The development of funding policies for hospices: is casemix-based funding an option?
The 1993 health reforms, with their emphasis on the purchasing of defined amounts or units of service, have led to the implementation of casemix-based funding for the acute medical and surgical services of the public hospitals. Despite growing interest in New Zealand in casemix-based funding for non-acute services such as palliative care, the nature of this service and the characteristics of its patient population pose particular difficulties for the development and implementation of casemix. This paper examines the feasibility of implementing casemix-based funding for hospice/palliative care services and discusses the development of casemix classification systems for palliative care. Problems associated with implementing casemix-based funding are considered including: the dual funding of hospices, the multi-agency nature of palliative care service provision and the need for the Health Funding Authority to identify and specify the hospice services it is willing to fund. While it is concluded that these problems will impede the introduction of casemix-based funding of hospice care, they highlight important issues that the hospice movement must address if it is to ensure its future within the new health environment.
Carter
H
H
Mary Potter Hospice, Wellington.
MacLeod
R
R
Hicks
E
E
Carter
J
J
D003953:Diagnosis-Related Groups / Q000145:classification / Q000191:economics*; D005240:Feasibility Studies; D005378:Financial Support; D006738:Hospices / Q000191:economics*; D006779:Hospitals, Public / Q000191:economics*; D006801:Humans; D009520:New Zealand; D010166:Palliative Care / Q000191:economics*