Discussion paper on the emergency care costing study (part of the Emergency care costing and classification development project)

Date published: 7 August 2015

The Independent Hospital Pricing Authority (IHPA) is developing a new national classification system for emergency care departments and services.

The classification will be underpinned by a targeted costing study that will investigate the impact of cost variation between emergency departments/services, and data development to modify and enhance selected data items in the emergency care data collections to support the implementation of the new emergency care classification.

This document has been prepared as the basis for discussion with key stakeholders about how the costing study component of the overall project will be undertaken. It covers issues such as the time frames for the costing study, data collection and costing processes.

Why We Are Consulting

IHPA encourages interested parties to provide submissions to help inform the costing study, with respect to the following consultation questions:

  1. Are these time frames realistic for this project? In particular (a) Is the lead time for setting up the project within individual sites adequate? (b) Are the dates for the submission of the activity data adequate? (c) Are the dates for the submission of the cost data adequate?
  2. (a) Is the ‘core’ data collection (i.e. one month for emergency departments, and three months for emergency services) long enough or too long for the collection of clinical staff time allocated to individual patients to inform costing? (b) What are the issues in collecting the staff time data over the period specified and what would be the alternatives??
  3. (a) What are the issues in the collection of additional patient clinical characteristics and other stay-related information for up to a 3 month period? (b) Which aspects of the additional patient clinical characteristics and other stay-related information are already collected through routine sources and which will require additional data collection?
  4. Are there any issues for sites in providing National Minimum Data Set data and cost data for the retrospective costing period (1 July 2015 to 31 March 2016)?
  5. What are the best tools and methods to achieve the capture of the additional data elements?
  6. How is mapping of local data elements/ fields against those set up for the study (e.g. presenting problem) best handled? For example, should this be done at an individual site level, or at a state/ territory level?
  7. How should the collection of clinical staff time with individual patients be approached?
  8. What issues do costing teams and costing practitioners envisage with using study specific data (clinician time) to generate relative value units (RVUs) for the study?  
  9. To want extent will study sites want to develop their own RVUs from study data, versus the consortium developing these on behalf of the sites?
  10. Will it be possible to apply RVUs developed through the study for the costing (i.e. are sites limited in any way in applying alternative RVUs)?  
  11. What are the practicalities of running a costing study related to just the study period (1 April to 30 June 2016) compared with the whole year (1 July 2015 to 30 June 2016)?

These questions are included in the Discussion paper on the emergency care costing study.

What Happens Next

Submissions closed at 5pm, 30 September 2015.

All submissions will be published unless respondents specifically identify sections that they believe should be kept confidential due to commercial or other reasons.

Submissions were forwarded to IHPA in a range of formats including Word, RTF, PDF and handwritten or typed hardcopy. In order to make submissions available as soon as possible, most submissions have been published in their original format. Handwritten submissions have been scanned into PDF documents. If the content has been emailed to IHPA the text of email submissions has been reproduced in Word format.

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