Developing a classification for artificial limbs
Duration: October 2012 – December 2013
Download the final report:
Gordon R, Navakatikyan M and Green J (2014) Developing a classification for artificial limbs: Final report. Centre for Health Service Development, Australian Health Services Research Institute, University of Wollongong.
EnableNSW is the government agency responsible for funding the provision of artificial limb services to eligible clients in NSW. Artificial limb services are provided to clients on behalf of EnableNSW by commercial limb manufacturers. EnableNSW is looking to implement a range of policy options, including funding reforms, to improve the effectiveness and efficiency with which artificial limb services are provided. The CHSD was commissioned in late 2012 by EnableNSW to undertake a project to contribute to this reform process.
What we did
One potential way to improve the efficiency of the current model is to develop a classification system that assigns services into resource homogeneous classes. This offers the potential advantage of streamlining payment arrangements by allowing manufacturers to be paid based on the number of services provided to clients in a particular class rather than being required to invoice for individual services. Under such a scenario, it is important to ensure that the classification system does not have any adverse impacts on either the funder or the provider and equally that the system does not introduce any unintended or perverse incentives.
In this context, the core objectives of the current project were to:
- Undertake a systematic analysis of existing EnableNSW cost and service use data to assess the potential to develop an artificial limb classification system;
- Based on the results of the above analysis, develop a classification system that accurately classifies the range of artificial limb services funded by EnableNSW;
- Test the impact of the classification, using a set of funding rules that could be applied in the payment of artificial limb services.
The project was undertaken in two stages. The first stage involved obtaining data from EnableNSW, developing a study dataset and conducting a range of exploratory analyses. The second stage involved applying recognised classification development principles to produce a recommended classification and an associated set of funding rules.