Safety And Quality Practices In Australian Health Care †Free Samples

Question: Discuss about the Safety And Quality Practices In Australian Health Care. Answer: Introduction The outcome of the paper is the thorough literature review on the safety and quality practices in Australian health care for pricing and funding arrangements undertaken by the IHPA and commission. The aim of the assignment is to discuss the four funding models defined by Egar et al. (2013) as used by the public hospitals in Australia. Further, the system of the National Efficient price is critically discussed. In this regard, it is discussed as to how this system may provide an incentive to improve the health status of any selected segment of the Australian population. Funding models The four overarching models used by public hospitals in Australia, which are identified by the literature review of IHPA and commission are- Best practice pricing Normative pricing Quality structure pricing models Payment for performance or safety and quality pricing The Best practice pricing is the model that refers to use of the car pathways that are based on strong evidence. The best solution is for treatment of the particular health condition and for which the hospitals would be paid a set fee. Based on the best evidence, the price for implementing this model of care is decided and an additional incentive is paid. There is a limited literature evaluating the efficacy of this model as this scheme represents the value for money. In England, the health care system had implemented the scheme of Best Practice Tariffs. However, there is limited conclusive evidence except for the findings from the National Hip Fracture Database of UK (Eagar et al., 2013). As per the literature review by the IHPA on this model, the best practice pricing has modest gains with methodological inadequacies as evidence based care pathways can be implemented for limited conditions. Normative pricing is the system where the price is used to influence the outcomes of delivery of care. It may be used in certain cases such as incentivising the day surgeries or when there is a need of more home care nurses, for a particular disability or illness, or where the patient seeks residential care. Substantial improvement was noted by implementing this pricing system in the radiology area. There is a lack of conclusive evidence on the use of this pricing system due to uncertainty in determining the cost of implementing the new model (Eagar et al., 2013). In the Quality structure pricing models, the pricing or funding is linked with the meeting of the accreditation standards by the health care providers, participation in the safety improvement activities, quality registries, and clinical benchmarking. The aim of this system to increase savings, however, there might be high initial cost. The pricing or the funding may be high for accredited hospitals and then the non-accredited counterparts. There is strong evidence that this kind of funding system leads to improvement in quality and safety (Eagar et al., 2013). However, it lacks the direct measuring of patient outcomes. The Payment for performance is the funding model that refers to pushing the care providers to improve the quality and safety by behaving in certain manner. The model uses financial incentives for positive clinical outcomes or disincentives for poor services. It aims to encourage the service givers to increase the quality through rewards and penalty. There is a lack of evidence on beneficial outcomes from this scheme. However, in England an advancing quality initiative was taken and the results showed improvement in quality scores and reduction in short-term in-hospital mortality. It means there were few deaths due to heart failure or pneumonia (Eagar et al., 2013). National Efficient price In Australia, the National Efficient price or NEP is used for identifying the contribution of the commonwealth to public hospital funding. In this system each hospital will be paid a fixed fee for each episode of care. As per activity based funding, the contributions determined by IHPA to be paid by the Australian government is the approximately 40% of the public hospital funding. The commonwealth contribution may be influenced if IHPA builds any incentives into the model for quality and safety. In case any hospital is in deficit then expecting the states to fund the deficit will hamper the potential of NEP to improve efficiency (Eagar et al., 2013). Based on the literature review all the above mentioned funding models lack strong evidence in regards to their efficacy in improving the quality and safety of the health care services. Considering the grey literature, I agree that NEP may not be able to provide an incentive to improve the health status of any selected segment of the Australian population to a great extent. It is difficult to determine the level at which the scheme actually work or is critical (Downie, 2015). It is because it is difficult to identify the onset of health condition. The major limitation of NEP includes misallocation of resources in cases the set price does not reflect the relative cost-effectiveness of these services. Further, each hospital will have losses if they give care above the fixed price. Consequently, it may result in patient dumping, and recruitment of more enrolled nurses (Sheridan, 2016). Further, it is doubtful that the major changes will be stimulated in the public hospitals of Australia in regards to safety and quality. It because the funding for the public hospital is not directed to specific clinical departments within the hospitals or to the specific hospitals. It means to have any effect; there is a need of delivering the incentives to a level of the clinical department. Bu there are no rewards for quality (Eagar et al., 2013). Since some hospitals in rural areas have disadvantage. Therefore, there is a need of considering the potential for regional disparities to improve the quality of the health care to a great extent (Safetyandquality.gov.au, 2017). Although the activity based funding has the potential to make the functioning of the hospitals more efficient, there are flaws in the manner the scheme is designed. There is a chance that the flaws may negatively influence the potential cost savings. Eventually it will result in ineffective funding system and poor change in the quality of care (Eagar et al., 2013). If the providers find that the incentives are substantial then they might change the care pathways or behaviour. Otherwise the chances are less that the clinicians would respond to incentives. Further, there are chances that the pricing will only affect some aspects of care (Safetyandquality.gov.au, 2017). Thus the only way the NEP can secure efficiency gains by stimulating the change behaviour of the health professionals. References Downie, J. (2015). Possible options for introducing quality aspects in Activity-Based Funding pricing.BMC health services research,15(2), A2. Eagar, K., Sansoni, J., Loggie, C., Elsworthy, A., McNamee, J., Cook, R., Grootemaat, P. (2013). A literature review on integrating quality and safety into hospital pricing systems. Safetyandquality.gov.au. (2017).Supplementary Briefing and Literature Update Integrating safety and quality into hospital pricing systems.safetyandquality.gov.au. Retrieved 12 October 2017, from https://safetyandquality.gov.au/wp-content/uploads/2012/12/Supplementary-Briefing-and-literature-update-on-pricing-for-safety-and-quality3.pdf Sheridan, J. (2016).Activity Based Funding: The implications for Australian health policy(Master's thesis, University of Sydney).