The implementation of casemix in Victoria--a clinician's view

Although a number of concerns remain, casemix-based funding is seen by clinicians in Victoria to be a more equitable way of determining public hospital inpatient budgets than historical allocation, and will provide a valuable source of data for service provision planning. The concerns in particular are the inadequacy of the current Australian national diagnosis-related groups 2 system to classify modern clinical practice and describe complex patients; the absence of adequate baseline data to allow an accurate assessment of the impact of casemix-based funding on quality of care; the lack of direct recognition within diagnosis-related groups of the training, research and development roles of public hospitals; and the instability of a funding system which is in evolution.