Rowley knew that jibe might get me out of "lurkerdom."
The reference is to work in which I was involved more than 10 years ago. It
was initiated when it seemed likely that A&E Department funding, and hence
staffing, would be based simply on global numbers of attendances. We were
not seeking to build a system for billing single patients, rather a way of
making sure that, if a unit cared for a high proportion of demanding, very
ill patients, they would be better funded than one with same total numbers
but a high proportion of very minor work. We wanted to use information
which would be collected anyway, rathert than an expensive new dataset. At
that time we found the best discriminator was disposal at the end of episode
(discharged, clinic follow-up or admitted). Of course, in any group there
will be outliers. Triage category worked well in Australia but was a bit
inconsistent in the UK at that time.
The various tests specified have refined the casemix measures but there will
always be variation in a group.
The linking of fixed amounts of money to the groups was always scarey and
was not something in which I had a direct part. Unfortunately work intended
to make sure there is adequate resourcing can also be used to cut you down,
depending on the pricing scale used. More and better data may be useful in
arguing for improved pricing but folk need to understand that any discussion
will be about broad groups, not individual cases.
This is a bit like the clothes in Granny's attice becoming fashionable if
you keep them long enough. Sorry chaps
Jonathan
----- Original Message -----
From: "Rowley Cottingham" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Wednesday, March 22, 2006 10:14 AM
Subject: Re: Corrected tariff for the 2006/07 Payment by Results
> Maybe it has moved, but I find it here:
>
> http://www.ic.nhs.uk/casemix/downloads/sub8/AEDefinitionsManual.pdf/file
>
> I see the blame is placed firmly at a Dr Marrow's door!
>
> /Rowley./
>
>
>
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