal cases”.

Another aspect of Dr Shin’s research was analysing data around the population-based funding formula, which provides lump sums to hospitals based on their population mix.

She found that the larger hospitals were being under-funded – not because fewer complex cases were being sent to them – but because the population-based funding formula does not directly reimburse providers for the complexity or volume of cases they receive.

She found that some ethnic groups, such as Māori and Pacific people, used the health system in excess of their population share.

Population-based funding means some district health boards may find a disproportionate amount of their funding goes towards a smaller group within the population mix who use services more intensively. This means that in those cases, those hospitals were effectively under-funded.

Dr Shin’s supervisor, Innovation and Economics professor Christoph Schumacher, said Dr Shin’s was the first piece of research which showed larger hospitals are under-funded.

“By looking at a very large data set, there is sufficient evidence to show they do get penalised.”

ENDS

© Scoop Media

 
 
 
 
 
Culture Headlines | Health Headlines | Education Headlines

 

Electronica: Restoring The World’s First Recorded Computer Music

University of Canterbury Distinguished Professor Jack Copeland and UC alumni and composer Jason Long have restored the earliest known recording of computer-generated music, created more than 65 years ago using programming techniques devised by Alan Turing. More>>

ALSO:

Scoop Review Of Books: Almost Getting Away With Murder

The Black Widow by Lee-Anne Cartier: Lee-Anne Cartier is the sister of the Christchurch man found to have been murdered by his wife, Helen Milner, after an initial assumption by police that his death, in 2009, was suicide. More>>

Howard Davis: Triple Echo - The Malevich/Reinhardt/Hotere Nexus

Howard Davis: The current juxtaposition of works by Ralph Hotere and Ad Reinhardt at Te Papa perfectly exemplifies Jean Michel Massing's preoccupation with the transmigration of imagery in a remarkable triple echo effect... More>>

Scoop Review Of Books: Nō Tāu Manawa

Vaughan Rapatahana responds to Fale Aitu | Spirit House by Tusiata Avi: "fa’afetai Tusiata, fa’afetai, / you’ve swerved & served us a masterclass corpus / through graft / of tears & fears..." More>>

9 Golds - 21 Medals: NZ Team Celebrates As Rio 2016 Paralympic Games Close

The entire New Zealand Paralympic Team, led by kiwi sprinter and double gold medallist Liam Malone as flag bearer, are on the bus to the Maracanã Stadium in Rio de Janeiro for the Closing Ceremony of the Rio 2016 Paralympic Games. There, they will celebrate the fantastic successes of the past 10 days. More>>

ALSO:

New Zealand Improv Festival: The Festival Of Moments To Return To The Capital

The eighth incarnation of the New Zealand Improv Festival comes to BATS Theatre this 4-8 October , with a stellar line-up of spontaneous theatre and instant comedy performed and directed by top improvisors from around New Zealand and the world. More>>

ALSO:

Get More From Scoop

 
 

LATEST HEADLINES

 
 
 
 
Education
Search Scoop  
 
 
Powered by Vodafone
NZ independent news