20
Using Activity Based Modelling & Costing for Planning Health Services An International Trading Perspective Monika Sarangal More info: tahpi.net
Using Activity Based Modelling & Costing for Planning
Health Services
An International Trading Perspective
Monika Sarangal
More info: tahpi.net
Outline
Introduction to the organisation
Health service planning
Casemix based approaches to health planning
Challenges
Growth Opportunities
More info: tahpi.net
More info: tahpi.net
Leading the Field in Health Planning & Design Headquartered in Sydney, Australia, and with an international branch network TAHPI is
strategically placed to provide the A to Z of Health Planning
Health Facility Guidelines
Health Service Planning
Health Facility Planning
Health Architecture
Health Interior Design
Health Project Management
Health Software Development
Health Service Planning Responsive to population’s health needs, TAHPI’s proprietary Tools and approaches translate
the science of planning into practice to develop High Quality and Contemporary Clinical Services
Services • Needs assessment • Demand projections • Market analysis • Catchment flow analysis • Clinical service plans • Detailed capacity and
resource profiling • Business case
development
• Feasibility studies • Financial assessments • Economic appraisal • Organisation policies and
procedures • Models of care and
patient flow • Compliance and due
diligence
More info: tahpi.net
Information Sources A vast expanse of credible and reliable data sources from all around the world form
TAHPI’s Data Library
Sources • IHPA, Australia • AIHW, Australia • NSW Health
Ministry, Australia • AHRQ, USA • CDC, USA • CIHI, Canada • NHS, UK • HMDB, Europe • MOH, Singapore • WHO ,
International
• OECD, Health Statistics, International
• Population and statistical government bodies of various countries (ABS, Statistics Canada, UK Statistics Authority, US Data.gov, etc.)
More info: tahpi.net
Methodology & Approach A sophisticated evidence based approach utilising the most up to date techniques of
Modern Sciences and Statistics
Methods Statistics from reference populations; where relative equilibrium exists between supply and demand Clinical specialty frameworks and casemix classification system mapping Time series modelling at age, gender and casemix-specific level Demand projections through to 2035
SUPPLY DEMAND
More info: tahpi.net
Health Workforce
Acute Inpatient Care
Non Acute Care
Intensive Care
Operating Theatre Care
Emergency Care
Procedural Care
Outpatient Care
Health Service Planning Reference Datasets A wide scope of service types
TAHPI’s Data Library
More info: tahpi.net
Health Service Planning Process
Databases
More info: tahpi.net
Cost Modelling Approach
Bed/room profile
based on estimated
gaps
Activity estimates
for relevant casemix groups
Cost estimates
by weighted activity
Adjustment for public or
private provision
Revenue and
Expenditure Profile
Rates of Return
More info: tahpi.net
Good News- Service Planning Tools
More info: tahpi.net
Higher sensitivity and predictability More valid cross country comparisons
Increased specificity Conservative and reliable approach
012345678
2010 2015 2020 2025 2030 2035
Invasive Cardiology
DRG SRG ESRG
Why Casemix Based Approach for Service Planning?
0
5
10
15
20
25
30
2010 2015 2020 2025 2030 2035
Gastroenterology
*Projected acute overnight episodes per thousand population
*Results are preliminary
Superior statistical outcomes
More info: tahpi.net
Why Casemix Based Approach for Service Planning?
• Countries around the world are frequently adopting casemix concept for better health outcomes specifically concerning hospital financing
• Foundation for intra and inter country comparisons
• Modifiable to account for county specific practice cultures
• Similar frameworks are being adopted for other service types like non acute and sub acute care
• Allows planning for specific resources like medical equipment and skilled workforce
More global acceptance
More info: tahpi.net
International Trading of Service Planning Intelligence
Advanced Health
Systems
Setting internationally
accepted benchmarks
Superior consultancy services for
global markets
Developing uniform &
transparent health data structures
Collaborate to build
universal well being & provider
value
More info: tahpi.net
Challenges
Casemix Classification
• Different casemix classification frameworks and versions across countries
• Underdeveloped classification systems for service types other that Acute Care
Health Workforce
• Human resource profiles vary significantly between different countries
• Differences in the remuneration and work practice cultures across countries
Cost Indicators
• Full expenditure and revenue profiles are frequently unavailable leading to assumptions for many cost indicators
• Relative price adjustments and international health price indices need development to allow homogeneity and transparency in health care costs worldwide
Lack of comprehensive reference database spanning a wide range of countries
More info: tahpi.net
Casemix Classification Differences Across Countries
Coding System
Australia USA UK Abu Dhabi
Diagnoses ICD10-AM ICD9-CM ICD10 ICD10
Procedures ACHI ICD9-CM CPT
OPCS -4 CPT
Casemix AR-DRG HCFA/CMS/ AP/APR/ 3MAPR/ MS-DRG
HRG HAAD-DRG
More info: tahpi.net
TAHPI’s Mapping Framework- An Example AR-DRG AR-DRG-Name HAAD-DRG HAAD-DRG-Name
D01Z COCHLEAR IMPLANT 31201 IP OTHER EAR-NOSE-MOUTH & THROAT PROCEDURES
D01Z COCHLEAR IMPLANT 31202 IP OTHER EAR-NOSE-MOUTH & THROAT PROCEDURES w/CC
D01Z COCHLEAR IMPLANT 31203 IP OTHER EAR-NOSE-MOUTH & THROAT PROCEDURES w/MCC
D02A HEAD AND NECK PROCEDURES W CATASTROPHIC OR SEVERE CC 31103 IP COMPLEX LARYNX PROCEDURES w/MCC
D02A HEAD AND NECK PROCEDURES W CATASTROPHIC OR SEVERE CC 31113 IP OTHER COMPLEX HEAD & NECK PROCEDURES w/MCC
D02B HEAD AND NECK PROCEDURES W MALIGNANCY OR MODERATE CC 31102 IP COMPLEX LARYNX PROCEDURES w/CC
D02B HEAD AND NECK PROCEDURES W MALIGNANCY OR MODERATE CC 31112 IP OTHER COMPLEX HEAD & NECK PROCEDURES w/CC
D02C HEAD AND NECK PROCEDURES W/O MALIGNANCY W/O CC 31101 IP COMPLEX LARYNX PROCEDURES
D02C HEAD AND NECK PROCEDURES W/O MALIGNANCY W/O CC 31111 IP OTHER COMPLEX HEAD & NECK PROCEDURES
D03Z SURGICAL REPAIR FOR CLEFT LIP OR PALATE DIAGNOSIS 31141 IP CLEFT LIP & PALATE REPAIR
D03Z SURGICAL REPAIR FOR CLEFT LIP OR PALATE DIAGNOSIS 31142 IP CLEFT LIP & PALATE REPAIR w/CC
More info: tahpi.net
Global approach • Standard coding frameworks and mapping protocols to allow international
comparison of hospital and clinic activity and costs • A collaborative approach towards setting international benchmarks and health
standards with common goal for enhancing health service planning export
Transparent and comprehensive reporting systems • Inclusion of principal diagnoses and procedure codes in activity tables reported by
DRG • Quantifying the potential sources of error in activity based data collections • Inclusion of private health providers in all activity based data collection • Full disclosure of costing process broken down by a comprehensive list of cost
components
Moving Towards Future
Uniformity is a necessity of the future
More info: tahpi.net
Growth Opportunities
A global opportunity for Developed countries to emerge as leaders in exporting health planning
intelligence Developing countries to leverage their health systems with expert
knowledge and intelligence to international standards
Establishment of universal standards and conventions for health systems worldwide
Enhancement of health care equity and outcomes worldwide
More info: tahpi.net
ABU DHABI HAAD Demand Model
and Healthcare Capacity Planning Development
and Improvement
AUSTRALIA Camden Medical Campus
Concept Plan and Development Strategy
KSA Long Term Care and
Rehabilitation Services, Sukoon International
Due Diligence
DUBAI Dubai Clinical Services
Capacity Plan
MALAYSIA
Universiti Tunku Abdul Rahman Hospital
KSA
Security Forces Medical Center
DUBAI Mohammed Omar Bin
Haider Hospital Feasibility Study
ABU DHABI
Adam Vital Rehabilitation Hospital
TAHPI’s Health Service Planning Portfolio A showcase of our most recent projects
More info: tahpi.net
Thank You! Questions? [email protected]
More info: tahpi.net
Activity based approach to service planning is a big step towards improving health systems on a global scale and building high value export services with more exciting job opportunities in Australia and
worldwide
