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

 

Caracals: Small Cats With Big Ears Arrive At Wellington Zoo

Visitors to Wellington Zoo will be able to see New Zealand’s first Caracals in the Zoo’s new Grassland Cats habitat, with a special visitor opening day on Saturday 27 September. More>>

Gordon Campbell: Classics - Tales From Moominvalley
Can’t speak for the reading end of it but the Moomins ( or maybe the story about Margaret Wise Brown) were the most enjoyable subject to think about and write about during these whole first 50 issues of Werewolf. For that reason – and because the Moomins always reward re-reading – I’ve decided to reprint it. The only added element is a link to an interesting hour long documentary about Tove Jansson. More>>

ALSO:

Repping In The Pacific: All Blacks And Manu Samoa To Play Historic Apia Test

The All Blacks will play Manu Samoa in Apia on Wednesday 8 July next year as part of both teams’ preparations for Rugby World Cup 2015. More>>

ALSO:

Monarchy: Duke And Duchess Of Cambridge Are Expecting Second Child

Their Royal Highnesses The Duke and Duchess of Cambridge are very pleased to announce that The Duchess of Cambridge is expecting their second child. More>>

ALSO:

2015: Elton John Plans Wellington Show

After nine years, Elton John and his band will return to Westpac Stadium, Wellington for one spectacular concert! The November 21, 2015 concert will feature iconic hits and classic album tracks from throughout his incredible five-decade career... More>>

Book Awards: Jill Trevelyan's Story Of Peter McLeavey Is Book Of The Year

The story of Wellington art dealer Peter McLeavey and his gallery has won the prestigious New Zealand Post Book of the Year 2014 in a glittering ceremony in Wellington. More>>

ALSO:

Scoop Review Of Books: King Richard

Simon Nathan reviews 'Richard Seddon, King of God’s Own': My father grew up in Wellington during Seddon’s premiership... I can recall him standing under the Seddon statue in the grounds of parliament and telling me that Seddon had more backbone than Sid Holland and all his cabinet colleagues put together.. More>>

8 October: Miley Cyrus Bangerz Tour Coming To Auckland!

Dainty Group announced today that global superstar Miley Cyrus will bring her BANGERZ TOUR to New Zealand in October this year. This will be Miley’s first ever visit to New Zealand and there will only be one Auckland show before she takes her tour to Australia. More>>

ALSO:

Get More From Scoop

 
 

LATEST HEADLINES

 
 
 
 
Education
Search Scoop  
 
 
Powered by Vodafone
NZ independent news