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Effect of casemix funding on outcomes in patients admitted to hospital with suspected unstable angina
Author(s) -
Kerr Geoffrey D,
Dunt David,
Gordon Ian R
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.tb126711.x
Subject(s) - medicine , unstable angina , confidence interval , emergency medicine , angina , coronary care unit , prospective cohort study , coronary heart disease , surgery , myocardial infarction
Objectives To determine the effect of the introduction of casemix funding on resource utilisation and clinical outcomes in patients admitted to hospital with suspected unstable angina. Design A prospective cohort study with a 6‐month follow‐up. Setting A suburban community hospital in Melbourne, Victoria. Patients 336 consecutive patients admitted to the coronary care unit with suspected unstable angina before (156) and after (180) the introduction of casemix funding. Intervention Introduction of casemix funding in July 1993. Main outcome measures Indices of resource utilisation: length of stay in hospital, length of stay in the coronary care unit, and total cost of investigations (pathology and radiology). Rates of serious cardiac events during hospital stay and after discharge. Readmissions within 28 days and 6 months of discharge. Results After the introduction of casemix funding there was a 1 % increase in duration of hospital stay and a 5% increase in time spent in the coronary care unit, but neither of these increases was statistically significant. However, there was a significant reduction in total cost of investigations (39% decrease; 95% confidence interval, 14%‐70%; P< 0.001). The rate of serious cardiac events after discharge did not increase, and neither did readmission rates, either within 28 days or over the 6 months' follow‐up. Conclusion Casemix funding had no effect on short term clinical outcomes but resulted in significantly reduced investigation costs.