Outcome
Acute Care
13
Australians have access to public hospitals and related hospital care underpinned
by appropriate medical indemnity arrangements.
Outcome Summary
Outcome 13 aims to provide all Australians with access to cost-effective and high quality acute care services.
The outcome also aims to ensure a safe supply of blood and blood-related products; increase the rate
of organ and tissue donation in Australia; and support doctors who provide private medical services.
The Department worked to achieve this outcome by managing initiatives under the programs outlined below.
Programs Administered Under Outcome 13 (Program Objectives in 2008–09)
Program 13.1 – Blood and Organ Donation Services
yy Provide funding to the National Blood Authority
to ensure demand for blood and blood products
is met.
yy Support Australian patients under the
Bone Marrow Transplant Program.
yy Fund non-government organisations in the
blood and organ donation sectors.
yy Fund State and Territory Governments under
the Hepatitis C Litigation Settlement Scheme.
Program 13.3 – Public Hospitals and Information
yy Support the provision of free public hospital
services to public patients through the Australian
Health Care Agreements.
yy Fund the development of national classification
systems for patients, their treatment and
associated costs.
yy Provide funding to State and Territory Governments
to help improve access to public dental treatment.
Program 13.2 – Medical Indemnity
yy Ensure doctors have access to fair, affordable
and secure medical indemnity insurance.
This chapter reports on the major activities undertaken by the Department during the year, addressing
each of the key strategic directions and performance indicators published in the Outcome 13 chapters
of the 2008–09 Health and Ageing Portfolio Budget Statements and 2008–09 Health and Ageing Portfolio
Additional Estimates Statements. It also includes a table summarising the estimated and actual expenditure
for this outcome.
Outcome 13 was managed in 2008–09 by the Acute Care Division and the Regulatory Policy and Governance
Division.
Department of Health and Ageing Annual Report 2008–09 | 201
2.3
Major Achievements for the
Outcome:
Key Strategic Directions for
2008–09 – Major Activities
yy More sustainable public hospital services
into the future, achieved through the
provision of an additional $500 million in
base health care funding for states and
territories (see Supporting Improvements
in the Efficiency of, and Access to, Public
Hospitals and Health Services);
Long Term, Sustainable Health
Reform through the National
Health and Hospitals Reform
Commission
yy Worked with the states and territories to
develop an outcome-focused National
Healthcare Agreement to provide
timely and quality health care services
to all Australians (see Supporting
Improvements in the Efficiency of,
and Access to, Public Hospitals and
Health Services);
yy Worked with the states and territories to
deliver elective surgery to an additional
41,584 patients by implementing stage
one of the Elective Surgery Waiting List
Reduction Plan (see Improving Elective
Surgery and Reducing the Waiting List);
and
Outcome 13 | Acute Care
yy Worked to increase the number of lifesaving and life-transforming transplants
for Australians by establishing the new
Australian Organ and Tissue Donation
and Transplantation Authority to
implement the national reform package
(see Reforming National Efforts to Lift
Organ and Tissue Donation Rates).
13
Challenges for the Outcome:
yy Delayed reduction of waiting lists
for public dental services, due to the
postponed implementation of the
Commonwealth Dental Health Program
(see Improved Access to Commonwealth
Dental Health Services); and
yy Activation of the National Blood Supply
Contingency Plan due to a shortage
of red cells nationally (see Ensuring the
Safe Supply of Blood and Blood-related
Products).
To ensure sustainable improvements
in health outcomes, the Department
worked to address a range of challenges
faced by the health and hospital system,
such as the burden of chronic disease,
an ageing population, rising health costs,
and pressures such as increased demand
for services. This involved supporting the
National Health and Hospitals Reform
Commission to develop and oversee a
long-term health reform plan for Australia.
The Department did this, in addition to
the provision of funding, by informing the
community about the Commission’s role
and encouraging people to contribute to
the reform process through submissions.
The Commission subsequently received over
500 initial submissions which helped inform
a series of discussion papers on possible
reform areas, and an interim report, which
was released in December 2008 (available
at <www.nhhrc.org.au>). The interim report
emphasised four strategic reform directions
and contributed to the process through:
promoting individual and collective action
to take responsibility for good health
and wellbeing; establishing connections
in services so that patients receive
comprehensive care throughout their life;
recognising and addressing health inequities;
and improved use of people, resources
and knowledge. The Commission received
feedback from almost 700 individuals and
organisations on its interim report.
The Commission released the final report in
July 2009. In 2009–10, the Department will
assist the Government in the community
consultation process, and provide advice to
the Government on the final report.
Funding for the above activities was sourced
from Program 13.3 – Public Hospitals and
Information.
202 | Department of Health and Ageing Annual Report 2008–09
The Department administers funding to
assist the states and territories to deliver free
public hospital services to the community
and to support improvements in the access,
efficiency and care available through the
public health system. During 2008–09,
provision of this assistance involved the
conclusion of funding under the Health
Care (Appropriation) Act 1998 and the
introduction of transitional arrangements
to prepare for the new Council of
Australian Governments’ federal financial
framework.
In 2008–09, the Department administered
$10.257 billion under the Ministerial
Determination, to extend the terms of the
2003–08 Australian Health Care Agreements
by one year. The provision of an additional
$500 million base health care funding to the
states and territories, and more generous
indexation provisions under the new Health
Specific Purpose Payments, contributed
to better relationships with the Australian,
State and Territory Governments, and
put public hospital services on a more
sustainable footing for the future.
A major achievement for the Department
during the year was completing negotiations
with the states and territories to develop
a new National Healthcare Agreement.
The agreement aims to shape the health
system around the health needs of patients,
their families and communities; and focus on
disease prevention and injury management;
not simply the treatment of illness. The
agreement also supports an integrated
approach to the promotion of healthy
lifestyles, and diagnosis and treatment of
illness across the continuum of care; and
provides people with timely access to quality
health services based on their needs, not
ability to pay.
In addition, the Government provided
$1.286 billion in 2008–09 for activity based
funding, subacute care and Taking Pressure
off Public Hospitals (Emergency Department)
Council of Australian Governments reforms,
which are part of the National Partnership
Agreement on Hospital and Health
Workforce Reform. The Department
worked with the states and territories on
the implementation of these initiatives.
A National Framework and Implementation
Plan for activity based funding was finalised
and jurisdictions commenced development
of state-level implementation plans for
delivery in August 2009. The Department also
worked closely with the states and territories
on the development of implementation plans
for the subacute care and Taking Pressure off
Public Hospitals elements, to enable approval
of the plans in 2008–09.
2.3
In 2009–10, the Department will monitor the
implementation of the National Healthcare
Agreement and National Partnerships
through a range of mechanisms such
as regular meetings with the states and
territories, to ensure that the new outcomesfocused approach delivers improved
performance in health care.
Funding for the above activities was sourced
from Program 13.3 – Public Hospitals and
Information.
Improved Access to Commonwealth
Dental Health Services
Under the Commonwealth Dental Health
Program, the Australian Government
intends to provide $290 million to the State
and Territory Governments to fund around
one million additional public dental visits
over three years. Planned closure of the
previous government’s Medicare Chronic
Disease Dental Scheme did not proceed
in 2009–10 with the consequence that the
Commonwealth Dental Health Program has
not been implemented. The Senate did not
support the closure and the Government
was unable to put in place the necessary
subordinate legislation to close the scheme,
with the consequence that funding for the
program is not presently available.
Improving Elective Surgery and
Reducing the Waiting List
A key focus during the year was to reduce
the number of people waiting longer than
clinically recommended for elective surgery.
Department of Health and Ageing Annual Report 2008–09 | 203
Outcome 13 | Acute Care
Supporting Improvements in the
Efficiency of, and Access to, Public
Hospitals and Health Services
13
2.3
The Department aimed to do this by
implementing a waiting list reduction
plan by boosting elective surgery and
expanding the capacity of hospitals,
for example through additional equipment
and operating theatres.
Waiting Lists
Outcome 13 | Acute Care
In 2008–09, the Department worked with the
states and territories to implement the Elective
Surgery Waiting List Reduction Plan, which
aims to ensure sustainable improvements in
the delivery of elective surgery.
13
The Department began implementing the
plan in three distinct stages. Under the first
stage, which ended on 31 December 2008,
the Department administered funding
to jurisdictions to reduce the number
of patients waiting longer than clinically
recommended for surgery. A national
target of 25,278 additional procedures
was set for 2008, which was exceeded by
64 per cent. An additional 41,584 patients
received elective surgery in 2008 than
in 2007. As at 31 December 2008,
22,615 patients were waiting longer than
recommended, which compares favourably
with the 33,654 patients overdue for
an operation as at 30 September 2007.
Reporting for this performance of the plan
was provided quarterly and published on the
internet at <www.health.gov.au> following
Australian Health Ministers’ Conference
endorsement.
During 2009–10, the Department will
provide additional funding to the states and
territories to support elective surgery system
improvements and reward those jurisdictions
that meet reduction targets.
Increased Public Hospital Capacity
Increasing the capacity of hospitals will make
surgery more efficient and reduce waiting
lists. During 2008–09, the Department began
the second stage of the Elective Surgery
Waiting List Reduction Plan, to build public
hospitals’ capacity to improve elective
surgery performance. Projects supported
included: the construction of additional
operating theatres in places such as the
Geelong and Frankston hospitals, a number
of facilities in South Australia and the Royal
Darwin and Alice Springs hospitals; and the
purchase of new surgical equipment and
improved elective surgery management in
hospitals such as the Children’s Westmead
Hospital in New South Wales.
Funding for the above activities was sourced
from Program 13.3 – Public Hospitals and
Information.
Ensuring the Safe Supply of Blood
and Blood-related Products
Australia needs about 20,000 donations
of blood every week to meet current
demand. The ability for patients to have
blood products when they need them is
called ‘supply security’. If supply security
is adequate, it means there are always
products available to meet clinical demand
regardless of a range of adverse events.
In 2008–09, the Department worked
to ensure supply security of blood and
blood-related products by supporting
quality and safety improvements; and
increasing blood and plasma donation rates.
Quality and Safety Improvements
The ongoing quality and safety of Australia’s
blood supply is dependent on ensuring
that the Australian Red Cross Blood
Service has access to high quality blood
manufacturing infrastructure, as supply
shortages most commonly occur when
there is a problem in the manufacture of
a blood product. To this end, in 2008–09,
the Department worked closely with the
National Blood Authority and the Australian
Red Cross Blood Service to secure funding
for the redevelopment of the principal
blood manufacturing sites in Sydney and
Melbourne. Final funding approval for the
Sydney development was provided on
18 April 2009. Work will continue in 2009–10
to finalise the funding arrangements for the
development in Melbourne.
The Department also worked to accelerate
the introduction of universal leucodepletion
(where white cells are removed from blood
products), testing of platelets for bacterial
contamination as part of the manufacturing
process, and to increase monitoring of
adverse transfusion reactions.
204 | Department of Health and Ageing Annual Report 2008–09
The Department provided funding to
the Australian Red Cross Blood Service
to support initiatives during 2008–09
(the ‘Year of the Blood Donor’), to: celebrate
blood donors; enhance community
awareness of the value of, and need for,
blood and plasma donors; and to help
recruit new donors to meet growing need.
As at 26 May 2009, the Australian Red Cross
Blood Service reported that more than
17,000 Australians had visited the Year
of the Blood Donor travelling exhibition,
during which more than 9,000 blood typing
tests were conducted and test recipients
had pledged to donate blood.
A major challenge for the year occurred
on 4 September 2008, when the National
Blood Authority activated the National
Blood Supply Contingency Plan due to
low Group O blood stocks nationally.
The authority activated the lowest level
of the plan (White Alert), which aims to
increase collection and production to
build stock levels while meeting demand
for emergency services and the majority
of other clinical requirements. During the
alert, the Department coordinated national
media advice on the blood supply level
and coordinated the jurisdictional analysis
of the public health impact of the shortage.
The alert continued until 23 October 2008
when the National Blood Authority in
conjunction with the Jurisdictional Blood
Committee and the Australian Red Cross
Blood Service agreed that blood stocks and
donation trends were sufficiently robust.
a new national approach to organ and
tissue donations and transplantation,
and support for the National Cord Blood
Collection Network.
National Reforms
2.3
A major achievement for the Department
in 2008–09, was the establishment of the
Australian Organ and Tissue Donation
and Transplantation Authority as an
independent legal entity within the Health
and Ageing portfolio on 1 January 2009,
which will provide leadership and drive
implementation of Government reforms
to lift donation and transplantation rates.
The Department was responsible for
creating the statutory office and functions
of the Chief Executive Officer and the
Authority’s governance structure.
The Department led the development of
the transitional framework for moving the
responsibility of the reform package from
the Department to the Australian Organ
and Tissue Donation and Transplantation
Authority. It also provided the Authority
with high level support to build its
operational infrastructure.
Funding for the above activities was sourced
from Program 13.1 – Blood and Organ
Donation Services.
Reforming National Efforts to Lift
Organ and Tissue Donation Rates
In 2008, there were 259 deceased donors
who enabled life-saving kidney, heart,
lung, liver and pancreas transplants for
1,000 Australians; as at 1 January 2009,
1,625 patients were on waiting lists for
organ transplants. This year, the Department
worked to address this imbalance through
Department of Health and Ageing Annual Report 2008–09 | 205
Outcome 13 | Acute Care
Blood and Plasma Donation
13
National Cord Blood Collection Network
2.3
Cord blood is the blood left behind in the
placenta and umbilical cord. While it is
usually discarded after childbirth, cord blood
is rich in blood-forming (haemopoietic)
stem cells which can be transplanted into a
patient to produce different types of blood
cells after the patient’s own cells have been
destroyed through treatments such as
chemotherapy and irradiation. In 2008–09,
the Department in conjunction with the
states and territories, helped ensure a
sufficient cord blood supply, by supporting
the National Cord Blood Collection network.
The network collects, banks and stores
umbilical and placental cord blood. It also
provides a coordinated approach delivering
matched unrelated umbilical cord blood to
patients requiring haemopoietic stem cell
transplantation.
Funding for the above activities was sourced
from Program 13.1 – Blood and Organ
Donation Services.
Outcome 13 | Acute Care
Implementation of Australian Health
Care Classification Systems
13
In 2008–09, the Department worked closely
with the Australian Institute of Health and
Welfare to manage the annual collection,
validation and reporting of national health
care data submitted by states and territories
as part of their reporting obligations under
the Australian Health Care Agreements.
In August 2008, the Department published
the Round 11 (2006–07) National Hospital
Cost Data Collection. The National Hospital
Cost Data Collection produces national
average costs and costs weights for acute
patients in the public and private hospital
sectors. Cost data for private hospitals was
published for the first time in four years and
comprised 59 per cent of all private hospital
acute separations. The private same-day
National Hospital Cost Data Collection
was initiated in Round 11 for the first time,
however due to low levels of participation,
the collection was not published. The
Department worked closely with industry
in 2008–09 to overcome the low levels of
participation for day hospitals. This has
resulted in a private same day costing
collection being able to be published
with all results in the Round 12 (2007–08)
collection in August 2009.
In January 2009, the Department
commissioned a review of the Australian
Refined Diagnosis Related Group system’s
management. The Australian Refined
Diagnosis Related Group provides the
basis of national admitted hospital patient
information in Australia. This review sought
to examine the operation of the refinement
of the system (including the International
Statistical Classification of Diseases and
Related Health Problems, 10th Revision,
Australian Modification, (ICD-10-AM)) and
provided recommendations based on
stakeholder consultation for improvements.
Along with this, the Department published
the Australian Refined Diagnosis Related
Group version 6.0 in November 2008. This
major review followed on from the release of
the ICD-10-AM version 6.0 in July 2008. Work
on ICD-10-AM version 7.0 began in July 2008.
A priority for the Department in 2009–10 will
be to implement recommendations arising
from a review of state and territory based
information on diagnoses and procedures,
aimed at ensuring that Australia remains
an international leader in the field of health
care information.
Funding for the above activities was sourced
from Program 13.3 – Public Hospitals and
Information.
Safe and Sustainable Service at
Mersey Community Hospital
On 7 March 2008, the Department
commenced a two stage tender process
to identify a suitably qualified and
experienced organisation to operate the
Mersey Community Hospital. The successful
organisation would have been responsible
for improving the health care services for
people in the north-west region of Tasmania.
However, the tender process did not result
in a concluding bid.
The Department subsequently signed a
Heads of Agreement with the Tasmanian
Government for the Tasmanian Department
206 | Department of Health and Ageing Annual Report 2008–09
of Health and Human Services to operate
and manage the Mersey Community Hospital
from 1 September 2008 to 30 June 2011.
The agreement provides funding of up to
$180 million over three years to be used
solely at the Mersey Community Hospital.
This arrangement ensures that the Mersey
Community Hospital is integrated within
the Tasmanian health care system, and will
allow the hospital to continue to provide the
current range of services and to identify any
potential to enhance hospital services, for
the benefit of the Mersey and surrounding
communities. The funding also provides
for capital works and improvements at the
hospital. The Department closely monitored
the services and finances of the hospital,
through quarterly and annual reporting.
2.3
Funding for the above activities was sourced
from Program 13.3 – Public Hospitals
and Information.
Key Facts for 2008–09: Highlights from the State of Our Public Hospitals June 2009 Report
yy In 2008–09, there were:
–– 4.7 million admissions to public hospitals; and
–– 3.1 million admissions to private hospitals.
yy Fifty per cent of patients admitted to public hospitals and 66 per cent of patients
admitted to private hospitals were discharged on the same day.
yy Of all public patients admitted, 67 per cent received acute medical care, 18 per cent
surgery, six per cent medical procedures, six per cent maternity and three per cent
sub-acute services.
yy Of all private patients admitted, 34 per cent received acute medical care, 38 per cent
surgery, 20 per cent medical procedures, three per cent maternity, and four per cent
sub-acute services.
yy A total of 565,501 patients underwent some form of elective surgery as public patients,
with a median waiting time of 34 days. Of these, 84 per cent were seen within the time
recommended.
yy Sixty-nine per cent of people were seen within the time recommended for their triage
category. Half of all patients were seen within 24 minutes.
yy Twenty-eight per cent of people who presented to an emergency department were
admitted to hospital or referred for treatment.
Performance Information for Outcome 13 Administered Programs
Program 13.1 – Blood and Organ Donation Services
Indicator:
Increased rates of organ donations.
Reference Point/
Target:
Implement measures to achieve a long-term, sustainable increase in Australia’s organ
donation rate.
Result: Indicator substantially met.
In 2008, there were 259 organ donations in Australia, a rate of 12.1 donors per million population. This is
an increase on the previous year of 198 deceased donations, a rate of 9.4 donors per million population.
The Department worked collaboratively with the Australian Organ and Tissue Donation and Transplantation
Authority, and the states and territories to implement the national organ and tissue reform package to
improve donation rates. The authority assumed full responsibility of all elements of the reform package
from the Department on 6 March 2009, three months ahead of schedule.
Department of Health and Ageing Annual Report 2008–09 | 207
Outcome 13 | Acute Care
yy There were over 7.1 million presentations to emergency departments in public hospitals.
13
Program 13.2 – Medical Indemnity
2.3
Indicator:
Reduction in the number of doctors requiring support under the Premium Support
Scheme.
Reference Point/
Target:
Reduction in the number of participating doctors.
Result: Indicator met.
The number of doctors requiring support under the Premium Support Scheme has fallen as medical
indemnity premiums have become more affordable relative to the gross medical income of eligible
doctors. This indicator was not met in 2007–08, where 3,611 doctors required support, an increase from
the 3,533 requiring support in 2006–07, and 3,573 in 2005–06. In 2008–09, 2,607 doctors required support
under the Premium Support Scheme.
Program 13.3 – Public Hospitals and Information
Indicator:
Improve access to public dental services.
Reference Point/
Target:
Reduction in state and territory public dental waiting lists for priority groups assisted.
Result: Indicator not met.
The Department was unable to meet this indicator due to delays in implementing the Commonwealth
Dental Health Program.
Indicator:
Access to free public hospital emergency services. Measured by the number of public
emergency department patients per 1,000 weighted population.
Reference Point/
Target:
The same or increase on previous year.
Outcome 13 | Acute Care
Result: Indicator met.
13
In 2007–08, 7.1 million emergency presentations/occasions of service were provided to Australians.
This equates to 321 presentations to accident and emergency departments of hospitals per
1,000 weighted population, an increase of 10 presentations per 1,000 weighted population since
2006–07. ‘Per 1,000 weighted population’ is a methodology applied by the Department to standardise
the population on an age cohort basis across states and territories to make comparisons meaningful.
Table 2.3.13.1: Number of Accident and Emergency Presentations, Public Hospitals, 2006–07 and 2007–08
2006–07
2007–08
Number
Number per
1,000 Weighted
Population
Number
Number per
1,000 Weighted
Population
6,741,304
311
7,100,618
320.6
Australia
Source: State of Our Public Hospitals 2008 and 2009 reports.
Figures for 2008–09 will be available by June 2010, as required under the extended conditions of the
Australian Health Care Agreements.
208 | Department of Health and Ageing Annual Report 2008–09
Indicator:
Timely treatment of public emergency department patients. Measured by the
proportion of patients seen within the recommended timeframe.
Reference Point/
Target:
Increased proportion seen within the recommended time across each state and
territory.
2.3
Result: Indicator not met.
In 2007–08, around 69% of patients at emergency departments of hospitals were seen within the clinically
recommended timeframe, a reduction of 1% from 2006–07. However, emergency departments treated more
patients, with the total volume of people seen within the recommended timeframe increasing by around
130,000 in 2007–08. Half of all emergency department patients were seen within 24 minutes in 2007–08,
the same as in 2006–07.
Source: Australian Hospital Statistics 2006–07 and 2007–08 reports.
Table 2.3.13.2: Emergency Departments – Median Waiting Times for all Patients and Number Seen Within
Recommended Time, 2006–07 and 2007–08
2006–07
2007–08
Minutes
% Seen Within
Recommended
Time
Minutes
% Seen Within
Recommended
Time
24
70
24
69
Australia
Source: State of Our Public Hospitals 2008 and 2009 reports.
Figures for 2008–09 will be available by June 2010, as required under the extended conditions of the
Australian Health Care Agreements.
Indicator:
Timely public admission of people for elective surgery. Measured by the proportion of
public patients admitted within the clinically appropriate timeframe.
Reference Point/
Target:
Increased proportion across each state and territory.
In 2007–08, 84% of patients were admitted for elective surgery within the recommended time. This is
unchanged from 2006–07. Figures for 2008–09 will be available by June 2010, as required under the
extended conditions of the Australian Health Care Agreements.
Indicator:
Additional patients receiving elective surgery.
Reference Point/
Target:
An additional 25,278 patients on waiting lists treated under the Elective Surgery
Waiting List Reduction Plan by December 2008.
Result: Indicator exceeded.
States and territories reported that 41,584 more patients received elective surgery in 2008 compared
with 2007, which is 64% above the plan target of an additional 25,278 patients treated.
Outcome 13 | Acute Care
Result: Indicator not met (note the proportion remained stable across years).
13
Department of Health and Ageing Annual Report 2008–09 | 209
Figure 2.3.13.1: Elective Surgery Proportion of Patients Admitted to Public Hospitals within the Clinically
Appropriate Time, by Clinical Urgency Category
100
2.3
88
90
92
89
92
84
80
75
84
74
70
Per cent
60
50
40
30
20
10
0
Clinical Urgency Category Clinical Urgency Category Clinical Urgency Category
1
2
3
2006–07
Total
2007–08
Outcome 13 | Acute Care
Source: Elective Surgery Waiting Times (additions and removals) National Minimum Data Set.
13
Indicator:
Accurate costing and reporting of hospital activity and healthcare services through
national healthcare classification, service costing and performance monitoring.
Reference Point/
Target:
National Hospital Cost Data Collection round 11 reported by August 2008.
Release of Australian Refined Diagnosis Related Groups v6.0 by 1 September 2008.
Implementation of the National Hospital Cost Data Collection Review
recommendations.
Agreement on a new broader hospitals classification and performance framework
and development program.
Result: Indicator substantially met.
The Department released the National Hospital Cost Data Collection Round 11 report in August 2008 for
public and private hospitals and began work on Round 12 in November 2008; Version 6.0 of the Australian
Refined Diagnosis Related Groups was released in November 2008.
The development work on broader hospitals classification and performance work was deferred during
2008–09 while the Council of Australian Governments considered broader hospital reform.
In May 2008, the review of the National Health Cost Data Collection was completed, however the
Department delayed the implementation of the review’s recommendations following the Council of
Australian Governments’ development of the broader health reform agenda, in particular the Activity
Based Funding initiative possessive.
210 | Department of Health and Ageing Annual Report 2008–09
Indicator:
Enhanced, safe and sustainable hospital services for the people in the north-west
region of Tasmania.
Reference Point/
Target:
Implementation of effective governance arrangements for the Mersey Community
Hospital which will enable safe and sustainable hospital services to be delivered to
the north-west region of Tasmania.
2.3
Result: Indicator met.
The Department signed a Heads of Agreement with the Tasmanian Government on 27 August 2008 for the
Tasmanian Government to operate and manage the Mersey Community Hospital and integrate the hospital
into the Tasmanian health care system, implementing effective governance arrangements.
Performance Information for Outcome 13 Departmental Outputs
Output Group 1 – Policy Advice
Indicator:
Quality, relevant and timely advice for Australian Government decision-making
measured by ministerial satisfaction.
Reference Point/
Target:
Ministerial satisfaction.
Result: Indicator met.
Ministers were satisfied with the quality, relevance and timeliness of advice provided for Australian Government
decision-making.
Indicator:
Production of relevant and timely evidence-based policy research.
Reference Point/
Target:
Relevant evidence-based policy research produced in a timely manner.
Result: Indicator met.
The Department undertook a number of research related projects to assist with policy development
and measuring the cost of health care services. A review of the management of the Australian Refined
Diagnosis Related Group classification system is informing improvements in the management of processes
supporting national clinical coding practices for diagnoses and procedures that produce quality health care
information about hospital patients. In addition, the investigation and collection of hospital costs and activity
data; the development of patient-level data for outpatient services to assist in the development of a long
term strategy for outpatient services information development; and the development of comprehensive
indicators to capture rehabilitation services performance all contributed towards the evidence-base required
for policy development.
The Department engaged the Australian Institute of Health and Welfare to undertake oral health research
and the reports produced informed policy development and advice.
Outcome 13 | Acute Care
The Department provided a range of high quality and timely evidence-based research and analysis to inform
the Government within the timeframes required.
13
Output Group 2 – Program Management
Indicator:
Administered budget predictions are met and actual expenses vary less than 0.5%
from budgeted expenses measured by comparison of actual expenses against budget.
Reference Point/
Target:
0.5% variance from budgeted expenses.
Result: Indicator met.
The actual Administered expenses for Outcome 13 were 0.4% greater than budgeted expenses.
Department of Health and Ageing Annual Report 2008–09 | 211
2.3
Indicator:
Stakeholders participate in program development through a range of avenues,
such as conferences and regular meetings.
Reference Point/
Target:
Stakeholders participated in program development.
Result: Indicator met.
The Department worked with consumers, industry and all State and Territory Governments towards
improving the provision of acute care hospital services by ensuring that policy directions reflect,
where appropriate, the broader concerns of the health sector. Consultation was achieved through the:
yy annual Australian Health Care Agreement Data Meeting;
yy quarterly Hospital Casemix Protocol Fund Data Working Group;
yy quarterly Private Hospital Data Working Group;
yy monthly Elective Surgery Waiting List Reduction Plan Working Group; and
yy regular National Partnership Agreement Implementation Steering Committee and its working groups –
the Emergency Department/Activity Based Funding and Sub Acute Care Measurement Working Groups.
Outcome 13 | Acute Care
Outcome 13 – Financial Resources Summary
13
Program 13.1: Blood and Organ Donation Services
Administered Items
Annual Appropriation Bill 1
(Ordinary Annual Services)
Annual Appropriation Bill 2
(Other Services)
Special appropriations
National Health Act 1953 - Blood
Fractionation, Products and Blood
Related Products - to National Blood
Authority
Departmental Outputs
Annual Appropriation Bill 1
(Ordinary Annual Services)
Revenues from other sources
Subtotal for Program 13.1
Program 13.2: Medical Indemnity
Administered Items
Special appropriations
Medical Indemnity Act 2002
Departmental Outputs
Annual Appropriation Bill 1
(Ordinary Annual Services)
Revenues from other sources
Subtotal for Program 13.2
(A)
Budget
Estimate
2008–09
$’000
(B)
Actual
2008–09
$’000
Variation
(Column B
minus
Column A)
$’000
Budget
Estimate
2009–10
$’000
13,222
12,104
(1,118)
11,134
639
98
(541)
-
523,808
523,808
-
564,386
7,689
428
545,786
7,063
374
543,447
(626)
(54)
(2,339)
9,573
436
585,529
91,600
43,269
(48,331)
125,993
1,310
73
92,983
1,203
64
44,536
(107)
(9)
(48,447)
1,631
74
127,698
212 | Department of Health and Ageing Annual Report 2008–09
(A)
Budget
Estimate
2008–09
$’000
(B)
Actual
2008–09
$’000
Variation
(Column B
minus
Column A)
$’000
Budget
Estimate
2009–10
$’000
70,846
68,677
(2,169)
72,361
197,900
197,900
-
-
10,263,233
10,261,485
(1,748)
-
14,991
834
10,547,804
13,769
729
10,542,560
(1,222)
(105)
(5,244)
18,664
848
91,873
Total Resources for Outcome 13
11,186,573
Outcome 13 Resources by Departmental Output Group
Department of Health and Ageing
Output Group 1: Policy Advice
15,716
Output Group 2: Program Management
9,609
Total Departmental Resources
25,325
11,130,543
(56,030)
805,100
14,454
8,748
23,202
(1,262)
(861)
(2,123)
19,453
11,773
31,226
157
(4)
192
Program 13.3: Public Hospitals and Information
Administered Items
Annual Appropriation Bill 1
(Ordinary Annual Services)
Annual Appropriation Bill 2
(Other Services)
Special appropriations
Health Care (Appropriation) Act 1998
- Australian Health Care Agreements Provision of Designated Health (p)
Departmental Outputs
Annual Appropriation Bill 1
(Ordinary Annual Services)
Revenues from other sources
Subtotal for Program 13.3
Average Staffing Level (Number)
161
2.3
Outcome 13 | Acute Care
(p) = part.
13
Department of Health and Ageing Annual Report 2008–09 | 213
214 | Department of Health and Ageing Annual Report 2008–09