Australia’s public hospitals have been drawn into a murky world of fudged figures, “virtual wards” and suspected data fraud, a doctor says.
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Reports of the deliberate manipulation of hospital data have surfaced in both NSW and Victoria since performance-based funding was introduced in the 1990s.
Dubbo-based Dr Antony Nocera said the system required a significant overhaul, starting with laws requiring consistent reporting of hospital data across the states and criminal penalties for any individuals involved in “data fraud”.
“In the absence of adequate funding to maintain basic services, performance-based funding has prompted hospital data fraud in Victoria and NSW,” Dr Nocera writes in a paper published in the Medical Journal of Australia.
“Any attempts to promote healthcare reform in Australia through the use of incentive funding schemes must be backed up with legislation making it clear that data corruption is not tolerated in the public sector.”
Dr Nocera, an emergency physician at Dubbo Base Hospital, points to the Corporations Act, which sets out national standards for the honest reporting of financial data.
Criminal penalties are provided for directors of public companies found to have breached them.
Reported cases of fudged hospital data have included the creation of “virtual wards” which exist only on a hospital’s computer system.
Patients nearing a point where they should be rated as waiting too long for beds were admitted to the virtual ward instead, despite no real beds being available.
Dr Nocera said hospitals could then fraudulently claim they had met key performance indicator (KPI) targets to remain eligible for incentive payments.
This resulted in a financial benefit for not only the hospital, he said.
“The possible relationship between KPI fraud and the practice of paying KPI-based salary bonuses to hospital administrators has not been investigated,” Dr Nocera said.
The Australian Bureau of Statistics should also be considered for an auditing role, he said.
Aside from deliberate attempts to fudge the data, he said hospital administrations across the country had differing views on their reporting requirements.
“Comparisons of hospital performance among states are meaningless,” Dr Nocera said.
“Urgent action is needed to develop realistic outcome measures that base hospital funding on the quality and safety of patient care and less on patient throughput numbers.”