❓ Dr. Woollard questions the cost-effectiveness of major teaching hospitals and the feasibility of maintaining tertiary services in community hospitals. Minister McGinty dismisses the latter and provides cost comparisons, highlighting Fremantle Hospital's efficiency while noting limitations of the data.
AnsweredQoN 510Legislative Assembly
QuestionView source ↗
Given that a quarter of the state budget is spent on health services, and a large proportion of that on the major teaching hospitals - (1) Will the minister provide comparisons of the cost effectiveness of the three general teaching hospitals, as such information is essential if we are to make decisions on where tertiary services should be located under the plans put forward by both the Government and the coalition? (2) Can tertiary services be maintained at community or general hospitals? Mr J.A. McGINTY
AnswerView source ↗
(1)-(2) It is fairly obvious that the answer to the second question posed by the member for Alfred Cove is that it is a complete nonsense to suggest that a comprehensive tertiary service can be provided through a general or community hospital. It simply cannot be done. In answer to the first question, the decision about where future tertiary services should be located has more to do with strategic positioning and clinical service planning in relation to population and growth requirements than the relative cost effectiveness of current hospitals, although that is obviously a factor. Suitability of a location, infrastructure conditions and ease of expansion are also among the factors that should be assessed. The key performance indicator generally used to reflect relative cost effectiveness, at least in terms of admitted patients, is the average cost per case mix adjusted inpatient episode. Over the past few years, this indicator as reported by Fremantle Hospital for that area has averaged about 18 per cent lower than the report of the other two general teaching hospitals - that is, Royal Perth Hospital and Sir Charles Gairdner Hospital. To be specific, the average cost per case mix adjusted inpatient episode at Fremantle Hospital for the past few years is $2 760. For Royal Perth Hospital it is $3 399 and for Sir Charles Gairdner Hospital it is $3 342. It should be noted, however, that although this is a good indicator, other important factors, such as the degree of complexity within the case mix of the inpatient episode and the broader role of the hospital - for example, providing super specialties such as cancer and burns treatment - impact on the costs of providing services within the hospital. However, subject to those qualifications, it is true that Fremantle Hospital is our most efficient tertiary hospital.
(1) Will the minister provide comparisons of the cost effectiveness of the three general teaching hospitals, as such information is essential if we are to make decisions on where tertiary services should be located under the plans put forward by both the Government and the coalition? (2) Can tertiary services be maintained at community or general hospitals? Mr J.A. McGINTY replied: (1)-(2) It is fairly obvious that the answer to the second question posed by the member for Alfred Cove is that it is a complete nonsense to suggest that a comprehensive tertiary service can be provided through a general or community hospital. It simply cannot be done. In answer to the first question, the decision about where future tertiary services should be located has more to do with strategic positioning and clinical service planning in relation to population and growth requirements than the relative cost effectiveness of current hospitals, although that is obviously a factor. Suitability of a location, infrastructure conditions and ease of expansion are also among the factors that should be assessed. The key performance indicator generally used to reflect relative cost effectiveness, at least in terms of admitted patients, is the average cost per case mix adjusted inpatient episode. Over the past few years, this indicator as reported by Fremantle Hospital for that area has averaged about 18 per cent lower than the report of the other two general teaching hospitals - that is, Royal Perth Hospital and Sir Charles Gairdner Hospital. To be specific, the average cost per case mix adjusted inpatient episode at Fremantle Hospital for the past few years is $2 760. For Royal Perth Hospital it is $3 399 and for Sir Charles Gairdner Hospital it is $3 342. It should be noted, however, that although this is a good indicator, other important factors, such as the degree of complexity within the case mix of the inpatient episode and the broader role of the hospital - for example, providing super specialties such as cancer and burns treatment - impact on the costs of providing services within the hospital. However, subject to those qualifications, it is true that Fremantle Hospital is our most efficient tertiary hospital.
(2) Can tertiary services be maintained at community or general hospitals? Mr J.A. McGINTY replied: (1)-(2) It is fairly obvious that the answer to the second question posed by the member for Alfred Cove is that it is a complete nonsense to suggest that a comprehensive tertiary service can be provided through a general or community hospital. It simply cannot be done. In answer to the first question, the decision about where future tertiary services should be located has more to do with strategic positioning and clinical service planning in relation to population and growth requirements than the relative cost effectiveness of current hospitals, although that is obviously a factor. Suitability of a location, infrastructure conditions and ease of expansion are also among the factors that should be assessed. The key performance indicator generally used to reflect relative cost effectiveness, at least in terms of admitted patients, is the average cost per case mix adjusted inpatient episode. Over the past few years, this indicator as reported by Fremantle Hospital for that area has averaged about 18 per cent lower than the report of the other two general teaching hospitals - that is, Royal Perth Hospital and Sir Charles Gairdner Hospital. To be specific, the average cost per case mix adjusted inpatient episode at Fremantle Hospital for the past few years is $2 760. For Royal Perth Hospital it is $3 399 and for Sir Charles Gairdner Hospital it is $3 342. It should be noted, however, that although this is a good indicator, other important factors, such as the degree of complexity within the case mix of the inpatient episode and the broader role of the hospital - for example, providing super specialties such as cancer and burns treatment - impact on the costs of providing services within the hospital. However, subject to those qualifications, it is true that Fremantle Hospital is our most efficient tertiary hospital.
Mr J.A. McGINTY replied: (1)-(2) It is fairly obvious that the answer to the second question posed by the member for Alfred Cove is that it is a complete nonsense to suggest that a comprehensive tertiary service can be provided through a general or community hospital. It simply cannot be done. In answer to the first question, the decision about where future tertiary services should be located has more to do with strategic positioning and clinical service planning in relation to population and growth requirements than the relative cost effectiveness of current hospitals, although that is obviously a factor. Suitability of a location, infrastructure conditions and ease of expansion are also among the factors that should be assessed. The key performance indicator generally used to reflect relative cost effectiveness, at least in terms of admitted patients, is the average cost per case mix adjusted inpatient episode. Over the past few years, this indicator as reported by Fremantle Hospital for that area has averaged about 18 per cent lower than the report of the other two general teaching hospitals - that is, Royal Perth Hospital and Sir Charles Gairdner Hospital. To be specific, the average cost per case mix adjusted inpatient episode at Fremantle Hospital for the past few years is $2 760. For Royal Perth Hospital it is $3 399 and for Sir Charles Gairdner Hospital it is $3 342. It should be noted, however, that although this is a good indicator, other important factors, such as the degree of complexity within the case mix of the inpatient episode and the broader role of the hospital - for example, providing super specialties such as cancer and burns treatment - impact on the costs of providing services within the hospital. However, subject to those qualifications, it is true that Fremantle Hospital is our most efficient tertiary hospital.
(1)-(2) It is fairly obvious that the answer to the second question posed by the member for Alfred Cove is that it is a complete nonsense to suggest that a comprehensive tertiary service can be provided through a general or community hospital. It simply cannot be done. In answer to the first question, the decision about where future tertiary services should be located has more to do with strategic positioning and clinical service planning in relation to population and growth requirements than the relative cost effectiveness of current hospitals, although that is obviously a factor. Suitability of a location, infrastructure conditions and ease of expansion are also among the factors that should be assessed. The key performance indicator generally used to reflect relative cost effectiveness, at least in terms of admitted patients, is the average cost per case mix adjusted inpatient episode. Over the past few years, this indicator as reported by Fremantle Hospital for that area has averaged about 18 per cent lower than the report of the other two general teaching hospitals - that is, Royal Perth Hospital and Sir Charles Gairdner Hospital. To be specific, the average cost per case mix adjusted inpatient episode at Fremantle Hospital for the past few years is $2 760. For Royal Perth Hospital it is $3 399 and for Sir Charles Gairdner Hospital it is $3 342. It should be noted, however, that although this is a good indicator, other important factors, such as the degree of complexity within the case mix of the inpatient episode and the broader role of the hospital - for example, providing super specialties such as cancer and burns treatment - impact on the costs of providing services within the hospital. However, subject to those qualifications, it is true that Fremantle Hospital is our most efficient tertiary hospital.
(1) Will the minister provide comparisons of the cost effectiveness of the three general teaching hospitals, as such information is essential if we are to make decisions on where tertiary services should be located under the plans put forward by both the Government and the coalition? (2) Can tertiary services be maintained at community or general hospitals? Mr J.A. McGINTY replied: (1)-(2) It is fairly obvious that the answer to the second question posed by the member for Alfred Cove is that it is a complete nonsense to suggest that a comprehensive tertiary service can be provided through a general or community hospital. It simply cannot be done. In answer to the first question, the decision about where future tertiary services should be located has more to do with strategic positioning and clinical service planning in relation to population and growth requirements than the relative cost effectiveness of current hospitals, although that is obviously a factor. Suitability of a location, infrastructure conditions and ease of expansion are also among the factors that should be assessed. The key performance indicator generally used to reflect relative cost effectiveness, at least in terms of admitted patients, is the average cost per case mix adjusted inpatient episode. Over the past few years, this indicator as reported by Fremantle Hospital for that area has averaged about 18 per cent lower than the report of the other two general teaching hospitals - that is, Royal Perth Hospital and Sir Charles Gairdner Hospital. To be specific, the average cost per case mix adjusted inpatient episode at Fremantle Hospital for the past few years is $2 760. For Royal Perth Hospital it is $3 399 and for Sir Charles Gairdner Hospital it is $3 342. It should be noted, however, that although this is a good indicator, other important factors, such as the degree of complexity within the case mix of the inpatient episode and the broader role of the hospital - for example, providing super specialties such as cancer and burns treatment - impact on the costs of providing services within the hospital. However, subject to those qualifications, it is true that Fremantle Hospital is our most efficient tertiary hospital.
(2) Can tertiary services be maintained at community or general hospitals? Mr J.A. McGINTY replied: (1)-(2) It is fairly obvious that the answer to the second question posed by the member for Alfred Cove is that it is a complete nonsense to suggest that a comprehensive tertiary service can be provided through a general or community hospital. It simply cannot be done. In answer to the first question, the decision about where future tertiary services should be located has more to do with strategic positioning and clinical service planning in relation to population and growth requirements than the relative cost effectiveness of current hospitals, although that is obviously a factor. Suitability of a location, infrastructure conditions and ease of expansion are also among the factors that should be assessed. The key performance indicator generally used to reflect relative cost effectiveness, at least in terms of admitted patients, is the average cost per case mix adjusted inpatient episode. Over the past few years, this indicator as reported by Fremantle Hospital for that area has averaged about 18 per cent lower than the report of the other two general teaching hospitals - that is, Royal Perth Hospital and Sir Charles Gairdner Hospital. To be specific, the average cost per case mix adjusted inpatient episode at Fremantle Hospital for the past few years is $2 760. For Royal Perth Hospital it is $3 399 and for Sir Charles Gairdner Hospital it is $3 342. It should be noted, however, that although this is a good indicator, other important factors, such as the degree of complexity within the case mix of the inpatient episode and the broader role of the hospital - for example, providing super specialties such as cancer and burns treatment - impact on the costs of providing services within the hospital. However, subject to those qualifications, it is true that Fremantle Hospital is our most efficient tertiary hospital.
Mr J.A. McGINTY replied: (1)-(2) It is fairly obvious that the answer to the second question posed by the member for Alfred Cove is that it is a complete nonsense to suggest that a comprehensive tertiary service can be provided through a general or community hospital. It simply cannot be done. In answer to the first question, the decision about where future tertiary services should be located has more to do with strategic positioning and clinical service planning in relation to population and growth requirements than the relative cost effectiveness of current hospitals, although that is obviously a factor. Suitability of a location, infrastructure conditions and ease of expansion are also among the factors that should be assessed. The key performance indicator generally used to reflect relative cost effectiveness, at least in terms of admitted patients, is the average cost per case mix adjusted inpatient episode. Over the past few years, this indicator as reported by Fremantle Hospital for that area has averaged about 18 per cent lower than the report of the other two general teaching hospitals - that is, Royal Perth Hospital and Sir Charles Gairdner Hospital. To be specific, the average cost per case mix adjusted inpatient episode at Fremantle Hospital for the past few years is $2 760. For Royal Perth Hospital it is $3 399 and for Sir Charles Gairdner Hospital it is $3 342. It should be noted, however, that although this is a good indicator, other important factors, such as the degree of complexity within the case mix of the inpatient episode and the broader role of the hospital - for example, providing super specialties such as cancer and burns treatment - impact on the costs of providing services within the hospital. However, subject to those qualifications, it is true that Fremantle Hospital is our most efficient tertiary hospital.
(1)-(2) It is fairly obvious that the answer to the second question posed by the member for Alfred Cove is that it is a complete nonsense to suggest that a comprehensive tertiary service can be provided through a general or community hospital. It simply cannot be done. In answer to the first question, the decision about where future tertiary services should be located has more to do with strategic positioning and clinical service planning in relation to population and growth requirements than the relative cost effectiveness of current hospitals, although that is obviously a factor. Suitability of a location, infrastructure conditions and ease of expansion are also among the factors that should be assessed. The key performance indicator generally used to reflect relative cost effectiveness, at least in terms of admitted patients, is the average cost per case mix adjusted inpatient episode. Over the past few years, this indicator as reported by Fremantle Hospital for that area has averaged about 18 per cent lower than the report of the other two general teaching hospitals - that is, Royal Perth Hospital and Sir Charles Gairdner Hospital. To be specific, the average cost per case mix adjusted inpatient episode at Fremantle Hospital for the past few years is $2 760. For Royal Perth Hospital it is $3 399 and for Sir Charles Gairdner Hospital it is $3 342. It should be noted, however, that although this is a good indicator, other important factors, such as the degree of complexity within the case mix of the inpatient episode and the broader role of the hospital - for example, providing super specialties such as cancer and burns treatment - impact on the costs of providing services within the hospital. However, subject to those qualifications, it is true that Fremantle Hospital is our most efficient tertiary hospital.
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