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Reduction in length of hospital stay for acute childhood asthma associated with the introduction of casemix funding
Author(s) -
South Mike
Publication year - 1997
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1997.tb138755.x
Subject(s) - asthma , medicine , emergency medicine , acute care , adverse effect , prospective cohort study , health care , pediatrics , economics , economic growth
Objective To examine changes to hospital admission rates, length of stay (LOS), bed use, and unplanned readmission rates for children with acute exacerbations of asthma following the change of the Victorian health care system to casemix funding. Setting Large university‐affiliated children's hospital in Melbourne, Victoria. Design Prospective collection of data from July 1989 to June 1996 for all children admitted with acute asthma (n= 11 939). Results The number of admissions for acute asthma showed a rising trend before the introduction of casemix funding in July 1993, and subsequently fell. There was a significant fall in mean LOS (64.5 to 39 hours; ‐40%; P=0.001), and hence in bed‐ hours occupied for asthma (115370 to 61116; ‐47%; P=0.001). There were no increases in unplanned readmission rates for asthma within the next seven or 14 days. Conclusion LOS and bed use for acute asthma at our hospital have been significantly reduced since the introduction of casemix funding, although this study does not prove a causal relationship. There was no increase in readmission rates, and thus no suggestion of any adverse effects as a result of reducing LOS. The 47% reduction in bed‐hours should lead to large reductions in cost to the hospital.