Department of Health

Acute admitted care is care provided to patients who have undergone a formal admission process, where the clinical intent or treatment goal is the provision of acute care.

For more information on admitted services, please refer to the Victorian Hospital Admission Policy and the Victorian Admitted Episodes Dataset (VAED) criteria for reporting.

Scope

Eligible facilities in scope for activity based funding in the acute admitted care stream are all current health services that report to the VAED, except those health services listed at Appendix A of the Independent Health and Aged Care Pricing Authority’s National Efficient Cost Determination

Classification

Australian Refined Diagnosis Related Groups (AR-DRG) are used to classify acute admitted care.

Price weights expressed as national weighted activity units are set out in the annual National Efficient Price Determination.

Counting

All acute admitted care data are collected at the patient level and reported through the VAED.

The unit of count for Activity Based Funding (ABF) acute admitted care is ‘inpatient separation’. It includes stays for patients who are treated and go home, and patients who are subsequently admitted to hospital or transferred to another facility for further care.

Costing

Cost data for ABF acute admitted care is collected at the patient level. All Victorian health services are required to submit annual patient-level cost data to the Victorian Cost Data Collection (VCDC). VCDC data is then submitted to the National Health Cost Data Collection (NHCDC) via the Independent Health and Aged Care Pricing Authority (IHACPA).

Key differences between pre-2021-22 Weighted Inlier Equivalent Separation (WIES) model and National model adopted from 2021-22

Component Difference
Funding model and data sources

WIES: Victorian Admitted Episodes Dataset and Victorian cost data collection.

National: Admitted Patient Care dataset and National Hospital Cost Data Collection 

ICU adjustment

WIES: Per WIES basis for mechanical or non-invasive ventilation, six hour continuous ventilation condition applies, as per list of approved hospitals.

National: Paid on hourly basis for mechanical ventilation hospitals, no NIV loading. Specified list of ICU hospitals in National Efficient Price determination. No loading for: Austin Repat, Hamilton, Goulburn Valley, Wangaratta, Werribee Mercy, Angliss, Central Gippsland, Warrnambool, Horsham, Mildura, Latrobe, Casey.

Radiotherapy and dialysis

WIES: Vic modification (R64Z), conditional WIES based payments or special funding arrangements apply.

National: Dialysis loading: ~28 per cent loading for specified ACHI codes when not L61Z or L68Z. 
Radiotherapy loading: ~40 per cent loading for specified ACHI radiotherapy intervention codes.

Paediatric Patient adjustment

WIES: n/a

National: DRG specific adjustments capped and floored at 2.0 and 0.8 respectively. (applies to Monash and Royal Children's Hospital)

Indigenous Loading

WIES27: 4 per cent (WIES26 and prior = 30 per cent).

National: 4 per cent.

Private Patient adjustment

WIES: Public and private price.

National: Private patient discounts for accommodation and service adjustment. Private patient price neutrality factors apply from 2021 onwards.

Emergency

WIES: Funds admitted emergency component of activity.

National: Admitted activity and emergency presentations funded through separate national funding models.

Short stay observation

WIES: Designated short stay observation unit weight.

National: Funded through DRG price weight.

Loadings

WIES: Applies loadings for Thalassaemia, Abdominal aortic aneurysm, stent, atrial septal defect closure devices and cochlear prosthetic devices.

National: Funded through DRG price weight.

HITH

WIES: High outlier per diem discounted by 20 per cent.

National: Funded through DRG price weight.

Boundary policy, same-day /one day weights

WIES: Based on Victorian activity and costs.

National: Based on National activity and costs.

Vic Modification

WIES: R64Z Radiotherapy, B02Y Endovascular Clot Retrieval, L42Z Lithotripsy.

National: Unmodified AR-DRG classification.

Normative p15ricing for prostheses

WIES: Normative pricing for Hips and knees.

National: Funded through DRG price weight.

 

Reviewed 15 November 2022

Health.vic

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