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Hospital Circular 24/1995

Date Issued: 11 September 1995
Publication: 24/1995
Distribution: Public Hospitals
Subject: Provision of Aids and Equipment and Domiciliary Oxygen
Purpose: To advise of the new division of responsibility for the provision of aids, equipment and domiciliary oxygen between public hospitals and the Program of Aids for Disabled People (PADP).

Background

  1. There have been significant difficulties experienced by discharged patients requiring the provision of aids, equipment and domiciliary oxygen. The new arrangements are designed to clarify hospitals' responsibilities for the provision of these services following the introduction of casemix funding, as well as the role of the PADP.

  2. The purpose of this Hospital Circular is to announce a more streamlined policy which will improve patient service and clarify agency responsibilities.

  3. This policy is effective 1 October 1995.

Public Hospital Responsibility

  1. Public hospitals have a responsibility to provide aids and equipment (including domiciliary oxygen) required by patients for a safe and effective discharge. This equipment may be defined as that which is necessary for recuperation and, if not provided, would result in either continued hospitalisation or readmission to hospital.

  2. For admitted patients who do not have a certifiable permanent or long term disability, hospitals must provide any aids and equipment necessary to enable discharge for as long as these are required. This shall be at no cost to the patient for a period of 30 days. Hospitals may charge fees for these aids and equipment after the expiry of the 30 day?period as stipulated in the Hospital Conditions of Funding with respect to outpatient services.

  3. For admitted patients, who have or are likely to have a certifiable permanent or long term disability, hospitals must provide any aids and equipment necessary to enable discharge for a period of 30 days after discharge at no cost to the patient. PADP will assume this responsibility thereafter (as per paragraph 10 below).

  4. The exception to paragraph 6 is that where a patient is already in receipt of PADP assistance, and is admitted for an unrelated condition, PADP will continue to provide aids and equipment (including domiciliary oxygen) upon discharge.

  5. These arrangements link hospital responsibility more clearly to the acute admission episode and the core business of acute hospitals.

PADP Responsibility

  1. The objective of PADP is to provide functional aids and equipment to people with certifiable permanent or long term disabilities to enable them to remain living in their own homes.

  2. Thirty days after discharge from hospital, PADP will assume responsibility for the provision of aids and equipment, as set out in its approved list, to patients who have a certifiable permanent or long term disability, subject to paragraph 7 above.

  3. PADP guidelines will be amended so that all outpatients with a certifiable permanent or long term disability will now be eligible for aids and equipment (including domiciliary oxygen) under the PADP. This means that patients who attended outpatient clinics five or more times in the previous year are no longer excluded from PADP eligibility.

  4. PADP guidelines will also be amended so that domiciliary oxygen will be made available 30 days after discharge from a public hospital to all people meeting the Australian and New Zealand Thoracic Society guidelines for the provision of domiciliary oxygen (WA, Vol 154, 1 April 1991), with no waiting period.

Monitoring and Review

  1. The Department will monitor utilisation patterns for a period of twelve months to assess the impact of these new arrangements, and in particular:

    • the extent of demand arising from discharged patients;
    • the extent of demand arising from utilisation by "chronic outpatients"; and
    • the extent to which "new" demand is generated by the promulgation of new PADP guidelines and improved patient information about the program.

    Hospitals may also wish to formally monitor the impact of these new arrangements on their resource utilisation and referral patterns in order to assess the impact on their local circumstances.

  2. A key objective of this policy is for service?delivery to be as "seamless" as possible from a patient perspective. Consequently, hospitals should incorporate timely referral to PADP in care planning processes. Hospitals are also encouraged to take the opportunity afforded by the new policy to review arrangements and agreements currently in place with PADP Issuing Centres to optimise a smooth transition for patients from hospital to PADP responsibility.

  3. During the implementation period, any refinements, observations or suggested improvements regarding this policy should be forwarded by agencies to the relevant H&CS Regional Office.

Dr Michael Walsh
Director
Acute Health Services

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