Press Release

Minister Martin launches a major modernisation and expansion of Casemix

Mr Micheál Martin, T.D., Minister for Health and Children will launch a major modernisation of the National Casemix Programme at the National Casemix Working Conference in Kilkenny on 1 and 2 April, 2004.

Casemix categorises each hospitals caseload into discrete groups or Diagnoses Related Groups (DRGs) – so the ´mix´ of ´cases´ each hospital treats can be identified. This allows the comparison of activity and costs between different hospitals. It is used for many different purposes, including cost comparison, quality control, strategy planning and epidemiological data, etc. It provides a common language for service planning, management and development. It places patient-centred clinical information and health professionals at the heart of the process.

The rationale for the use of Casemix systems as part of the budgetary process is the wish to base funding on measured costs and activity, rather than on less objective systems of resource allocation, and to ensure that hospitals are adequately funded for the patients they actually treat. Casemix is in use world-wide since the 1980´s, and now forms a central part of most developed countries health system.

Ireland operates a unique ´budget-neutral´ Casemix policy – any funding saved through efficiencies is reinvested with hospitals who have demonstrated that additional funding allocated to them will result in real benefits. Casemix is not used to reduce acute hospital funding.

In his address to the Select Committee on Health and Children last June, the Minister said: “There is a clear need to move towards a resource based allocation system in the future where funding is allocated on the basis of service outcomes linked to sound VFM objectives . . . It has been agreed that there is a need for equity, efficiency and transparency in the way our systems are funded, managed and delivered. It is also agreed that there is a need for greater stakeholder participation and accountability in the management of their own resources.”

The Health Strategy committed the Department to the expansion of Casemix when it stated: “Performance measurement and transparent, evidence-based allocations are essential. The most developed system for assessing comparative efficiency and for creating incentives for good performance is Casemix.”

Following three years of detailed consultation and a ´root-and-branch´ review of every aspect of the national programme, a major strategy for the modernization and expansion of Casemix nationally has been agreed, including developing links with Australia who have the most open, transparent, government sponsored systems internationally, with significant clinical involvement. The medium-term Casemix strategy will see Casemix placed as a central pillar in acute hospital funding policy.

The conference will include presentations from senior U.K. and German Casemix programme managers, among others. Both these countries are following our lead by embarking on major Casemix development programmes to ensure that additional investment results in real patient choice and Value-for-money.

As the Minister said in his foreword to the Conference: “When the present modernization process is completed, Ireland will have a truly world-class Casemix system. The patients deserve it; the clinicians deserve it; the tax-payer deserves it.”