The DRG system inadequately evaluates costing in palliative care; moreover, funding systems based on prodiem costs are poorly estimated and tend to create negative funding incentives. This study represents the first step in evaluating variables capable of validating resource utilisation and consequently cost-weights, aiming to facilitate development of an appropriate data set for a patient-needs based classification and rational resource allocation in a community PC setting. The present report aims to verify the variables, identified as cost drivers in a large Australian study, qualify their usefulness on a routine basis, and as indicators of resource drivers.
Methods: The sample group consists of 90 pts admitted to a Hospice at Home service from Jan.’03 and deceased at the time of analysis. Data were recorded for each patient on a daily basis and included: Palliative care phase (stable, unstable, deteriorating, terminal) Functional dependency: RUGADL Problem Severity Score (pain, symptoms, psycho social problems pt/ family) Patient attributable time Staff care provider A preliminary data analysis is currently ongoing. A multiple regression model will be used to analyse variations in resource utilisation against age, KPS, Phase, RUGADL, PSS as independent variables.
Results: To date the only available result is a descriptive summary of variables. Failure in recording data and a low specificity of PSS, which resulted as being too subjective, appear to be the most important issues to be corrected along with poor consensus amongst staff in defining Phase change. The complete final report will be included in the presentation.
Conclusions: The measurement tools could be appraised with celerity and required minimal observation. However, further definition of PPS tools is required together with better staff awareness in correct data collection.