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Hospital Performance: Costs of acute admitted patients in public hospitals from 2011–12 to 2013–14

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Data source

The Authority worked with the Independent Hospital Pricing Authority (IHPA) on the development of the report. Data outputs used for the report were prepared by the IHPA using specifications that were developed between the two agencies, using data from the National Hospital Cost Data Collection (NHCDC), the Admitted Patient Care National Minimum Data Set (APC NMDS), and the Hospital Casemix Protocol (HCP) data collection.

National Hospital Cost Data Collection

The NHCDC is a voluntary collection of public hospital costs, collected by financial year. It was established in 1996–97. More information can be found at: https://www.ihpa.gov.au/what-we-do/NHCDC

Hospitals allocated their costs for 2011–12 and 2012–13 to individual patient records according to the Australian Hospital Patient Costing Standards (AHPCS), version 2.0.2 The AHPCS version 3.1 was used for 2013–14.3

The AHPCS version 3.1 contains four new standards. These relate to the distribution of clinical salary and wages, allocation of medical costs for private and public patients, intermediate product/service matching method and interpretation of product costs data. These new standards should improve the validity and completeness of the NHCDC.

For more information about the NHCDC see IHPA’s National Hospital Cost Data Collection Australian Public Hospitals Cost Report 2013–14.3

Admitted Patient Care National Minimum Data Set

The APC NMDS was used to count the number of same-day and overnight separations at a hospital. For the purposes of this report, each separation represents, ‘an episode of care’ and an admission to hospital.

More information about the APC NMDS can be found at: http://meteor.aihw.gov.au/content/index.phtml/itemId/491555

Hospital Casemix Protocol

The HCP data collection has episodic benefit and charge data (that is, financial data) for privately insured admitted patients.

The HCP data collection was used to calculate a more accurate representation of hospital costs as some private patient costs are not reported to the NHCDC.4 See What costs are included for more information on costs included.

Hospital results included in the report

To ensure robust comparable results, hospitals were reported in a specific financial year if the following criteria were met:

  • The hospital was a major metropolitan, large metropolitan, major regional or large regional non-specialist public hospital with an emergency department, where costing and activity data were available for at least two full consecutive financial years (Note: emergency department costs are not included. See What costs are included for more information)
  • At least 90% of patient unit records were included in the derived Cost per NWAU of all patient unit records (excluding error DRGs) that were recorded in the APC NMDS
  • Where no anomalies were identified following triangulation analysis of cost data between the NHCDC and the National Public Hospital Establishments Database (NPHED). One hospital was suppressed in 2011–12 for not meeting this criteria
  • Where a hospital had an intensive care unit (ICU) that was eligible for an NWAU ICU adjustment, the hospital must have recorded ICU hours greater than zero. Eight hospitals were suppressed for not meeting this criterion in 2012–13.

The number of major and large public hospitals for which a result is available on the MyHospitals website after inclusion and exclusion criteria were applied is:

2011–12 2012–13 2013–14
Non-specialist major and large hospitals 114 115 115
Excluded 19 23 14
Hospital result included in report or on website* 95 92 101

Data supply

Data outputs used in this report were supplied to the Authority by IHPA on 18 and 28 October 2014 (2011–12 data) and 27 November 2015 (2012–13 and 2013–14 data). The Authority acknowledges that data provided to Commonwealth agencies may be updated as improvements are made in their collections.

2
Independent Hospital Pricing Authority (IHPA). National Hospital Cost Data Collection Australian Public Hospitals Cost Report 2012–13, Round 17 [Internet]. 2015 [cited 2015 Nov 12]. Available from: https://www.ihpa.gov.au/publications/national-hospital-cost-data-collection-australian-public-hospitals-cost-report-2012
3
Independent Hospital Pricing Authority (IHPA). National Hospital Cost Data Collection Australian Public Hospitals Cost Report 2013–14, round 18 [Internet]. 2015 [cited 2015 Nov 12]. Available from: https://www.ihpa.gov.au/publications/australian-public-hospitals-cost-report-2013-2014-round-18
4
Independent Hospital Pricing Authority (IHPA). The Pricing Framework for Australian Public Hospital Services 2015–16 [Internet]. 2014 [cited 2016 Mar 15]. Available from: https://www.ihpa.gov.au/sites/g/files/net636/f/publications/final-2015-16-pricing_framework_for_australian_public_hospital_services_d14-43339.pdf