Need to evaluate management Control the costs Fulfill new requirements Greater demandings Creation of information systems that allow to grade the.

Apresentação em tema: "Need to evaluate management Control the costs Fulfill new requirements Greater demandings Creation of information systems that allow to grade the."— Transcrição da apresentação:

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4 Need to evaluate management Control the costs Fulfill new requirements Greater demandings Creation of information systems that allow to grade the management [3] Ribeiro N. Indicadores de Gestão para Administração Pública. TOC. 2000 June

5 In a general way… …measurement units to monitor and evaluate through comparison between different entities …are… Two main functions EvaluateDescribe [3] Ribeiro N. Indicadores de Gestão para Administração Pública. TOC. 2000 June

6 Efficiency Efficacy Effectiveness Cost-efficiency Comparability Availability Relevance Consistency Reliability [3] Ribeiro N. Indicadores de Gestão para Administração Pública. TOC. 2000 June [4] Correia L F. Indicadores de Desempenho Económico na Saúde [Internet]. 2005

7 Lack of technical means Input/Output measurement difficulties Availability of funding Employees lack of instruction Little dynamism from commissions responsible for executing indicators Inadequacies of information systems [3] Ribeiro N. Indicadores de Gestão para Administração Pública. TOC. 2000 June [4] Correia L F. Indicadores de Desempenho Económico na Saúde [Internet]. 2005

8 Facing an inefficient and non productive governmental management of public health systems Construction of evaluation means for the efficiency and effectiveness levels of health systems [3] Ribeiro N. Indicadores de Gestão para Administração Pública. TOC. 2000 June

9 Comparative quality reporting Public reporting Pay-for-performance Public reporting Pay-for-performance Comparative quality reporting

10 The financing of Health entities is based on Diagnosis Related Groups (DRGs) Sorting systems for patients in clinically coherent and homogeneous groups – in a resource consumption point of view Built from the diagnostic features and patients therapeutic profiles that explain the resource consumption in hospitals Tendency to rationalize the funds distribution process [5] Bentes M, Gonçalves M, Urbano J, Tranquada S. A utilização dos GDHs como instrumento de financiamento hospitalar. Revista Gestão Hospitalar. 1996 December-1997 January;33: 33-43.

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12 Norte Centro Lisboa Alentejo Algarve Região Autónoma dos Açores Região Autónoma da Madeira Establish a comparison between the different areas of Portugal Compare the numbers from 2000 to 2007 Evolution of the services quality and efficiency [25] Nomenclatura de Unidades Territoriais para fins estatísticos, Wikipédia, 2008 [26] Parlamento Europeu, Conselho da União Europeia. Regulamento (CE) N.º 1059/2003 do Parlamento Europeu e do Conselo, relativo à instituição de uma Nomenclatura Comum das Unidades Territoriais Estatísticas (NUTS), Jornal Oficial da União Europeia. 2003 May 26.

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14 Excluded episodes (ambulatory episodes): Planned admission Release date equals admission date Patients do not change hospitals Patients do not leave against medical advice nor die % Inpatient episode85,4 Ambulatory episode14,6 Database with inpatient episodes from 87 Portuguese public Hospitals between 2000 and 2007

15 Gender Male 44,4 Female 55,6 Age 1719,8 18 - 245,4 25 - 3412,6 35 - 449,3 45 - 549,3 55 - 6410,8 65 - 7414,2 7518,2 Nuts II Alentejo4,9 Algarve3,7 Centro26,0 Lisboa26,5 Norte33,8 Discharge Year 200012,1 200112,2 200212,4 200312,7 200412,6 200513,0 200612,5 200712,5 Total admissions: 7.768.467

16 HOSP_ID EPIS_ID SEXO DDX1-DDX20 SRG1-SRG20 DSP BIRTH_WGT ADM_TIP HOSP_FROM HOSP_TO TOTDIAS SAIDLAST DRG MDC RESIDE ENT1 HOSP_RESIDE DISTANCIA

17 Discharged patients Exceptional admission episodes Surgical admission time Complication-free long-term admissions Readmissions Short-term inappropriate admissions Newborns Vaginal Deliveries Unspecified surgical procedures Medical DRGs complications Exceptional admission episodes Surgical admission time Complication-free long-term admissions Readmissions Short-term inappropriate admissions Vaginal Deliveries Unspecified surgical procedures Medical DRGs complications Discharged patients Newborns Exceptional admission episodes Surgical admission time Complication-free long-term admissions Readmissions Short-term inappropriate admissions Newborns Vaginal Deliveries Unspecified surgical procedures Medical DRGs complications Discharged patients Surgical admission time Complication-free long-term admissions Readmissions Short-term inappropriate admissions Newborns Vaginal Deliveries Unspecified surgical procedures Medical DRGs complications Discharged patients Exceptional admission episodes Complication-free long-term admissions Readmissions Short-term inappropriate admissions Newborns Vaginal Deliveries Unspecified surgical procedures Medical DRGs complications Discharged patients Exceptional admission episodes Surgical admission time Readmissions Short-term inappropriate admissions Newborns Vaginal Deliveries Unspecified surgical procedures Medical DRGs complications Discharged patients Exceptional admission episodes Surgical admission time Complication-free long-term admissions Short-term inappropriate admissions Newborns Vaginal Deliveries Unspecified surgical procedures Medical DRGs complications Discharged patients Exceptional admission episodes Surgical admission time Complication-free long-term admissions Readmissions Newborns Vaginal Deliveries Unspecified surgical procedures Medical DRGs complications Discharged patients Exceptional admission episodes Surgical admission time Complication-free long-term admissions Readmissions Short-term inappropriate admissions Vaginal Deliveries Unspecified surgical procedures Medical DRGs complications Discharged patients Exceptional admission episodes Surgical admission time Complication-free long-term admissions Readmissions Short-term inappropriate admissions Newborns Unspecified surgical procedures Medical DRGs complications Discharged patients Exceptional admission episodes Surgical admission time Complication-free long-term admissions Readmissions Short-term inappropriate admissions Newborns Vaginal Deliveries Medical DRGs complications Discharged patients Exceptional admission episodes Surgical admission time Complication-free long-term admissions Readmissions Short-term inappropriate admissions Newborns Vaginal Deliveries Unspecified surgical procedures Discharged patients Exceptional admission episodes Surgical admission time Complication-free long-term admissions Readmissions Short-term inappropriate admissions Newborns Vaginal deliveries Unspecified surgical procedures Medical drgs complications

18 b) Establish a comparison between the different areas of Portugal a) Compare the numbers from 2000 to 2007

19 2000(%)2001(%)2002(%)2003(%)2004(%)2005(%)2006(%)2007(%) Exceptional admission episodes Short-term episode 19,219,419,719,8 20,319,719,8 Long-term exceptional episode 2,42,11,91,71,61,5 Complication-free long-term admissions 1) 1,3 1,00,8 0,60,50,6 Readmissions45,845,546,045,9 46,345,844,4 Newborns1,041,081,15 1,081,061,041,02 Vaginal Delivery Complications free75,576,471,374,873,976,772,973,5 With complications24,523,628,725,226,123,327,126,5 Unspecified surgical procedures13,412,612,313,012,612,411,711,8 Medical DRGs complications10,511,312,412,512,214,013,113,9 1) Calculated from a 1 % sample

20 Alentejo (%)Algarve(%)Centro(%)Lisboa(%)Norte(%) Exceptional admission episodes Short-term episode 16,618,318,621,319,8 Long-term exceptional episode 2,12,41,71,91,6 Complication-free long-term admissions 1) 0,81,40,9 0,8 Readmissions 78,677,675,376,775,3 Newborns 1,1 1,51,21,3 Vaginal Delivery Complications free 86,088,371,273,5 With complications 14,011,7 28,8 26,5 Unspecified surgical procedures 6,33,726,730,127,5 Medical DRGs complications 4,43,226,629,529,9 Alentejo (%)Algarve(%)Centro(%)Lisboa(%)Norte(%) Exceptional admission episodes Short-term episode 16,618,318,621,319,8 Long-term exceptional episode 2,12,41,71,91,6 Complication-free long-term admissions 1) 0,81,40,9 0,8 Readmissions 78,677,675,376,775,3 Newborns 1,1 1,51,21,3 Vaginal Delivery Complications free 86,088,371,273,5 With complications 14,011,7 28,8 26,5 Unspecified surgical procedures 6,33,726,730,127,5 Medical DRGs complications 4,43,226,629,529,9 Alentejo (%)Algarve(%)Centro(%)Lisboa(%)Norte(%) Exceptional admission episodes Short-term episode 16,618,318,621,319,8 Long-term exceptional episode 2,12,41,71,91,6 Complication-free long-term admissions 1) 0,81,40,9 0,8 Readmissions 78,677,675,376,775,3 Newborns 1,1 1,51,21,3 Vaginal Delivery Complications free 86,088,371,273,5 With complications 14,011,7 28,8 26,5 Unspecified surgical procedures 6,33,726,730,127,5 Medical DRGs complications 4,43,226,629,529,9 Alentejo (%)Algarve(%)Centro(%)Lisboa(%)Norte(%) Exceptional admission episodes Short-term episode 16,618,318,621,319,8 Long-term exceptional episode 2,12,41,71,91,6 Complication-free long-term admissions 1) 0,81,40,9 0,8 Readmissions 78,677,675,376,775,3 Newborns 1,1 1,51,21,3 Vaginal Delivery Complications free 86,088,371,273,5 With complications 14,011,7 28,8 26,5 Unspecified surgical procedures 6,33,726,730,127,5 Medical DRGs complications 4,43,226,629,529,9 Alentejo (%)Algarve(%)Centro(%)Lisboa(%)Norte(%) Exceptional admission episodes Short-term episode 16,618,318,621,319,8 Long-term exceptional episode 2,12,41,71,91,6 Complication-free long-term admissions 1) 0,81,40,9 0,8 Readmissions 78,677,675,376,775,3 Newborns 1,1 1,51,21,3 Vaginal Delivery Complications free 86,088,371,273,5 With complications 14,011,7 28,8 26,5 Unspecified surgical procedures 6,33,726,730,127,5 Medical DRGs complications 4,43,226,629,529,9 Alentejo (%)Algarve(%)Centro(%)Lisboa(%)Norte(%) Exceptional admission episodes Short-term episode 16,618,318,621,319,8 Long-term exceptional episode 2,12,41,71,91,6 Complication-free long-term admissions 1) 0,81,40,9 0,8 Readmissions 78,677,675,376,775,3 Newborns 1,1 1,51,21,3 Vaginal Delivery Complications free 86,088,371,273,5 With complications 14,011,7 28,8 26,5 Unspecified surgical procedures 6,33,726,730,127,5 Medical DRGs complications 4,43,226,629,529,9 Alentejo (%)Algarve(%)Centro(%)Lisboa(%)Norte(%) Exceptional admission episodes Short-term episode 16,618,318,621,319,8 Long-term exceptional episode 2,12,41,71,91,6 Complication-free long-term admissions 1) 0,81,40,9 0,8 Readmissions 78,677,675,376,775,3 Newborns 1,1 1,51,21,3 Vaginal Delivery Complications free 86,088,371,273,5 With complications 14,011,7 28,8 26,5 Unspecified surgical procedures 6,33,726,730,127,5 Medical DRGs complications 4,43,226,629,529,9 Alentejo (%)Algarve(%)Centro(%)Lisboa(%)Norte(%) Exceptional admission episodes Short-term episode 16,618,318,621,319,8 Long-term exceptional episode 2,12,41,71,91,6 Complication-free long-term admissions 1) 0,81,40,9 0,8 Readmissions 78,677,675,376,775,3 Newborns 1,1 1,51,21,3 Vaginal Delivery Complications free 86,088,371,273,5 With complications 14,011,7 28,8 26,5 Unspecified surgical procedures 6,33,726,730,127,5 Medical DRGs complications 4,43,226,629,529,9 Alentejo (%)Algarve(%)Centro(%)Lisboa(%)Norte(%) Exceptional admission episodes Short-term episode 16,618,318,621,319,8 Long-term exceptional episode 2,12,41,71,91,6 Complication-free long-term admissions 1) 0,81,40,9 0,8 Readmissions 78,677,675,376,775,3 Newborns 1,1 1,51,21,3 Vaginal Delivery Complications free 86,088,371,273,5 With complications 14,011,7 28,8 26,5 Unspecified surgical procedures 6,33,726,730,127,5 Medical DRGs complications 4,43,226,629,529,9 Alentejo (%)Algarve(%)Centro(%)Lisboa(%)Norte(%) Exceptional admission episodes Short-term episode 16,618,318,621,319,8 Long-term exceptional episode 2,12,41,71,91,6 Complication-free long-term admissions 1) 0,81,40,9 0,8 Readmissions 78,677,675,376,775,3 Newborns 1,1 1,51,21,3 Vaginal Delivery Complications free 86,088,371,273,5 With complications 14,011,7 28,8 26,5 Unspecified surgical procedures 6,33,726,730,127,5 Medical DRGs complications 4,43,226,629,529,9

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