Hospital In the Home Relative Value Unit development

Hospital in the Home has been shown to reduce the length of stay in hospital or avoid an admission altogether for certain conditions. Peer-reviewed literature suggests that the costs of HITH are lower than ward-based care for equivalent quality. However, the costs of HITH can’t be ascertained from routine costing studies due to the imprecise way in which costs are identified and allocated to patients.

To improve their understanding, the NSW Ministry of Health engaged HPA to develop and deliver a study to capture data on HiTH in NSW and develop relative value units (RVUs), one of the critical steps to more accurately cost HiTH.

HPA designed a study that could reach across hospitals and Local Health Districts, and capture the more extensive and robust data in the delivery of HiTH services.

Working collaboratively with the NSW Ministry of Health, the study recruited ten HITH services collected to collect activity data over two month period (between July and August 2018). The data included:

Clinicians used barcode scanners to collect this information. At the end of the data collection period, the scanned data was linked with the routine admitted patient data to provide a comprehensive record for each patient episode.

The RVUs generated from the study offer a better basis for allocating the costs of key resources to patients and thus can greatly improve the costing of this service. In addition to improved costing, the project also demonstrated where future improvements could be made to further improve the accuracy and precision of RVU allocation in the local costing process.