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Government of Alberta For further information on this report and its contents contact: Information and Analysis Branch Health System Performance and Information Management Division Alberta Health and Wellness 17th floor, 10025 Jasper Avenue Edmonton, Alberta T5J 1S6 Rick Leischner, Senior Manager, Health Costing (780) 427-0664 [email protected] ISSN 1703-3055 ISSN 1920-5392 (Online) December 2009 To obtain the electronic version ofthis report, please visit Alberta Health and Wellness’ Internet Site at: http://www.health.gov.ab.ca Alberta Case Cost Report Alberta Health and Wellness For 2006/2007HospitalActivity December2009 Table ofContents Introduction 2-12 Definitions_ 13 Schedule 1 InpatientCostResults 14-79 Schedule2 AmbulatoryCare CostResults 80-99 InformationandAnalysisBranch,AlbertaHealthandWellness 1 of99 ©2009GovernmentofAlberta Digitized by the Internet Archive 2016 in https://archive.org/details/albertacasecostr2006albe Alberta Case Cost Report Alberta Health and Wellness For 2006/2007 HospitalActivity December2009 Introduction The Alberta Costing Partnership hassuccessfully developed patientspecific case costsfor both inpatientand ambulatory care, forthetenth year. The partnership includesthe costing Regional Health Authorities (RHAs) alongwith Alberta Health and Wellness. The 2006/2007 Case Cost Reportdisclosesthe costofcasesthatwere handled bythe participating health regions between April 1, 2006and March 31, 2007. Cases are grouped by linkingcostdata toactivitydatato provide appropriate summary information. Although the data submitted hasgonethrough reasonabilityvalidation, the Alberta Costing Partnership provides no external assurance overthe appropriateness and completeness ofcost allocations done bythe RHAs. The inpatientcostsare grouped byCase Mix Groups (CMGs), and ambulatorycare costs are grouped bytheAmbulatoryCare Classification System (ACCS). Schedules 1 and 2 summarize costdata by CMGsand ACCS cells, respectively. Alberta’s CostingPartnership The Information and Analysis Branch resides within Alberta Health and Wellness and is responsible forcarryingon the health costing mandate. Health costingwas done in conjunction with the regional health authorities (RHAs) usinga common costingframeworkto generate patientspecific case costs. Representativesfrom the costing RHAs and Alberta Health and Wellness participate inthe costing round table reviewofthe provincial cost results. The participants ofthis Costing Function Team reviewthe statistical analysisand costcomparisons. Issues identified in this process are investigated and resolved priorto publication ofthis report. InformationandAnalysisBranch,AlbertaHealthandWellness 2of99 ©2009GovernmentofAlberta Alberta Case Cost Report Alberta Health and Wellness For 2006/2007HospitalActivity December2009 2006/2007 Costs Volumes ofCostandActivityData Collected Inpatient AmbulatoryCare Costed Provincial Costed Provincial Records Costed Activity Records Costed Activity as%of Records Reported as%of Records Reported Activity (millions) (millions) Activity 2001/2002 185,000 337,500 55% 1.5 5.9 25% 2002/2003 194,000 345,000 56% 1.9 6.2 31% 2003/2004 195,000 353,000 55% 1.9 6.8 28% 2004/2005 196,000 357,000 55% 2.0 6.9 29% 2005/2006 206,000 365,000 56% 2.1 6.9 30% 2006/2007 216,000 364,000 59% 2.2 6.9 32% Costdata were provided from 12 differentsites. Each sitetracks costs on a patientspecific basis in one or morefunctional centres. The bulkofthe costsfor inpatientcasesflowfrom inpatient nursingfunctional centres, therefore, onlysiteswith theabilitytotrack nursingcosts on a patientspecific basis are included in this report. Since inpatients routinely receiveservices in otherfunctional centressuch as operatingand recovery rooms, diagnostic imagingand laboratoryservices, regions have developed the capabilitytotrack costs inthese centres on a patientspecific basis. Wherethis capabilitydoes notexist, regions use allocation modelsto ensurethatappropriate costsare properlydistributed to inpatientcases. The costsforambulatory care cases are reported wherethere aresystemstotrack costs on a patientspecific basis in thefunctional centres directly providingambulatory care. InformationandAnalysisBranch,AlbertaHealthandWellness 3of99 ©2009GovernmentofAlberta Alberta Case Cost Report Alberta Health and Wellness For 2006/2007HospitalActivity December2009 The followingtable outlines the facility and availability of patient specific cost information submitted inthe 2006/2007 fiscal year. 2006/2007 CostData byRegion/Facility Regional Inpatient Procedure Health E.R. Day Clinics 2 Rehab Authority Site Hj. AlbertaChildren's V Yes Yes Yes No Yes No y J Hospital , FoothillsMedical Yes No Yes Yes Yes No Centre . Rockyview Yes No Yes Yes Yes No GeneralHospital ! • / PeterLougheed Yes No No No Yes No j // Glenrose - : Rehabilitation Yes No Yes Yes Yes Yes Hospital Misericordia Community Yes Yes Yes Yes Yes Yes Hospital GreyNuns Community Yes Yes Yes Yes Yes Yes Hospital /k RHoosypailtAallexandra Yes Yes Yes Yes ! Yes Yes Universityof Yes Yes Yes Yes Yes Yes AlbertaHospital LeducCommunity Yes Yes Yes Yes Yes Yes Hospital Sturgeon Community Yes Yes Yes Yes Yes Yes Hospital Northeast CommunityHealth No Yes No Yes Yes Yes Centre | Capital Health currently providesthe bulk ofthe ambulatory care costdata. Calgary Health Region and Capital Health providesimilaramounts of Inpatientdata. Thetable below showsthe percent contribution from the respective regions: 2006/2007 Costed Cases Region Inpatient Ambulatory Capital 53% (113,822) 92% (2,021,471) Calgary 47% (101,990) 8% (157,432) InformationandAnalysisBranch,AlbertaHealthandWellness 4of99 ©2009GovernmentofAlberta Alberta Case Cost Report Alberta Health and Wellness For 2006/2007HospitalActivity December2009 Data Flows Costdata collected bythe participating RHAs isforwarded tothe Health Information and Anaysis Branch (IAB) ofAlberta Health and Wellness on an annual basis. Processingofthe raw costdata is done atAlberta Health and Wellnesswith the results reviewed and validated in consultation with the Costing Function Team. The process ultimately results in the developmentof patientspecific case costs, average costs and relative values. The processed cost records reside inthe Alberta Health and Wellness database and are availableforextractionfor research and management purposessubjecttothe provisions ofthe Health Information Act. One ofthe primary users ofthe information isthe Health Funding UnitatAlberta Health and Wellness. Forambulatory care, thesystem wide relative values are used in thefundingformula. Fundingcalculationsfor Province Wide Services usethe average costsfrom the inpatientdata. CIHI isalsoa significant userofthe costingresults. Alberta Health and Wellnesssendsthefinal set ofcostdata to CIHI to be combined with costdatafrom Ontario and British Columbia to develop national weights. Onesetofweights produced isthe Resource IntensityWeights (RIWs) byCase Mix Groups. The Health Funding Unit usesthese RIWs inthefundingformula for inpatientcare. The other major users ofdata arethe regional health authorities. Finalized costand activitydata are provided backtothe regions in a summarized format. Regions use costdata for ratesettingwith third party payersand providers, revenueanalysis,financial planning, evaluation, and benchmarking. In summary, various users have used the cost information to improve resource allocation and consumption decisions. Data Collection Processes The costingexercise is heavilydependent upon data collection systems. There aretwo components tothe data utilized byAlberta Health and Wellness in developingcase costs: activitydata and patient specific costdata. ActivityData Patientspecificactivity data is collected byall regions and represents unique information foreach particularservice. Forexample, theactivity data includes: patientdemographics (birth date, personal health number, gender, etc.) responsibilityfor payment procedure/diagnosis codes service dates service location patientdisposition providertype InformationandAnalysisBranch,AlbertaHealthandWellness 5of99 ©2009GovernmentofAlberta