Page 6403 - Week 19 - Tuesday, 17 December 1991
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EARLY STAGE OF OUR INQUIRY THAT BED NUMBERS ARE ONLY ONE, RATHER CRUDE INDICATOR OF QUALITY. IT IS POSSIBLE, OF COURSE, TO USE BEDS MORE EFFICIENTLY, OR EVEN NOT AT ALL (FOR EXAMPLE, DIALYSIS TREATMENT OR TREATMENT OF CONDITIONS BY DRUGS) BUT STILL ACHIEVE THE EFFICIENT TREATMENT OF PATIENTS PROBLEMS AND A HIGH DEGREE OF PATIENT SATISFACTION.
THE COMMITTEE WAS DIRECTED TO A NUMBER OF "ALTERNATIVE INDICATORS", INCLUDING ADMISSION LEVELS, DWGs (DIAGNOSIS-RELATED GROUPS), HSI (RELATIVE STAY INDEX), CASEMIX SYSTEMS, OCCUPIED BED DAYS, COST PER BED DAYS, COSTS PER ADMISSION, SEPARATION RATES, READMISSION RATES OR RATES OF INFECTION, TO NAME BUT A FEW. HOWEVER IN THE COURSE OF CONSIDERING THESE INDICATORS, TWO PROBLEMS EMERGED.
FIRST, EACH OF THESE "ALTERNATIVE INDICATORS" ARE IN VARYING DEGREES MEASURES OF PERFORMANCE, NOT CAPACITY; THEY SHOW WHAT THE SYSTEM HAS DONE, NOT WHAT IT WAS CAPABLE OF DOING.
SECONDLY, MOST OF THE MORE SOPHISTICATED METHODS OF ASSESSING EVEN PERFORMANCE ARE QUITE EMBRYONIC. IN SOME CASES THE COMMITTEE WAS TOLD THESE METHODS ARE FIVE YEARS FROM BEING A USEFUL TOOL IN DETERMINING POLICIES GOVERNING SERVICES. THUS, ALTHOUGH WE ACCEPT AND INDEED OUTLINE IN THE REPORT THE LIMITATIONS OF BED NUMBERS AS AN INDICATOR OF THE QUALITY OF A HOSPITAL SYSTEM, TO DISCARD BED NUMBERS ALTOGETHER AS A TOOL WOULD LEAVE US, AND THE PUBLIC OF CANBERRA, LARGELY UNABLE TO ASSESS HOW CAPABLE OUR HOSPITAL SYSTEM IS IN THE IMMEDIATE FUTURE OF MEETING THE ACUTE HOSPITAL NEEDS OF OUR
PEOPLE.
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