The health services within VIC undertake the costing onsite and submit the cost data annually to the DH for the VCDC. All Victorian metropolitan and major rural health services are required to submit patient level cost data to the VCDC. Once the costed dataset is received by the DH, a number of validation checks and mapping activities are performed in accordance with the AHPCS and ‘VCDC Business Rules’ for reporting cost data. Examples of tests performed by DH include:
Initial validations on file format, data structure and value ranges. Submissions containing errors were required to be submitted.
Validation of imported columns and derived fields using rules. Errors are listed at the end of each processing cycle.
Review of high and low cost episodes.
Review of low or zero cost areas or episodes.
Activities linked to Episodes were required to have Episode records. All hospital episodes were to be reported to the VCDC episode types (based on the program/area of service for which the episodes were created). For example – Program A for admitted episodes, Program E for admitted emergency episodes etc. Episodes that could not be linked to a valid VCDC program type were excluded from Round 17 NHCDC submission.
When critical or validation errors are identified on the submitted file, QA outputs are sent back to the Health Services. Submissions containing errors are required to be re-submitted once the issues are rectified and resolved. Any re-submission is required to have complete records for the financial years and goes through the complete QA process. In some cases where data fails the validation tests due to poor quality or missing information, it is removed from the final submissions to IHPA.
Adjustments to costed dataset
The following adjustments to the dataset for each of the nominated Health Services were made by the jurisdiction before submission to IHPA.
Barwon Health
WIP patients – $91.9 million was allocated to patients that were not discharged by the end of the financial year. These patients and their attributed costs will be submitted in future rounds.
Out of scope costs – $71.8 million was removed which related to out of scope costs.
Out of scope patients –Patient activity that was out of scope of ABF was not submitted to IHPA. This included:
$63.0 million for non-admitted activity, which includes unlinked encounters and un-registered Tier 2 or un-funded clinics. Also includes encounters without valid program type.
$46.5 million for admitted activity (such as Transition Care Residential patients).
$20.1 million for non-admitted mental health activity.
$6.2 million for radiotherapy.
$7.1 million for community health activity.
Admitted patients – $0.68 million excluded as these records failed VCDC validation checks (due to data quality or invalid program type) and activity data could not be linked to valid admitted episodes.
ED patients – $1,693 excluded as these records failed VCDC validation checks.
The impact of these adjustments on activity submitted across the hospital products is listed below.
Admitted program – Excluded 26 admitted encounters.
ED program – Excluded 259 ED episodes.
Out of scope patients (other admitted) – Excluded 2,319 admitted episodes.
Non-admitted patients (Non-admitted and other non-admitted) – 168,828 non-admitted encounters were excluded from final submission.
Non-admitted mental health episodes – 102,298 non-admitted mental health episodes were excluded.
Non-admitted radiotherapy patients – 29,011 non-admitted encounters under radiotherapy program were excluded.
Out of scope patients (Community Health) – 36,426 community health patient episodes were excluded.
Western Health
WIP patients – $12.1 million was allocated to patients that were not discharged by the end of the financial year. These patients and their attributed costs will be submitted in future rounds.
Excluded activity – $12.4 million was removed relating to activity that did not have a valid program and/or campus code.
Out of scope patients – Patient activity that was out of scope of ABF was not submitted to IHPA. This included:
$63.0 million for non-admitted activity, which includes unlinked encounters and un-registered Tier 2 or un-funded clinics.
$7.2 million excluded for other admitted patients (not part of Western Health, 4 wards operated by Melbourne Health).
Admitted patients – $3.6 million excluded as these records failed VCDC validation checks (due to data quality or invalid program type) and activity data could not be linked to valid admitted episodes.
ED patients – $4,824 excluded as these records failed VCDC validation checks or could not be linked to activity data.
The impact of these adjustments on activity submitted across the hospital products is listed below.
Admitted program – Excluded 687 admitted encounters.
ED program – Excluded eight ED encounters.
Out of scope patients (other admitted) – Excluded 424 admitted episodes.
Non-admitted patients (Non-admitted and other non-admitted) – 196,441 non-admitted encounters were excluded from final submission.
Reconciliation with IHPA
Table below compares the total costs and activity records submitted by the jurisdiction with the total costs and activity records that were received by IHPA. The reconciliation identified no variances.
