Call For Legislation To Criminalise Public Hospital Data Manipulation, Australia
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Nationally uniform legislation is needed to make health service reporting standards consistent and to criminalise public sector data fraud, according to an article published in the Medical Journal of Australia.
Dr Antony Nocera, an emergency physician at Dubbo Base Hospital, NSW, writes that systems for reporting the performance of Australian public hospitals are inadequate.
Performance-based hospital funding had been touted as a tool for health care reform, Dr Nocera said, but there is evidence that this had led to fraudulent reporting of hospital performance in Victoria and NSW.
He said hospital data manipulation included the use of "virtual wards" created on a hospital's computer system, whereby emergency department patients requiring admission to wards with no available beds were "admitted" to the virtual ward.
Hospitals then fraudulently claimed that they met key performance indicator (KPI) targets to be eligible for incentive payments.
Dr Nocera said the combination of performance data manipulation, data fraud and variable interpretation of reporting requirements meant the comparisons of hospital performance among states were meaningless.
"Any attempts to promote health care reform in Australia through the use of incentive funding schemes must be backed up with legislation," Dr Nocera said.
"Such legislation must be nationally uniform so that it regulates and defines the terms used in hospital data reporting processes to allow meaningful comparisons to be made among public hospital systems, and to allow appropriate evaluations of the impact of government health policy changes."
Dr Nocera called for comparative performance indicators to be developed that relate various hospital expenditures to their impact on patient care and measurable patient outcomes.
"Urgent action is needed to develop realistic outcome measures that base hospital funding more on the quality and safety of patient care and less on patient throughput numbers," Dr Nocera said.
Consideration should also be given to making the Australian Bureau of Statistics responsible for the collection of hospital performance data, he said.
The Medical Journal of Australia is a publication of the Australian Medical Association.
Medical Journal of Australia
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