Casemix and rehabilitation: evaluation of an early discharge scheme

Abstract

This paper presents a case study of an early discharge scheme funded by casemix incentives and discusses limitationsof a casemix model of funding whereby hospital inpatient care is funded separately from care in other settings. ThePOSITIVE Rehabilitation program received 151 patients discharged early from hospital in a twelve-month period.Program evaluation demonstrates a 40.9% drop in the average length of stay of rehabilitation patients and a 42.6%drop in average length of stay for patients with stroke. Other benefits of the program include a high level of patientsatisfaction, improved carer support and increased continuity of care. The challenge under the Australianinterpretation of a casemix model of funding is ensuring the viability of services that extend across acute hospital, non-acutecare, and community and home settings.