Non-payment for hospital-acquired infections could provide an incentive to reduce complications of care
Removing reimbursements to hospitals for treating hospital-acquired conditions (HACs) could add further incentive to current initiatives aimed at reducing complications of care, according to research published in the Medical Journal of Australia.
Mr Peter McNair, Clinical Epidemiologist at the Palo Alto Medical Foundation Research Institute, US, and Visiting Fellow at the University of California, San Francisco (UCSF), and co-authors conducted a retrospective study to model the effect of excluding payment for eight HACs on hospital payments in Victoria.
Such a policy has been implemented by the US Centers for Medicare and Medicaid Services, which ceased paying for eight specific HACs that are considered preventable.
Mr McNair said the study found that introducing a non-payment for HACs policy similar to that introduced in the US would have little direct financial impact in the Australian context.
“Based on 2007-08 hospital admission data, we estimate that the HACs policy would reduce total hospital payments by between $448,630 (0.01 per cent) and $1,690,724 (0.03 per cent),” he said.
“The financial impact for public hospitals would be between $302,914 (0.01 per cent) and $1,329,049 (0.04 per cent).”
The study found that although the potential impact of the HACs policy in Victoria was small, it was 10 times the estimated proportion of payments affected by the policy in the US.
Mr McNair said the main benefit of the HACs payment policy might be from reduced patient morbidity rather than large reductions in hospital payments.
“The HACs policy is predicated on the theory that financial incentives will at least raise the profile of the eight HACs and, at best, encourage systematic measures for minimising the likelihood of complications of care,” he said.
“Although the financial impact of introducing such a policy in jurisdictions using Australian refined diagnosis-related groups might be greater than the impact in the US, the policy would be unlikely to have a major detrimental impact on any single hospital, and might augment other initiatives to reduce complications of care.”
The Medical Journal of Australia is a publication of the Australian Medical Association.
The statements or opinions that are expressed in the MJA reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.
CONTACT: Mr Peter McNair 0011 1 415 630 3295 / mcnairp@pamfri.org
