What people are saying: Stephen Duckett’s latest report
Posted on March 7, 2014 in RACP
This week the Grattan Institute got some good coverage in the media for Stephen Duckett’s latest report Controlling Costly Care: A billion dollar hospital opportunity (http://grattan.edu.au/home/health). In this report the authors argue that activity based funding by which hospitals are paid, could be made more efficient by removing outlying inefficient performers in determining the average costs. Many people in the RACP would be aware that there is growing attention to the issue of ‘medical waste’. One of the more interesting approaches has been to involve clinicians themselves in identifying ineffective treatments. Programs in the USA and the UK have been established in which evidence and expert opinion are called upon to determine ineffective services which are then discouraged. With the new Government starting to float policy directions for health surely it can only be a matter of time before medical waste comes onto the agenda, and why not? It seems a sensible approach to me. If so, is this an area the RACP could play a role?
There are different perspectives on cost generation in health care and how they may be approached more effectively than current measures such as ABF, Case-Mix of DRGs. These are cost quality measures based predominantly on billing data and not clinical data and have minimal accuracy in measuring care.
Some of the significant cost, quality and outcome measures relate to clinical decision making (CDM) which are the most significant in overuse, underuse and misuse of resources. CDM is also a major factor in health care variation.
Hannan T, Celia C, Are doctors the weakness in the e-health building? IJM 43 Oct 2013.
Terry Thanks for your comment. I agree. I note that the causes of medical waste are described as not using best practice, lack of co-ordination of care, overly complex administration, inappropriately high prices and fraud. This conveys a much broader range of thinking. Is that what you are getting at?