❓ Hon Nick Goiran questions the Health Minister about funding discrepancies between level two and level three palliative care beds, given that level three beds require more specialised services. The Minister's answer explains the complexities of cost calculation and the lack of formal endorsement of the Palliative Care Australia framework within WA Health.
AnsweredQoN 4822Legislative Council
QuestionView source ↗
In relation to the answer to question on notice No. 3975 given by the Minister for Health on 9 August 2011 regarding the average cost of each Palliative Care day bed, I ask -
Given that a specialist care level three bed requires a more specialised service, in what circumstances is it appropriate for a level two bed to be given greater funding than a level three bed?
Given that a specialist care level three bed requires a more specialised service, in what circumstances is it appropriate for a level two bed to be given greater funding than a level three bed?
AnswerView source ↗
Answered
22 November 2011
Responded by
Minister for Mental Health representing the Minister for Health
Response time
35 days
There are many factors that influence the average cost of each palliative care level 2 and level 3 bed reported in PQ 3975.
The terms specialised specialist palliative care level one, two and three relate to the peak body Palliative Care Australia's (PCA) Capability and Resource Matrix framework described in the document "Standards for providing quality palliative care for all Australians" (2005.)
The PCA terms for categorising specialised palliative care service levels are not endorsed for use within the WA Department of Health nor are services formally funded or resourced according to this framework. Without clear definitions for the specialist levels, any reporting in relation to this framework will inevitably have inconsistencies.
Specialised palliative care services may self nominate a specialist service level when participating in the voluntary PCA National Standards Assessment Program. The nomination of the specialist level relates to the service ability to meet the national standards but not to funding and resources.
Palliative care bed usage is captured within health data as "palliative care type." For reporting purposes palliative care type will also capture patients who are in general hospital beds and not just in dedicated specialised palliative care units.
Economies of scale come into play. These factors may include:
The number of patients;
The number of specialist staff;
The ratio of specialist staff to patient numbers;
Hospital size - efficiencies that come with ability to apportion overhead costs across a high number of patients.
If a palliative care service is provided in a smaller hospital and not necessarily via a dedicated palliative unit; and there is a relatively small number of patients that will still require a minimum number of specialist staff; the high ratio of specialist staff per patient may, when combined with the apportionment of general overhead costs, result in a relatively high cost per patient.
Whereas a palliative care service that is provided by a dedicated palliative care unit as part of a larger hospital may have a higher number of patients and therefore a better staff to patient ratio. Additionally the larger hospital can be more efficient in terms of cost per bed day through having the opportunity to allocate overhead costs etc across a larger patient and service base.
Notice: This document is created or edited using unregistered or evaluation copy of rtLib valid for testing or development purposes only. To use it for productive or any other purposes please register it. You may purchase the license on
http://www.rtlib.com
The terms specialised specialist palliative care level one, two and three relate to the peak body Palliative Care Australia's (PCA) Capability and Resource Matrix framework described in the document "Standards for providing quality palliative care for all Australians" (2005.)
The PCA terms for categorising specialised palliative care service levels are not endorsed for use within the WA Department of Health nor are services formally funded or resourced according to this framework. Without clear definitions for the specialist levels, any reporting in relation to this framework will inevitably have inconsistencies.
Specialised palliative care services may self nominate a specialist service level when participating in the voluntary PCA National Standards Assessment Program. The nomination of the specialist level relates to the service ability to meet the national standards but not to funding and resources.
Palliative care bed usage is captured within health data as "palliative care type." For reporting purposes palliative care type will also capture patients who are in general hospital beds and not just in dedicated specialised palliative care units.
Economies of scale come into play. These factors may include:
The number of patients;
The number of specialist staff;
The ratio of specialist staff to patient numbers;
Hospital size - efficiencies that come with ability to apportion overhead costs across a high number of patients.
If a palliative care service is provided in a smaller hospital and not necessarily via a dedicated palliative unit; and there is a relatively small number of patients that will still require a minimum number of specialist staff; the high ratio of specialist staff per patient may, when combined with the apportionment of general overhead costs, result in a relatively high cost per patient.
Whereas a palliative care service that is provided by a dedicated palliative care unit as part of a larger hospital may have a higher number of patients and therefore a better staff to patient ratio. Additionally the larger hospital can be more efficient in terms of cost per bed day through having the opportunity to allocate overhead costs etc across a larger patient and service base.
Notice: This document is created or edited using unregistered or evaluation copy of rtLib valid for testing or development purposes only. To use it for productive or any other purposes please register it. You may purchase the license on
http://www.rtlib.com
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