Victoria - Public Hospitals Policy and Funding Guidelines 1997-1998
Section A: Policy
3.6 Trim Points
In 1997-98 boundary points for defining outliers will continue to be calculated on the basis of a multiple of the average length of stay (ALOS). The high boundary point is defined as ALOS multiplied by three, and the low boundary point is defined as ALOS divided by three. A maximum high boundary point of 100 days has been defined for 1997-98.
Exceptions to this trimming method are neonates; high cost AN-DRGs; and specific AN-DRGs where the trim points have been modified, as advised by clinical specialists, to better delineate between levels of patient severity.
The changes relating to neonates were outlined in section 16.4 of 1996-97 Guidelines. In the case of high cost AN-DRGs where there is significant clinical and cost heterogeneity within the DRG likely to result in biased funding for tertiary hospitals, a new trimming method has been introduced. The low boundary point has been calculated as two-thirds of the ALOS and the high boundary point as one and a half times the ALOS. This method better delineates patient severity; removes the influence of extreme outliers; and improves payment arrangements for outliers.
There will be a review of trimming policy in 1997-98, with particular emphasis on neonates, intensive care and complexity issues.
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Victoria - Public Hospitals
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1997-1998 - Table of Contents
