Review and update of the NSW prosthesis relative value units

Review and update of the NSW prosthesis relative value units

NSW Ministry of Health

Duration: August 2013 – September 2013

Background

The National Casemix and Classification Centre (NCCC) was engaged by the NSW Ministry of Health to develop Relative Value Units (RVUs) based on AR-DRG Version 6.x. RVUs are used in health service costing when there is insufficient patient utilisation data available to enable actual costs to be allocated to individual episodes. The last revision of prosthesis weights in 2005 did not include the use of NSW data. These NSW specific RVUs were to be applied for the costing of 2012/13 patient activity.

What we did

The costing data from 20 NSW hospitals were analysed. In these hospitals, costs had been allocated using prosthesis utilisation data and therefore should be reflective of actual costs. The data underwent a rigorous testing, and as a result, a number of costed episodes, and the entire dataset in the case of two hospitals, were discarded.

A set of RVUs were developed in Version 6.x AR-DRGs. The new RVUs were then included in detailed comparative analysis against the service weights which had previously been used to allocate prosthesis costs. In testing, the performance of the RVUs was greatly improved compared to the service weights, particularly in the areas of mental health and drug and alcohol treatment where the use of prostheses would be expected to be negligible.

The use of these RVUs in the costing of patient episodes for the 2012/13 year is expected to provide significant improvements in the quality and reliability of the costing data.

Last reviewed: 23 March, 2016

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