IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v108y2012i1p45-48.html
   My bibliography  Save this article

Improving the productivity of elective surgery through a new ‘package of care’

Author

Listed:
  • Ashton, Toni
  • Bramley, Dale
  • Armstrong, Delwyn

Abstract

In response to a need to improve the productivity and throughput of elective surgical services, one district health board (DHB) in New Zealand has introduced a ‘package of care’ (POC) in which incentive-based, risk-sharing contracts were developed collaboratively between DHB managers, surgeons and anaesthetists. The POC includes throughput targets and facilitates consistent surgical teams and the cohorting of patients. Whilst many staff are very supportive of the POC, some are of the view that it conflicts with the ideals and principles of working in a public health system, and creates inequities amongst the hospital staff. Analysis indicates that, after controlling for age, casemix and complexity the POC has resulted in shorter theatre times, shorter lengths of stay and lower average inpatient event costs compared with standard care at the public hospital. An unintended consequence could be that the POC may encourage throughput of less complex cases at the expense of more complex cases. The average complexity and range of cases performed publicly should be carefully monitored to ensure this does not occur.

Suggested Citation

  • Ashton, Toni & Bramley, Dale & Armstrong, Delwyn, 2012. "Improving the productivity of elective surgery through a new ‘package of care’," Health Policy, Elsevier, vol. 108(1), pages 45-48.
  • Handle: RePEc:eee:hepoli:v:108:y:2012:i:1:p:45-48
    DOI: 10.1016/j.healthpol.2012.08.007
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851012002163
    Download Restriction: Full text for ScienceDirect subscribers only

    As the access to this document is restricted, you may want to search for a different version of it.

    More about this item

    Keywords

    Elective surgery; Productivity; New Zealand;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:108:y:2012:i:1:p:45-48. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Dana Niculescu) or (). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    We have no references for this item. You can help adding them by using this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.