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.”


© Scoop Media

Culture Headlines | Health Headlines | Education Headlines


13/10: 40 Years Since The Māori Land March Arrived At Parliament

Traffic into Wellington came to a standstill as thousands of Māori and Pākehā streamed along the motorway into the capital on 13 October 1975, concluding the Māori land march to parliament. More>>


Scoop Review Of Books: Before The Quakes

Remembering Christchurch: Voices from decades past: The Christchurch I lived in for my first 23 years was where four-year-olds walked alone to kindergarten, crossing roads empty of all but a couple of cars per hour. My primary school, Ilam, was newly built on a grassy paddock surrounded by rural land... More>>

6-11 October: New Zealand Improvisation Festival Hits Wellington

Wellingtonians will have a wide selection of improv to feast on with a jam packed programme containing 22 shows, three companies from Australia, two companies from Auckland, one from Nelson, one from Christchurch and seven from Wellington. More>>


Bird Of The Year: New Zealanders Asked To Vote For Their Favourite Native Bird

Te Radar, David Farrier, Heather du-Plessis Allan and Duncan Garner are just some of the New Zealanders championing their favourite native bird in Forest & Bird’s annual Bird of the Year competition, which kicks off today.. More>>


Werewolf Film: It Follows - Panic In Detroit

Philip Matthews: When you heard last month that Wes Craven had died and you wanted to pay homage, you could have sat down with any one of five of his films that helped reinvent American horror at least three times over three decades... Or you could just have watched one of the greatest recent horror films that would probably not exist without Craven. More>>


Werewolf Music: Searching For The White Wail - On Art Pepper, etc

If the word ‘hipster’ means anything – which it arguably doesn’t – it seems to be more of an impulse than a condition. One always headed for the margins, and away from the white-bred, white-bread mainstream... More>>


Get More From Scoop



Search Scoop  
Powered by Vodafone
NZ independent news