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Journal articles on the topic 'Public hospitals Victoria Finance'

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Published: 10 December 2022

Last updated: 29 January 2023

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1

Sipra, Muhammad Wajid Khurshid, Muhammad Abdul Raziq, and Zia Ullah. "Fungal Species Detection in Onychomycosis by Culture and Direct Microscopy at Tertiary Care Hospital, Bahawalpur, Pakistan." Journal of Rawalpindi Medical College 26, no. 2 (June 30, 2022): 261–65. http://dx.doi.org/10.37939/jrmc.v26i2.1836.

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Objective: This study aimed to detect the common organisms by culture and KOH mount microscopy of nail infections.Setting: It was cross sectional study. Three hundred sixty clinically diagnosed cases were collected from 1st July 2018 to 31st July 2021 from Dermatology OPD of Bahawal Victoria Hospital and clinics. The samples were processed in the Microbiology section of the Pathology department of Quaid-e-Azam Medical College Bahawalpur, Pakistan. Method: The nail specimen was directly inoculated on SDA culture media and aerobically incubate at 25 Ć to 30 Ć for 3 to 4 weeks. The growth was identified in colony characteristics by using cotton blue stains. Whereas the nail is immersed in 20% KOH solution. The microscopic study revealed the hyphae or spores and that is considered a positive for the test. Result: out of three hundred sixty cases the culture positivity was 56.94% of the specimen while KOH mount was positive in 60.83% of specimens and the combination of Culture with KOH was 66.67%.Conclusion: The fungal culture and KOH mount microscopy combination are subtle laboratory methods for the detection of organisms causing onychomycosis. The species detection and precise usage of anti-mycological agents to prevent the complications raised public health considerably.

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Duckett, Stephen, and Amanda Kenny. "Hospital outpatient and emergencyservices in rural Victoria." Australian Health Review 23, no. 4 (2000): 115. http://dx.doi.org/10.1071/ah000115.

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Outpatient and emergency services in rural hospitals have rarely been studied. This paper analyses routinely collecteddata, together with data from a survey of hospitals, to provide a picture of these services in Victorian public hospitals.The larger rural hospitals provide the bulk of rural outpatients and emergency services, particularly so for medicaloutpatients. Cost per service varies with the size of the hospital, possibly reflecting differences in complexity. Fundingpolicies for rural hospital outpatient and emergency services should be sufficiently flexible to take into account thedifferences between rural hospitals.

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3

Sundararajan, Vijaya, Kaye Brown, Toni Henderson, and Don Hindle. "Effects of increased private health insurance on hospital utilisation in Victoria." Australian Health Review 28, no. 3 (2004): 320. http://dx.doi.org/10.1071/ah040320.

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The proportion of Victorians and Australians generally with private health insurance (PHI) increased from 31% in 1998 to 45% in 2001. We analysed a dataset containing all hospital separations throughout Victoria to determine whether changes in the level of private health insurance have had any impact on patterns of public and private hospital utilisation in Victoria. Total utilisation of private hospitals grew by 31% from 1998?99 to 2002?03, whereas utilisation of public hospitals increased by 18%. Total bed-days have increased in both private hospitals and public hospitals by 12%. The proportion of all separations at private hospitals has remained relatively stable between these 2 years, with 33% of all separations being private patients in private hospitals in 1998? 99, increasing slightly to 35% by 2002?03. Analysis of a number of specific DRGs shows that patients with more severe disease are more likely to be seen at public hospitals; notably this trend has strengthened between 1998?99 and 2002?03. The number of patients treated in Victorian public hospitals has continued to grow, despite a rapid increase in the utilisation of private hospitals. Given the limited extent of the shift in caseload share between the two sectors, the effectiveness of the Commonwealth?s subsidy of private health insurance as a mechanism to reduce pressure on the public sector needs to be carefully examined.

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McNair, Peter, and Stephen Duckett. "Funding Victoria's public hospitals: The casemix policy of 2000-2001." Australian Health Review 25, no. 1 (2002): 72. http://dx.doi.org/10.1071/ah020072.

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On 1 July 1993 Victoria became the first Australian state to use casemix information to set budgets for its public hospitals commencing with casemix funding for inpatient services. Victoria's casemix funding approach now embracesinpatient, outpatient and rehabilitation services.

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Bennett, Noleen J., Ann L. Bull, David R. Dunt, Lyle C. Gurrin, Denis W. Spelman, Philip L. Russo, and Michael J. Richards. "MRSA infections in smaller hospitals, Victoria, Australia." American Journal of Infection Control 35, no. 10 (December 2007): 697–99. http://dx.doi.org/10.1016/j.ajic.2006.12.011.

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6

O'Hara, Denise, and Chris Brook. "The utilisation of public and private hospitals in Victoria: An issue of access?" Australian Health Review 19, no. 3 (1996): 40. http://dx.doi.org/10.1071/ah960040b.

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Consumers regard access to hospital services as one of the key components of qualityin health care delivery. A mixed public/private system operates in Victoria, but amorbidity collection from private hospitals was commenced only relatively recently.In 1993?94 the collection covered 82- per cent of private hospital separations, andit was considered timely to examine the utilisation patterns in the private system andcompare them with those in the public system. Medical and surgical emergencies andother complex conditions and procedures are serviced largely in the public sector,whereas private hospitals are utilised for elective and less complex surgery and non-urgentconditions. Occupancy rates are around 79- per cent in public hospitals and67- per cent in private hospitals. Elective surgery waiting list data suggest that whileurgent cases are treated within a month, significant proportions wait six months ormore for non-urgent surgery. Private health insurance is the main factor indetermining access to and the utilisation private hospitals. The current MedicareAgreement and the move to separate the role of purchaser and provider may allowthe maximal utilisation of private hospitals and diminish the burden of chronicillness.

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7

Antioch, Kathryn M., Michael K. Walsh, David Anderson, and Richard Brice. "Forecasting hospital expenditure in Victoria: Lessons from Europe and Canada." Australian Health Review 22, no. 1 (1999): 133. http://dx.doi.org/10.1071/ah990133.

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This paper specifies an econometric model to forecast State government expenditure on recognised public hospitals in Victoria. The OECD's recent cross-country econometric work exploring factors affecting health spending was instructive. The model found that Victorian Gross State Product, population aged under 4 years, the mix of public and private patients in public hospitals, introduction of case mix funding and funding cuts, the proportion of public beds to total beds in Victoria and technology significantly impacted on expenditure. The model may have application internationally for forecasting health costs, particularly in short and medium-term budgetary cycles.

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RAMAN, RAMYA, and ANANTANARAYANAN RAMAN. "Public hospitals in Madras and people associated with them." National Medical Journal of India 35 (November 1, 2022): 112–17. http://dx.doi.org/10.25259/nmji_35_2_112.

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In this follow-up article, we refer to the other public hospital facilities of Madras, viz. the Lock and Naval Hospitals, the Native Infirmary, Lunatic Asylum, Eye Infirmary, Maternity Hospital (Egmore), and the Queen Victoria Hospital for Caste and Gosha Women, some of which are operational today. We also include brief notes on a few of the pioneering men and women, who contributed to the development of these facilities.

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9

Hanning, Brian W. T. "Impact on public hospitals if private health insurance rates in Victoria declined." Australian Health Review 28, no. 3 (2004): 330. http://dx.doi.org/10.1071/ah040330.

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The additional cost of treating acute care type Victorian private patients as public patients in Victorian public hospitals based on the current public sector payment model and rates was calculated, as was the loss of health fund income to public hospitals. If all private cases became public the net recurrent cost would be $1.05 billion assuming all patients were still treated. If private health insurance (PHI) uptake had declined to 23.3% as was projected without Lifetime Health Cover and the 30% rebate, the additional operating cost and income loss would be $385 million. This compares to the Victorian cost of the 30% rebate for acute hospital cases of $383 million. This takes no account of capital costs and possible public sector access problems. The analysis suggests that 31 extra operating theatres would be needed in the public sector (had the transfer of surgical patients from the public sector to the private sector not occurred). This analysis suggests that without the PHI rebate the current stresses on Victorian public hospitals would be increased, not decreased.

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10

Bennett, N., C. Boardman, A. Bull, M. Richards, and P. Russo. "Surgical Antibiotic Prophylaxis in Smaller Hospitals, Victoria, Australia." American Journal of Infection Control 34, no. 5 (June 2006): E82—E83. http://dx.doi.org/10.1016/j.ajic.2006.05.152.

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McLEAN, RALPH. "Small Rural Hospitals and Casemix Funding: Victoria, 1993-94." Australian Journal of Rural Health 2, no. 4 (August 1994): 33–36. http://dx.doi.org/10.1111/j.1440-1584.1994.tb00129.x.

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Carlon, Nicole, and Andrea Quanchi. "Private midwives in Public Hospitals: Creating choice for birthing families in Victoria." Women and Birth 30 (October 2017): 46. http://dx.doi.org/10.1016/j.wombi.2017.08.122.

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Stanton, Pauline. "Employment relationships in Victorian public hospitals: the Kennett years." Australian Health Review 23, no. 3 (2000): 193. http://dx.doi.org/10.1071/ah000193a.

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From 1992 to 1999, the Kennett government in Victoria moved to competitive market models of service delivery andthe measurement of service provision through casemix funding. Public hospital managers were given greateraccountability for the costs and provision of service delivery and a new range of service providers, many from theprivate sector, entered the public health market. The decentralisation of the industrial relations system led to newdevelopments in bargaining that brought both opportunities and problems. In the Victorian public health system therewas an increasing emphasis on decentralisation in both service provision and employment relations. In this paper Isuggest that there were contradictions in these developments for government, and new challenges and difficulties foremployers, employees and trade unions.

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Shih, S., R. Carter, S. Heward, and C. Sinclair. "Costs Related to Skin Cancer Prevention in Victoria and Australia." Journal of Global Oncology 4, Supplement 2 (October 1, 2018): 9s. http://dx.doi.org/10.1200/jgo.18.10800.

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Background: The aim of this presentation is to provide an update on the economic evaluation of the Australian SunSmart program as well as outline the cost of skin cancer treatment to the Victorian public hospital system. This follows the publication of two recently released published economic evaluations that discusses the potential effects of skin cancer prevention inventions. Aim: 1. To highlight the cost effectiveness of skin cancer prevention in Australia 2. To highlight the costs of skin cancer treatment in the Victorian public hospital system 3. To provide strong evidence to inform governments of the value of skin cancer prevention to reduce the costs of treatment in future years. Methods: Program cost was compared with cost savings to determine the investment return of the program. In a separate study, a prevalence-based cost approach was undertaken in public hospitals in Victoria. Costs were estimated for inpatient admissions, using state service statistics, and outpatient services based on attendance at three hospitals in 2012-13. Cost-effectiveness for prevention was estimated from 'observed vs expected' analysis, together with program expenditure data. Results: With additional $AUD 0.16 ($USD 0.12) per capita investment into skin cancer prevention across Australia from 2011 to 2030, an upgraded SunSmart Program would prevent 45,000 melanoma and 95,000 NMSC cases. Potential savings in future healthcare costs were estimated at $200 million, while productivity gains were significant. A future upgraded SunSmart Program was predicted to be cost-saving from the funder perspective, with an investment return of $3.20 for every additional dollar the Australian governments/funding bodies invested into the program. In relation to the costs to the Victorian public hospital system, total annual costs were $48 million to $56 million. Skin cancer treatment in public hospitals ($9.20∼$10.39 per head/year) was 30-times current public funding in skin cancer prevention ($0.37 per head/year). Conclusion: The study demonstrates the strong economic credentials of the SunSmart Program, with a strong economic rationale for increased investment. Increased funding for skin cancer prevention must be kept high on the public health agenda. This would also have the dual benefit of enabling hospitals to redirect resources to nonpreventable conditions.

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Lumley, Judith. "THE SAFETY OF SMALL MATERNITY HOSPITALS IN VICTORIA 1982-84." Community Health Studies 12, no. 4 (February 12, 2010): 386–93. http://dx.doi.org/10.1111/j.1753-6405.1988.tb00604.x.

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Williams, David J., and Jennifer R. Warfe. "THE CHARITIES SECTOR IN VICTORIA -CHARACTERISTICS AND PUBLIC ACCOUNTABILITY*." Accounting & Finance 22, no. 1 (February 25, 2009): 55–71. http://dx.doi.org/10.1111/j.1467-629x.1982.tb00130.x.

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Canaway, Rachel, Marie Bismark, David Dunt, and Margaret Kelaher. "Public reporting of hospital performance data: views of senior medical directors in Victoria, Australia." Australian Health Review 42, no. 5 (2018): 591. http://dx.doi.org/10.1071/ah17120.

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Objective The aim of the present study was to better understand senior medical directors’ perceptions of public reporting of hospital performance data, how public reporting affects institutional behavioural change towards quality improvement and how it could be improved. Methods Interviews were undertaken with 17 medical directors representing 26 metropolitan and regional public hospitals in Victoria, Australia, between June and August 2016. Data were analysed thematically. Results Medical directors are well placed to comment on clinical and administrative aspects of quality, safety and performance monitoring in public hospitals. Their responses largely suggested that public reporting of hospital performance data in Australia is immature and not fulfilling its potential. There was little consensus among informants around what public reporting is, who it is for or its purpose. Although public reporting was considered to have important functions for hospitals and consumers, it was generally considered to lack robustness and have underutilised potential to inform consumers, build trust and drive quality and performance improvements within hospitals. Conclusions The next steps needed to advance public reporting of hospital performance data in Australia include engaging clinicians and patients in selection and development of metrics, improving timeliness of reporting, and improving communication of information so that it is accessible and meaningful for different audiences. What is known about the topic? Public reporting of hospital performance data is a mechanism increasingly used in the Australian health system, but it has attracted little research. What does this paper add? This paper reveals a lack of shared understanding among medical directors in Victoria, Australia, on what public reporting of hospital performance data is, who it is for and its purpose. The paper highlights the potential importance of public reporting of hospital performance data for rural and regional healthcare consumers and how it may be strengthened. What are the implications for practitioners? Stronger systems of public reporting of hospital performance data have the potential to increase consumer engagement and improve hospital performance, quality and safety. Awareness of the discourse around public reporting of hospital performance data can increase practitioners’ engagement in debate and development of reporting systems.

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18

Connellan, Mary, and Euan M. Wallace. "Prevention of perinatal group B streptococcal disease: screening practice in public hospitals in Victoria." Medical Journal of Australia 172, no. 7 (April 2000): 317–20. http://dx.doi.org/10.5694/j.1326-5377.2000.tb123977.x.

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19

Ferguson, Brian, and Mark Baker. "Shifting Finance Out of Acute Hospitals." Journal of Health Services Research & Policy 3, no. 1 (January 1998): 2–4. http://dx.doi.org/10.1177/135581969800300102.

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Prior, Diego, and Jordi Surroca. "Performance Measurement and Achievable Targets for Public Hospitals." Journal of Accounting, Auditing & Finance 25, no. 4 (October 2010): 749–65. http://dx.doi.org/10.1177/0148558x1002500411.

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Vera, Antonio, and Ludwig Kuntz. "Finance-oriented vs. operations-oriented management control in public hospitals." Journal of Hospital Administration 3, no. 6 (November 12, 2014): 190. http://dx.doi.org/10.5430/jha.v3n6p190.

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The purpose of this paper is to investigate the impact of finance-oriented vs. operations-oriented management control in public hospitals on physicians’ role conflict and cost consciousness as well as on perceived organizational performance. First, we conduct a participatory research project, and identify two public university hospitals with clearly differing management control environments: one finance-oriented, the other operations-oriented. Then we collect quantitative data from 211 physicians employed in these hospitals, and analyze it using regression analyses and structural equation modeling. Our empirical results indicate that a finance-oriented control environment is preferable to an operations-oriented control environment with respect to cost consciousness, but with respect to role conflict the reverse is true. Regarding the perceived organizational performance, our findings indicate that an operations-oriented control environment is more advantageous than a finance-oriented control environment. The main implication of our study is that management control issues in public hospitals are important, risky, and therefore merit dedicated managerial support. To enable effective coordination without unnecessarily creating conflicts, top management has to find an appropriate balance not only between professional autonomy and monitoring requirements, or between trust and control, but also between financial and operational performance measures.

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Lee, Peter, Angela L. Brennan, Dion Stub, Diem T. Dinh, Jeffrey Lefkovits, Christopher M. Reid, Ella Zomer, and Danny Liew. "Estimating the economic impacts of percutaneous coronary intervention in Australia: a registry-based cost burden study." BMJ Open 11, no. 12 (December 2021): e053305. http://dx.doi.org/10.1136/bmjopen-2021-053305.

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ObjectivesIn this study, we sought to evaluate the costs of percutaneous coronary intervention (PCI) across a variety of indications in Victoria, Australia, using a direct per-person approach, as well as to identify key cost drivers.DesignA cost-burden study of PCI in Victoria was conducted from the Australian healthcare system perspective.SettingA linked dataset of patients admitted to public hospitals for PCI in Victoria was drawn from the Victorian Cardiac Outcomes Registry (VCOR) and the Victorian Admitted Episodes Dataset. Generalised linear regression modelling was used to evaluate key cost drivers. From 2014 to 2017, 20 345 consecutive PCIs undertaken in Victorian public hospitals were captured in VCOR.Primary outcome measuresDirect healthcare costs attributed to PCI, estimated using a casemix funding method.ResultsKey cost drivers identified in the cost model included procedural complexity, patient length of stay and vascular access site. Although the total procedural cost increased from $A55 569 740 in 2014 to $A72 179 656 in 2017, mean procedural costs remained stable over time ($A12 521 in 2014 to $A12 185 in 2017) after adjustment for confounding factors. Mean procedural costs were also stable across patient indications for PCI ($A9872 for unstable angina to $A15 930 for ST-elevation myocardial infarction) after adjustment for confounding factors.ConclusionsThe overall cost burden attributed to PCIs in Victoria is rising over time. However, despite increasing procedural complexity, mean procedural costs remained stable over time which may be, in part, attributed to changes in clinical practice.

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Gleeson, Patrick, and Stephen Duckett. "Modeling the Emergency Ambulance Pass-By of Small Rural Hospitals in Victoria, Australia." Journal of Rural Health 21, no. 4 (October 2005): 367–71. http://dx.doi.org/10.1111/j.1748-0361.2005.tb00109.x.

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MacIntyre, C. Raina, Chris W. Brook, Eugene Chandraraj, and Aileen J. Plant. "Changes in bed resources and admission patterns in acute public hospitals in Victoria, 1987‐1995." Medical Journal of Australia 167, no. 4 (August 1997): 186–89. http://dx.doi.org/10.5694/j.1326-5377.1997.tb138842.x.

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Evans, John H., Yuhchang Hwang, Nandu Nagarajan, and Karen Shastri. "Involuntary Benchmarking and Quality Improvement: The Effect of Mandated Public Disclosure on Hospitals." Journal of Accounting, Auditing & Finance 12, no. 3 (July 1997): 315–46. http://dx.doi.org/10.1177/0148558x9701200309.

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This paper documents the responses of Pennsylvania hospitals to the public dissemination by the Pennsylvania Health Care Cost Containment Council (PHC4) in 1990 of mandated hospital disclosures of financial and nonfinancial performance information. We find that PHC4's relative performance disclosures had an effect in that hospitals that performed poorly on patient quality of care, as measured by mortality outcomes, reacted by making significant improvements in this measure by 1992, although this was accompanied by lower reductions in length of stay. Further, we find that the improvements in mortality outcomes were more marked for DRGs in more competitive environments and for hospitals that ranked higher on financial condition in the year of disclosure. Additionally, the rationale for these costly quality improvements in the period following the disclosure appears to be related to market share, that is, poorly performing hospitals lost, whereas better performing hospitals gained in market share.

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Banker, Rajiv D. "Discussion: “Involuntary Benchmarking and Quality Improvement: The Effect of Mandated Public Disclosure on Hospitals”." Journal of Accounting, Auditing & Finance 12, no. 3 (July 1997): 347–52. http://dx.doi.org/10.1177/0148558x9701200310.

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This paper addresses an important empirical question: Does the mandated public disclosure of quality information cause predictable changes in managerial behavior? Evans et al. find that a new requirement for the disclosure of relative performance measures for Pennsylvania hospitals results in hospitals with higher quality (lower mortality rates) gaining market share. Anticipating this customer reaction, those hospitals with poorer quality levels, those facing more intense competition, and those small in size exhibit a greater improvement in their quality performance. However, the hospitals with higher mortality rates also exhibit the least improvement in productivity (as measured by length of stay).1

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Buathong, Suwimon, and Sirilak Bangchokdee. "The use of the performance measures in Thai public hospitals." Asian Review of Accounting 25, no. 4 (December 4, 2017): 472–85. http://dx.doi.org/10.1108/ara-03-2017-0043.

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Purpose The purpose of this paper is to examine the relationships between participation in performance measurement systems (PMS) and the use of performance measures; the use of performance measures and managerial performance; and participation in PMS and managerial performance in public hospitals in Thailand. Design/methodology/approach Data were collected using a mailed questionnaire. A total of 304 middle managers in public hospitals in Southern Thailand participated in the study. The data were analyzed using structural equation modeling. Findings The results reveal a positive relationship between participation in PMS and the use of performance measures, and a positive relationship between the use of performance measures and managerial performance. The results also indicate a positive relationship between participation in PMS and improved managerial performance. Practical implications Results indicate that top managers in hospitals should allow middle managers to have greater participation in their organization’s PMS. By sharing information between top and middle managers, a PMS can be developed that reflects the organization’s goals, as well as being suitable for departmental performance evaluation. This enhances PMS acceptance by middle managers, and reduces task ambiguity, leading to improved managerial performance. Originality/value As middle managers participate more in PMS, their acceptance of PMS increases. They then make greater use of both financial and non-financial performance measures to obtain comprehensive feedback about their department’s performance. This enhances their decision outcomes, resulting in improved managerial performance.

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Yen, Gili, and Eva C. Yen. "On phone reservations: Public versus private teaching hospitals." Atlantic Economic Journal 17, no. 1 (March 1989): 92. http://dx.doi.org/10.1007/bf02303282.

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Smith, Courtney, Allison Griffiths, Sandra Allison, Dee Hoyano, and Linda Hoang. "Escherichia coli O103 outbreak associated with minced celery among hospitalized individuals in Victoria, British Columbia, 2021." Canada Communicable Disease Report 48, no. 1 (January 26, 2022): 46–50. http://dx.doi.org/10.14745/ccdr.v48i01a07.

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Background: In April 2021, a Shiga toxin-producing Escherichia coli (E. coli) (STEC) O103 outbreak was identified among patients at two hospitals in Victoria, British Columbia (BC). The objective of this study is to describe this outbreak investigation and identify issues of food safety for high-risk products prepared for vulnerable populations. Methods: Confirmed cases of E. coli O103 were reported to the Island Health communicable disease unit. The provincial public health laboratory conducted whole genome sequencing on confirmed case isolates, as per routine practice for STEC in BC. Exposure information was obtained through case interviews and review of hospital menus. Federal and local public health authorities conducted an inspection of the processing plant for the suspect source. Results: Six confirmed cases of E. coli O103 were identified, all related by whole genome sequencing. The majority of cases were female (67%) and the median age was 61 years (range 24–87 years). All confirmed cases were inpatients or outpatients at two hospitals and were exposed to raw minced celery within prepared sandwiches provided by hospital food services. A local processor supplied the minced celery exclusively to the two hospitals. Testing of product at the processor was infrequent, and chlorine rinse occurred before mincing. The spread of residual E. coli contamination through the mincing process, in addition to temperature abuse at the hospitals, are thought to have contributed to this outbreak. Conclusion: Raw vegetables, such as celery, are a potential source of STEC and present a risk to vulnerable populations. Recommendations from this outbreak include more frequent testing at the processor, a review of the chlorination and mincing process and a review of hospital food services practices to mitigate temperature abuse.

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CANTA, CHIARA, and MARIE-LOUISE LEROUX. "Public and Private Hospitals, Congestion, and Redistribution." Journal of Public Economic Theory 18, no. 1 (January 26, 2016): 42–66. http://dx.doi.org/10.1111/jpet.12132.

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Jones, Graeme I., Katrina A. Alford, Ursula J. Russell, and David Simmons. "Removing the Roadblocks to Medical and Health Student Training in Rural Hospitals in Victoria." Australian Journal of Rural Health 11, no. 5 (October 2003): 218–23. http://dx.doi.org/10.1111/j.1440-1584.2003.00523.x.

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Jones, Graeme I., Katrina A. Alford, Ursula J. Russell, and David Simmons. "REMOVING THE ROADBLOCKS TO MEDICAL AND HEALTH STUDENT TRAINING IN RURAL HOSPITALS IN VICTORIA." Australian Journal of Rural Health 11, no. 5 (June 28, 2008): 218–23. http://dx.doi.org/10.1111/j.1440-1584.2003.tb00541.x.

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Wolfram Cox, Julie, and John Hassard. "Discursive Recontextualization in a Public Health Setting." Journal of Applied Behavioral Science 46, no. 1 (March 2010): 119–45. http://dx.doi.org/10.1177/0021886309357443.

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The authors discuss discursive recontextualization as a process of discursive change in which stable referents may be recombined. As such, discursive recontextualization recognizes the interplay of both stability and instability without necessarily privileging the latter. Drawing on intertextual document analysis of a series of public reports published in the wake of a major health policy initiative in Victoria, Australia— Health to 2050—the authors identify a discursive pattern in which descriptions of a disaggregation from large Health Care Networks to smaller Metropolitan Health Services echo those of an earlier aggregation of individual hospitals into the Health Care Networks. The authors suggest that future research into discourse and organizational change will benefit from greater attention to stabilization and such recontextualization as well as to fluidity and instability. They examine implications for change agents and for researchers in the field.

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Rezaei-Darzi, Ehsan, Janneke Berecki-Gisolf, and Dasamal Tharanga Fernando. "How representative is the Victorian Emergency Minimum Dataset (VEMD) for population-based injury surveillance in Victoria? A retrospective observational study of administrative healthcare data." BMJ Open 12, no. 12 (December 2022): e063115. http://dx.doi.org/10.1136/bmjopen-2022-063115.

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ObjectiveThe Victorian Emergency Minimum Dataset (VEMD) is a key data resource for injury surveillance. The VEMD collects emergency department data from 39 public hospitals across Victoria; however, rural emergency care services are not well captured. The aim of this study is to determine the representativeness of the VEMD for injury surveillance.DesignA retrospective observational study of administrative healthcare data.Setting and participantsInjury admissions in 2014/2015–2018/2019 were extracted from the Victorian Admitted Episodes Dataset (VAED) which captures all Victorian hospital admissions; only cases that arrived through a hospital’s emergency department (ED) were included. Each admission was categorised as taking place in a VEMD-contributing versus a non-VEMD hospital.ResultsThere were 535 477 incident injury admissions in the study period, of which 517 207 (96.6%) were admitted to a VEMD contributing hospital. Male gender (OR 1.13 (95% CI 1.10 to 1.17)) and young age (age 0–14 vs 45–54 years, OR 4.68 (95% CI 3.52 to 6.21)) were associated with VEMD participating (vs non-VEMD-participating) hospitals. Residing in regional/rural areas was negatively associated with VEMD participating (vs non-VEMD participating) hospitals (OR=0.11 (95% CI 0.10 to 0.11)). Intentional injury (assault and self-harm) was also associated with VEMD participation.ConclusionsVEMD representativeness is largely consistent across the whole of Victoria, but varies vastly by region, with substantial under-representation of some areas of Victoria. By comparison, for injury surveillance, regional rates are more reliable when based on the VAED. For local ED-presentation rates, the bias analysis results can be used to create weights, as a temporary solution until rural emergency services injury data is systematically collected and included in state-wide injury surveillance databases.

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Curtis, Panayiotis, and Theodore. "Health Care Finance, the Performance of Public Hospitals and Financial Statement Analysis." EUROPEAN RESEARCH STUDIES JOURNAL XII, Issue 4 (November 1, 2009): 199–212. http://dx.doi.org/10.35808/ersj/253.

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Shaoul, Jean, Anne Stafford, and Pam Stapleton. "The Cost of Using Private Finance to Build, Finance and Operate Hospitals." Public Money and Management 28, no. 2 (April 2008): 101–8. http://dx.doi.org/10.1111/j.1467-9302.2008.00628.x.

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Wilson, Beth. "Issues in Service Delivery for Women Statewide: The Consumer Context." Australian Journal of Primary Health 4, no. 3 (1998): 72. http://dx.doi.org/10.1071/py98032.

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This article presents data from two sources. The first set of data comes from complaints received by the Health Services Commissioner (Health Ombudsman) in Victoria from Consumers of Health Services about health service providers. The second set of data has been provided by 92 public hospitals using the health complaints information program. The Health Complaints Resolution Process is described and the data are presented in the hope that they may assist in formulating policies for women's health.

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Bennett, Noleen J., Ann L. Bull, David R. Dunt, Lyle C. Gurrin, Michael J. Richards, Philip L. Russo, and Denis W. Spelman. "A profile of smaller hospitals: Planning for a novel, statewide surveillance program, Victoria, Australia." American Journal of Infection Control 34, no. 4 (May 2006): 170–75. http://dx.doi.org/10.1016/j.ajic.2005.05.011.

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Kucsma, Daniella, and Krisztina Varga. "Exploring Effectiveness Reserves in Hospitals with the DEA Method." Pénzügyi Szemle = Public Finance Quarterly 66, Special edition 2021/2 (2021): 75–87. http://dx.doi.org/10.35551/pfq_2021_s_2_4.

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In our study, we undertake a relative efficiency analysis of hospitals providing inpatient care, which play a key role in the Hungarian health care system. According to the Competitiveness Report 2020 of the Hungarian National Bank, the Hungarian health care system has a number of reserves, and the sustainability of the system can be improved by using these reserves. In the 2015-2019 period, particular attention has been paid to the identification of achievable and meaningful indicators in the sector under review. The relative effectiveness analysis (DEA) method can be used to address this challenge. The units of our analysis are state-owned institutions in Hungary, typologised by the total number of beds. General profile hospitals with a bed count between 600 and 1200 beds were included in the analysis. The results of running the programme have clearly shown that there are some institutions that do not operate as efficiently as the majority of the organisations included in the study, but further research and refinement of the indicators is needed to determine the practical application of the pilot studies.

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Sharwood, Penny, and Bernadette O'Connell. "Assessing the relationship between inpatient and outpatient activity:a clinical specialty analysis." Australian Health Review 23, no. 3 (2000): 137. http://dx.doi.org/10.1071/ah000137a.

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General and specialist services in public acute hospital outpatient departments play a key role in the health care systemand represent a vital interface between inpatient and community care. Typically outpatient services involve millionsof patient visits within a very short time frame and in Victoria alone between 8-10 million outpatient occasions ofservice are provided each year. Drawing on the first full year of data from the Victorian Ambulatory ClassificationSystem (VACS) this paper examines the patterns underlying the distribution of inpatient separations and outpatientencounters at 16 major Victorian public hospitals and assesses the relationship between inpatient and outpatientactivity at the clinical specialty level.

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Duckett, Stephen J. "REGULATING THE CONSTRUCTION OF HOSPITALS OR VICE VERSA: THE COURTS AND PRIVATE HOSPITAL PLANNING IN VICTORIA." Community Health Studies 13, no. 4 (March 26, 2010): 431–40. http://dx.doi.org/10.1111/j.1753-6405.1989.tb00701.x.

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Ribonson, Priscilla, and Mark F. Gilheany. "Is there a role for podiatric surgeons in public hospitals? An audit of surgery to the great toe joint in Victoria, 1999–2003." Australian Health Review 33, no. 4 (2009): 690. http://dx.doi.org/10.1071/ah090690.

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This project aimed to describe and compare the frequencies of procedures performed by podiatric surgeons and orthopaedic surgeons for elective surgery to the great toe joint, an area of identified clinical need. The objective was to determine whether podiatric surgeons in the Australian context possess a surgical skill set which can be utilised in the public health sector. The Medicare Benefits Schedule (Medicare Australia) was reviewed to identify all codes relating to great toe joint surgery and frequency data were obtained for the period July 1999 to June 2003. A separate audit of the activity of Victorian podiatric surgeons was conducted. During the 4 years in Victoria, the number of procedures performed on this joint by 152 orthopaedic surgeons was 5882. Two podiatric surgeons in Victoria performed 1260 operations on this joint over this period (17.6% of great toe joint surgery on average each year in the private sector). Utilising orthopaedic workforce figures and on a per-surgeon basis, during this period the podiatric surgeons performed this type of surgery between 2 and 16 times more often than the orthopaedic surgeons, and consideration should be given to using these skills in the public sector to address the growing demand.

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Barniv, Ran, Kreag Danvers, and Joanne P. Healy-Burress. "An Empirical Examination of State and Local Revocations of Tax-Exempt Status for Nonprofit Hospitals." Journal of the American Taxation Association 27, no. 2 (September 1, 2005): 1–25. http://dx.doi.org/10.2308/jata.2005.27.2.1.

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In recent years, many states and local authorities have revoked the tax exemptions for several nonprofit hospitals. In this study we examine whether hospital-specific and governmental revenue-need characteristics, organized by four underlying constructs, affect state and local tax authorities' decisions to revoke nonprofit hospitals' tax-exempt status. Based on analyses of state and local tax laws, we distinguish three types of taxes paid by hospitals: Medicaid taxes; state revenue-based taxes; and local taxes. We separately examine the effects of these characteristics on the revocation of the tax-exempt status for each type. We use survivorship analysis and fit logistic regressions that employ panel data to study the risk of revocation for each type of tax. Our results suggest that the likelihood that state authorities assess Medicaid taxes increases with the size of the tax base (i.e., patient revenue) and ability to pay, but decreases with lower revenue needs. We find that the likelihood of revocation for hospitals paying state revenue-based tax increases with the size of the tax base (i.e., total operating revenue), but decreases with public health benefits provided (e.g., charity care) and lower revenue needs. Finally, we show that the size of the tax base (public health benefit provided) increases (decreases) the likelihood of revoking the tax-exempt status for hospitals that pay local tax. Implications for local tax authorities and hospital managers are briefly discussed.

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Austen, Agata. "Stakeholders management in public hospitals in the context of resources." Management 16, no. 2 (December 1, 2012): 217–30. http://dx.doi.org/10.2478/v10286-012-0067-8.

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AbstractStakeholders management in public hospitals - from stakeholders management to stakeholders relations Public sector organisations have a sufficient influence to win political legitimization and resources to finance their operations by satisfying their stakeholders. Organizations that adopt stakeholder management principles probably better satisfy their constituent needs and balance their interests, which results in higher capacity of goal achievement. The question of what initiatives were undertaken by public sector organisations to manage different stakeholders, and what were their motivations is still unanswered. The aim of this paper is to understand how stakeholder groups are being recognized in the public hospitals’ decision-making in context of resources.

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Kimmel, Lara A., Anne E. Holland, Natasha Lannin, Elton R. Edwards, Richard S. Page, Andrew Bucknill, Raphael Hau, and Belinda J. Gabbe. "Clinicians’ perceptions of decision making regarding discharge from public hospitals to in-patient rehabilitation following trauma." Australian Health Review 41, no. 2 (2017): 192. http://dx.doi.org/10.1071/ah16031.

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Objective The aim of the present study was to investigate the perceptions of consultant surgeons, allied health clinicians and rehabilitation consultants regarding discharge destination decision making from the acute hospital following trauma. Methods A qualitative study was performed using individual in-depth interviews of clinicians in Victoria (Australia) between April 2013 and September 2014. Thematic analysis was used to derive important themes. Case studies provided quantitative information to enhance the information gained via interviews. Results Thirteen rehabilitation consultants, eight consultant surgeons and 13 allied health clinicians were interviewed. Key themes that emerged included the importance of financial considerations as drivers of decision making and the perceived lack of involvement of medical staff in decisions regarding discharge destination following trauma. Other themes included the lack of consistency of factors thought to be important drivers of discharge and the difficulty in acting on trauma patients’ requests in terms of discharge destination. Importantly, as the complexity of the patient increases in terms of acquired brain injury, the options for rehabilitation become scarcer. Conclusions The information gained in the present study highlights the large variation in discharge practises between and within clinical groups. Further consultation with stakeholders involved in the care of trauma patients, as well as government bodies involved in hospital funding, is needed to derive a more consistent approach to discharge destination decision making. What is known about the topic? Little is known about the drivers for referral to, or acceptance at, in-patient rehabilitation following acute hospital care for traumatic injury in Victoria, Australia, including who makes these decisions of behalf of patients and how these decisions are made. What does this paper add? This paper provides information regarding the perceptions of acute hospital consultant surgeons and allied health, as well as rehabilitation clinicians, in terms of discharge destination decision making from the acute hospital following trauma. The use of case studies further highlights differences between, and within, these specialities with regard to this decision making. This research also highlights the importance of financial considerations as drivers of decision making, and the lack of consistency of the factors thought to be important drivers of discharge between these different clinical groupings. What are the implications for practitioners? This research shows that financial factors are significant drivers of discharge destination decision making for trauma patients. The present study highlights opportunities to engage with stakeholders (acute care, rehabilitation, administration, government and patients) to develop more consistent discharge processes that optimise the use of rehabilitation resources for those patients who could benefit from in-patient rehabilitation.

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Forster, Della A., Heather McKay, Rhonda Powell, Emma Wahlstedt, Tanya Farrell, Rachel Ford, and Helen L. McLachlan. "The structure and organisation of home-based postnatal care in public hospitals in Victoria, Australia: A cross-sectional survey." Women and Birth 29, no. 2 (April 2016): 172–79. http://dx.doi.org/10.1016/j.wombi.2015.10.002.

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Gamessa, Tadesse Waktola, Samuel Tadesse Abebe, Lemlem Degafu Abate, Megersa Kebede Abo, Alemu Abibi Mekonnen, Zerihun Ketema Tadesse, Addisu Fayera Woyesa, Regasa Bayisa Obse, Mahdi Abdella Ibrahim, and Gizeaddis Simegn. "Planning and Budgeting of Medical Devices Among Ethiopian Public Hospitals." ClinicoEconomics and Outcomes Research Volume 14 (May 2022): 405–13. http://dx.doi.org/10.2147/ceor.s363376.

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Jackson, Terri, and Petia Sevil. "Problems in counting and paying for multidisciplinary outpatient clinics." Australian Health Review 20, no. 3 (1997): 38. http://dx.doi.org/10.1071/ah970038.

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Policy-makers have always found it problematic to formulate fair and consistentcounting rules for public hospital outpatient activities. In the context of output-based funding, such rules have consequences which can affect patient care. This paper reviews the rationale for organising multidisciplinary clinics and reports on a series of focus groups convened in four Melbourne teaching hospitals to consider funding policy for such clinics. It discusses issues of targeting outpatient services, along with implications for payment policy. It evaluates counting rules in terms of intended andunintended consequences in the context of Victoria?s introduction of output-basedfunding for outpatient services.

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Zhang, Pengju, and Ling Zhu. "Does the ACA Medicaid Expansion Affect Hospitals’ Financial Performance?" Public Finance Review 49, no. 6 (November 2021): 779–814. http://dx.doi.org/10.1177/10911421211064676.

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This paper examines the effects of states’ Medicaid expansion under the Affordable Care Act (ACA) on hospitals’ financial performance in the United States. Extending previous studies that primarily focus on the immediate short-term impact of the ACA's Medicaid expansion, we investigate if the fiscal effects persist over a longer-term and if the fiscal effects vary across different hospitals. Using panel data on hospitals from 2011 to 2018, we find that hospitals’ financial performance, as gauged either by Medicaid net revenue and uncompensated care cost or by multiple profitability measures, improves in Medicaid expansion states, and the positive effects continue over time. In addition, there are significant heterogeneities in the fiscal effects across different hospitals. Hospitals’ profitability improves the most in the public sector, rural areas, and less wealthy counties.

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Tran, Aimy H. L., Danny Liew, Rosemary S. C. Horne, Joanne Rimmer, and Gillian M. Nixon. "Cost and economic determinants of paediatric tonsillectomy." Australian Health Review 46, no. 2 (April 5, 2022): 153–62. http://dx.doi.org/10.1071/ah21100.

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Objective Hospital utilisation research is important in pursuing cost-saving healthcare models. Tonsillectomy is one of the most common paediatric surgeries and the most frequent reason for paediatric hospital readmission. This study aimed to report the government-funded costs of paediatric tonsillectomy in the state of Victoria, Australia, extrapolate costs across Australia, and identify the cost determinants. Methods A population-based longitudinal study was conducted with a bottom-up costing approach using linked datasets containing all paediatric tonsillectomy and tonsillectomy with adenoidectomy surgeries performed in the state of Victoria between 2010 and 2015. Results The total average annual cost of tonsillectomy hospitalisation in Victoria was A$21 937 155 with a median admission cost of A$2224 (interquartile range (IQR) 1826–2560). Inflation-adjusted annual tonsillectomy costs increased during 2010–2015 (P < 0.001), not explained by the rising number of surgeries. Hospital readmissions resulted in a total average annual cost of A$1 427 716, with each readmission costing approximately A$2411 (IQR 1936–2732). The most common reason for readmission was haemorrhage, which was associated with the highest total cost. The estimated total annual expenditure of both tonsillectomy and resulting readmissions across Australia was A$126 705 989. Surgical cost in the upper quartile was associated with younger age, male sex, lower socioeconomic status, surgery for reasons other than infection alone, overnight vs day case surgery, public hospitals and metropolitan hospitals. Surgery for obstructed breathing during sleep had the strongest association to high surgical cost. Conclusions This study highlights the cost of paediatric tonsillectomy and associated hospital readmissions. The study findings will inform healthcare reform and serve as a basis for strategies to optimise patient outcomes while reducing both postoperative complications and costs.

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