Health costing in Alberta ... annual report

298 Pages·1999·76.3 MB·English

by  Alberta. Health Resourcing Branch

Alberta
HEALTH AND WELLNESS
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For further information on this report and its contents contact:
Health Costing Unit
Health Funding and Costing Branch
Alberta Health and Wellness
19% floor, 10025 Jasper Avenue
Edmonton, Alberta 1T5J 186
Rick Leischner, Manager Shannon Roden
[phone] OR [phone]
Rick.Leischner@ gov.ab.ca [email protected]
ISSN 1703-3055
August 2003
To obtain the electronic version of this report, visit Alberta Health and Wellness’ Internet
Site at:
http://www. health.gov.ab.ca/public/documCeonstti/ngH e2a0l03t.hp_df
Frequently Used
Acronyms
ACCS Ambulatory Care Classification System
CACS Comprehensive Ambulatory Classification System
CIHI Canadian Institute for Health Information
CMG Case Mix Group
CMI Case Mix Index
HSRV Hospital Specific Relative Value
RIW Resource Intensity Weight
RDRG Refined Diagnosis Related Group
RHA Regional Health Authority
SWRV System Wide Relative Value
Alberta
HEALTH AND WELLNESS
Health Costing in Alberta
2003 Annual Report
Table of Contents |
Frequently Used Acronyms ______________________________ inside front cover
WIELOAUGTION wimmmnoun inn We IMM ON I a |
Albertais Costing PAVtnhersmip sic Ne Z
Contributors to 2001/2002 Cost Development __________ sti‘ sé‘ 3
Processes for 2001/2002 Cost Development _______________________________ 5
DD ATOREIOU/S Manti mmanent 6
Data Collection PVOGeSSCS i 7
PAG EIVAGYVA) GEG min cet ue OO We eel iN 7
COST ACG Menno SERA al ic iM eel eMac oon ee DU Ny 7
Gost Data PROCESSES ei &
MMM G HO ACG) a meni Nin ee a ea | 9
GrOolpIngrolDataw irae ose ce 9
CGMGIGVOUDC rani mie rien omen Bole Ue a 9
GCS GROUPE rau lin erm lil outa Meee et Sal ice a de 1]
GVOUDINGIRES ULES aim Uri nna MSU NOG SG DU yo ea es 1]
DGCAgiOD UU pim Wim OU an UN Ue 12
Contribution to National Resource Intensity Weights ______________________ 13
GONGINSIONI mean Oe oun Ne 14
ADV CHAIXGe imam mucr ni mS NU OU a 17
Gost, Weight Development tion oe 17
PDC RINEOMS amen mu ce ninn nO Men 21
SGHCAUICS |W im miaine nto Me Oa 235
Inpatient Schedules
Schedule) ~ inpatient Gost Results 0.) 23
Schedule 2 - Inpatient Yearly Comparisons _________ 92
Schedule 3 - Inpatient Statistical Background________________________________ 162
Ambulatory Care Schedules
Schedule 5 - Ambulatory Care Cost Results____ 239
Schedule 6 - Ambulatory Care Yearly Comparisons__________________________ 253
Schedule 7 - Ambulatory Care Statistical Background _______________________ 267
Schedule 8 - Ambulatory Care Low Volume Cells ________ == 281
Prepared by: Health Funding and Costing
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Alberta
HEALTH AND WELLNESS
Health Costing in Alberta
2003 Annual Report
Introduction
The Alberta Costing Partnership has successfully developed patient specific
case costs for both inpatient and ambulatory care, for the fifth consecutive
year. The partnership consists of six costing regions along with the
department of Alberta Health and Wellness.
The 2003 Annual Report discloses the cost of cases that were handled by the
participating health regions between April 1, 2001 and March 31, 2002. Cost
data is blended with the prior year costs to smooth out the large cost
fluctuations that are inherent in health care service provision. Cases are
grouped by linking to activity data to provide appropriate summary
information.
The process of costing health services in Alberta is evolving, as is the reporting
of costs. Once again the inpatient costs are reported by Case Mix Groups
(CMGs). Since this format enhances age and complexity level reporting for
case mix groups, readers can better grasp the role that complexity and age
have on health care costs. The ambulatory care costs are reported by
Ambulatory Care Classification System (ACCS).
The 2003 cost schedules were designed to meet the needs of various users.
Direct and indirect cost components are provided in schedules 1 and 5.
Schedules 2 and 6 provide information on cost trends and schedules 3,4,7
and 8 provide statistical data to assist users in assessing the accuracy and
relevance of the cost data. Readers are encouraged to refer to the definitions
of column headings on page 21.
As costing processes improve and more information becomes available,
additional component details will be included in future reports.
The major driver behind health costing in Alberta continues to be its use in
the calculation of each health region’s global funding. The capitation rates
(for ambulatory care) and Province Wide Services funding are based on
Alberta costs. The cost weights for inpatient and import/export valuation are
based on the Canadian Institute for Health Information’s (CIHI’s) Resource
Intensity Weight (RIW), which includes Alberta data. In addition to funding
purposes, the use of cost information in other areas of the department and
within the regions is becoming more common as users learn more about this
information.
It should be noted that the cost information contained in this publication
does not represent the provincial average cost of hospital-based services
across the regional health authorities. Rather it reflects the average cost
derived from the data submitted by only three health authorities for 15
different sites. The costs from these sites reflect 55 percent of the provincial
level of hospital-based inpatient activity (separations) and 25 percent of the
ambulatory care activity (visits). Although the data submitted have gone
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Alberia
HEALTH AND WELLNESS
Health Costing in Alberta
2003 Annual Report
through reasonability validation, the Alberta Costing Partnership provides no
external assurance over the appropriateness and completeness of cost
allocations done by the health authorities.
In 2002, a Costing of Output Steering Committee was formed with Alberta’s
health authorities and department membership to guide an orderly
development of approaches, methodologies and standards relating to the
reporting of cost of outputs information. Among its responsibilities, the
group Is to leverage on research, studies and experiences in the province and
across Canada. It is expected that the work of the Alberta Costing
Partnership will be a cornerstone on which the Costing of Output Steering
Committee will build.
Beginning in 2003/2004, Alberta Health and Wellness plans to enter into
multi year performance agreements with all health regions. These agreements
will list expectations, key performance measures, and targets to be met by the
regions. One element of performance to be measured is the information on
the cost of services. The nature and extent of cost reporting will be
determined in future agreements.
Outside Alberta, significant interest has been expressed in the work done by
the Alberta Costing Partnership, with numerous inquiries received from
national bodies, other provincial health ministries, researchers, universities,
major pharmaceutical companies and medical personnel. Demand for
Alberta cost data continues to increase.
Alberta’s Costing
Partnership
Leadership of the Alberta Costing Partnership resides within the Ministry of
Health and Wellness. The health funding and costing branch is responsible
for carrying on the health costing mandate. Health costing was done in
conjunction with six regional health authorities (RHAs) who utilized a
common costing framework to generate patient-specific case costs. The six
regions were!:
Chinook Regional Health Authority,
Calgary Health Region,
David Thompson Regional Health Authority,
Crossroads Regional Health Authority,
Capital Health Authority, and
¢OO¢H6Mm— h¢lCUU c rmMhUi stahia Regional Health Authority.
In addition to collecting and submitting cost data, each of the costing regions
is expected to appoint a regional costing co-ordinator to represent its region
"On April 1, 2003 a significant restructuring of health regions took effect in Alberta. There are currently nine regions,
replacing the 17 regions in operation in 2001/2002.
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Alberta
HEALTH AND WELLNESS
Health Costing in Alberta
2003 Annual Report
on the Costing Function Team. Team members are expected to provide
input to any discussions/decisions regarding the costing framework and
process.
One of the major responsibilities of the team is to participate in the costing
round table review of the provincial cost results. The participants review the
statistical analysis. They also compare costs among the contributing regions
and from prior years. Issues identified in this process are investigated and
resolved by the team prior to publication of this report.
Contributors to
2001/2002 Cost
Development
Although six RHAs participated in the Alberta Costing Partnership, three
regions were not able to submit 2001/2002 cost data -- Chinook Regional
Health Authority, David Thompson Regional Health Authority and Mistahia
Regional Health Authority.
Cost data collected for 2001/2002 continued to focus on inpatient and
ambulatory care services. In total, cost data submitted by the regions for
inpatient services totaled over 185,000 patient records and over 1.5 million
costed visits for ambulatory care.
The availability of multiple years of cost data has improved the robustness
and stability of both the inpatient and ambulatory care data sets. Alberta's
continued success has been possible as a result of the commitment of the
regional health authorities and the Ministry to continue to collect and
produce reliable cost data.
Comparison of Cost and Activity Data Collected
Inpatient
00
11999/2000 104,000| 346,500] 30% if
Million Million
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Alberta
HEALTH AND WELLNESS
Health Costing in Alberta
2003 Annual Report
Cost data was provided from 15 different sites. Each site tracks costs on a
patient specific basis in one or more functional centres.
The bulk of the costs for inpatient cases flow from inpatient nursing
functional centres; therefore, only sites with the ability to track nursing costs
on a patient specific basis are included in this report. Since inpatients
routinely receive services in other functional centres such as emergency,
diagnostic imaging and laboratory services, regions have developed the
capability to track costs in these centres on a patient specific basis. Where this
capability does not exist, regions use allocation models to ensure that
appropriate costs are properly distributed to inpatient cases.
The costs for ambulatory care cases are not reported where there are no
systems to track costs on a patient specific basis in the functional centres
directly providing ambulatory care. The following table outlines the facility
and availability of patient specific cost information submitted in the
2001/2002 fiscal year.
2001/2002 Cost Data by Region/Facility
Regional
Health
Authority Site E.R. Day
Inpatient
Procedures
No
No
No
N
No cost data supplied for 2001/2002
Wetaskiwin
Crossroads Non- No No Nee
Hospital x
No cost data supplied for 2001/2002
| No cost data supplied for 2001/2002
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