Patient-based funding breathes new life into hospitals - The Globe and Mail - 0 views
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For the first time on a large scale, a province is beginning to reimburse hospitals based on what they actually do, rather than simply providing them with huge dollops of dollars, no matter what.
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The number of procedures is up, waiting lists are down, and hospital emergency departments covered by the program are processing patients as never before.
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At Nanaimo Regional General Hospital, for instance, waiting times in emergency have been cut by 50 per cent, fuelled by incentives as high as $600 for each extra patient admitted to an acute-care bed within 10 hours and lesser amounts for other treatment targets.
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In Prince George, the number of MRIs, rewarded by $275 per procedure beyond a set baseline total, is targeted to go up by a third this year, representing 1,250 additional screenings.
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The volume of shoulder surgeries, bringing in nearly $3,000 a pop for added procedures, is scheduled to virtually double, from 63 to 123.
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A government report on the program’s first year of operation estimates that the influx of only $53-million in new money resulted in 67,000 more emergency patients being treated on time at the 14 hospitals involved, and 36,000 additional procedures performed at B.C.’s 23 largest hospitals.
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Other aspects of the multipronged program include additional sums going to hospitals for taking on difficult cases and financing the introduction of a surgical quality-care system for B.C. hospitals.
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Les Vertesi, executive director of the B.C. Health Services Purchasing Organization, which is overseeing the radical shift
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not all of the $250-million earmarked for the program’s first two years is being claimed, because hospitals continue to struggle to improve capacity
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Overall, about 17 per cent of hospital funding in B.C. is covered in various ways by the new approach.
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“Throwing money at the problem may work, but an unintended consequence is that you essentially say to people: You don’t have to perform, until we give you money,” Mr. Lewis said.
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Dr. Butcher of the Northern Health Authority added there is a risk of hospitals becoming too attached to activity-based funding. “It can artificially change your focus to procedures that generate revenue,” he cautioned, rather than doing what the patient really needs.