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Outpatient costing and classification: are we any closer to a national standard for ambulatory classification systems?
Author(s) -
Cleary Michael I,
Murray Jo M,
Michael Robin,
Piper Kym
Publication year - 1998
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.1326-5377.1998.tb123472.x
Subject(s) - ambulatory , activity based costing , medicine , ambulatory care , medical emergency , emergency department , family medicine , emergency medicine , health care , nursing , business , surgery , political science , marketing , law
Synopsis The Outpatient Costing and Classification Study was commissioned by the Department of Health and Family Services to evaluate the suitability of the Developmental Ambulatory Classification System (DACS). Data on the full range of ambulatory services (outpatient clinics, emergency departments and allied health services) were collected prospectively from a stratified sample of 28 public hospitals. Patient encounters captured in the study represent 1% of the total ambulatory encounters in Australia in one year. Costing per encounter included time spent with the patient, cost of procedures, indirect costs (salaries and consumables), overhead costs and diagnostic costs. The most significant variable explaining cost variation was hospital type, followed by outpatient clinic type. Visit type and presence or absence of a procedure ‐‐‐ major splits for the proposed DACS ‐‐‐ did not produce splits that were consistent across all hospital strata. The study found that DACS is not an appropriate classification for hospital ambulatory services. A clinic‐based structure for outpatients and allied health departments is recommended for classifying and funding ambulatory services in Australia.