The Aboriginal and Torres Strait Islander casemix study.
With increasing implementation of casemix-based funding for hospitals, quantitative data were needed to confirm the clinical impression that treating Aboriginal (compared with non-Aboriginal) inpatients consumes significantly more resources. Utilisation data, collected over a three-month period in 10 hospitals, were used to determine a cost per inpatient episode, which was grouped according to AN-DRG-3 to give a cost per AN-DRG for Aboriginal and Torres Strait Islander (ATSI) patients and non-ATSI patients. ATSI patients had consistently longer average length of stay and significant variation in relative frequency of admissions, compared with non-ATSI patients, with higher prevalences of infectious diseases. Degenerative and neoplastic conditions were more common in non-ATSI patients. There were significant differences in casemix-adjusted costs per patient episode (ATSI, $1856; non-ATSI, $1558; P < 0.001). Our study has quantified differential resource consumption between two Australian populations, and highlights the need for recognition of some hospitals' atypical populations and special funding requirements.
Fisher
D A
DA
Royal Darwin Hospital, NT. dale.fisher@nt.gov.au
Murray
J M
JM
Cleary
M I
MI
Brewerton
R E
RE
D003953:Diagnosis-Related Groups / Q000191:economics / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005380:Financing, Government / Q000379:methods; D017721:Hospital Costs / Q000706:statistics & numerical data; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D015876:Northern Territory / Q000453:epidemiology; D011793:Queensland / Q000453:epidemiology; D013021:South Australia / Q000453:epidemiology; D014904:Western Australia / Q000453:epidemiology; D000095283:Australian Aboriginal and Torres Strait Islander Peoples