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Ambulatory case mix funding systems in Canada
1Department of Health Services Adminisration, University of Alberta, Edmonton.
Healthcare Management Forum
|February 2, 1995
Summary
Inpatient case mix funding in Alberta and Ontario lacks incentives for efficient outpatient care. Case mix funding is suitable for ambulatory surgery but not emergency or special clinics.
Area of Science:
- Health services research
- Healthcare economics
- Public health policy
Background:
- Current inpatient case mix funding models in Alberta and Ontario do not sufficiently incentivize resource reallocation to outpatient settings.
- There is a need to evaluate the applicability of case mix tools for outpatient services to improve efficiency and appropriateness of care.
Purpose of the Study:
- To explore the potential and challenges of extending case mix funding tools to outpatient services.
- To survey existing tools for characterizing output in day surgery, special clinics, and emergency care.
Main Methods:
- Literature review and analysis of existing case mix methodologies.
- Survey of tools for output characterization in ambulatory care settings.
Main Results:
- Case mix funding is deemed desirable and feasible for ambulatory surgery.
- The application of case mix funding for emergency care and special clinics presents significant challenges and is questionable.
- International developments, particularly in the United States, may influence future Canadian interest and application.
Conclusions:
- While case mix funding shows promise for ambulatory surgery, its suitability for emergency and special clinics requires further investigation.
- Continued advancements in case mix methodologies internationally are likely to sustain interest in Canada for improving outpatient care delivery and funding.