Investing in acute health services: is it time to change the paradigm?

Objective: Capital is an essential enabler of contemporary public hospital services funding hospital buildings, medical equipment, information technology and communications. Capital investment is best understood within the context of the services it is designed and funded to facilitate. The aim of t...

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Main Authors: Kerr, R., Hendrie, Delia, Moorin, Rachael
Format: Journal Article
Published: CSIRO Publishing 2014
Subjects:
Online Access:http://hdl.handle.net/20.500.11937/38678
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author Kerr, R.
Hendrie, Delia
Moorin, Rachael
author_facet Kerr, R.
Hendrie, Delia
Moorin, Rachael
author_sort Kerr, R.
building Curtin Institutional Repository
collection Online Access
description Objective: Capital is an essential enabler of contemporary public hospital services funding hospital buildings, medical equipment, information technology and communications. Capital investment is best understood within the context of the services it is designed and funded to facilitate. The aim of the present study was to explore the information on capital investment in Australian public hospitals and the relationship between investment and acute care service delivery in the context of efficient pricing for hospital services. Methods: This paper examines the investment in Australian public hospitals relative to the growth in recurrent hospital costs since 2000–01 drawing from the available data, the grey literature and the reports of six major reviews of hospital services in Australia since 2004. Results. Although the average annual capital investment over the decade from 2000–01 represents 7.1% of recurrent expenditure on hospitals, the most recent estimate of the cost of capital consumed delivering services is 9% per annum. Five of six major inquiries into health care delivery required increased capital funding to bring clinical service delivery to an acceptable standard. The sixth inquiry lamented the quality of information on capital for public hospitals. In 2012–13, capital investment was equivalent to 6.2% of recurrent expenditure, 31% lower than the cost of capital consumed in that year.Conclusions: Capital is a vital enabler of hospital service delivery and innovation, but there is a poor alignment between the available information on the capital investment in public hospitals and contemporary clinical requirements. The policy to have capital included in activity-based payments for hospital services necessitates an accurate value for capital at the diagnosis-related group (DRG) level relevant to contemporary clinical care, rather than the replacement value of the asset stock.
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spelling curtin-20.500.11937-386782017-09-13T14:15:05Z Investing in acute health services: is it time to change the paradigm? Kerr, R. Hendrie, Delia Moorin, Rachael hospital services clinical care recurrent hospital costs diagnosis-related group (DRG) acute care service delivery Capital investment Objective: Capital is an essential enabler of contemporary public hospital services funding hospital buildings, medical equipment, information technology and communications. Capital investment is best understood within the context of the services it is designed and funded to facilitate. The aim of the present study was to explore the information on capital investment in Australian public hospitals and the relationship between investment and acute care service delivery in the context of efficient pricing for hospital services. Methods: This paper examines the investment in Australian public hospitals relative to the growth in recurrent hospital costs since 2000–01 drawing from the available data, the grey literature and the reports of six major reviews of hospital services in Australia since 2004. Results. Although the average annual capital investment over the decade from 2000–01 represents 7.1% of recurrent expenditure on hospitals, the most recent estimate of the cost of capital consumed delivering services is 9% per annum. Five of six major inquiries into health care delivery required increased capital funding to bring clinical service delivery to an acceptable standard. The sixth inquiry lamented the quality of information on capital for public hospitals. In 2012–13, capital investment was equivalent to 6.2% of recurrent expenditure, 31% lower than the cost of capital consumed in that year.Conclusions: Capital is a vital enabler of hospital service delivery and innovation, but there is a poor alignment between the available information on the capital investment in public hospitals and contemporary clinical requirements. The policy to have capital included in activity-based payments for hospital services necessitates an accurate value for capital at the diagnosis-related group (DRG) level relevant to contemporary clinical care, rather than the replacement value of the asset stock. 2014 Journal Article http://hdl.handle.net/20.500.11937/38678 10.1071/AH13226 CSIRO Publishing fulltext
spellingShingle hospital services
clinical care
recurrent hospital costs
diagnosis-related group (DRG)
acute care service delivery
Capital investment
Kerr, R.
Hendrie, Delia
Moorin, Rachael
Investing in acute health services: is it time to change the paradigm?
title Investing in acute health services: is it time to change the paradigm?
title_full Investing in acute health services: is it time to change the paradigm?
title_fullStr Investing in acute health services: is it time to change the paradigm?
title_full_unstemmed Investing in acute health services: is it time to change the paradigm?
title_short Investing in acute health services: is it time to change the paradigm?
title_sort investing in acute health services: is it time to change the paradigm?
topic hospital services
clinical care
recurrent hospital costs
diagnosis-related group (DRG)
acute care service delivery
Capital investment
url http://hdl.handle.net/20.500.11937/38678