Analysing Length of stay variation in metropolitan Adelaide public acute hospitals
Stephen Duckett a, Nick Cugley b
IntroductionThe South Australian Health Performance Council is an independent government body charged with reviewing the overall quality, efficiency, and access of the South Australian (SA) health system. This presentation reports on the findings of a recent review conducted by the Council.
Background to the IssueOne finding of its statutorily required four-yearly review of the SA health system was that SA public hospitals were on average less efficient than other Australian public hospitals, and that there was efficiency variation within SA, with the state's largest hospital, the Royal Adelaide Hospital (RAH), being less efficient than other hospitals in Adelaide. The Council therefore initiated a specific review to understand causes of this variation.
MethodsBecause of some controversies over use of cost data at the RAH, comparisons of average length of stay (LOS) were undertaken. Separation data on all discharges from Adelaide public hospitals in 2021-22 were analysed, standardised for Diagnosis Related Group. The analysis focused mainly on LOS for overnight patients. Details of the methods are in the publicly released report: https://tinyurl.com/42tuwumy
ResultsThe review report revealed a small difference in LOS between the RAH and the metropolitan Adelaide average LOS, but this added up to a waste of 40 beds every day because of the size of the hospital. The review report analysed causes of this variation partly to address potential criticisms of the approach ('we treat more rural patients', 'you haven't standardised adequately for our casemix'), and partly to provide pointers to where the hospital might look to achieve improvements in efficiency.
ConclusionsThe presentation will describe the process followed by the Council in producing the review report and the response to the report to date.
a Chair, South Australian Health Performance Council, Australia
b South Australian Health Performance Council, Australia
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