This audit is the second in a series of performance audits
examining hospital efficiency and has again clearly identified a
number of opportunities for the Department of Health & Human
Services (DHHS) and hospital management to collectively improve the
way hospitals operate.
Using a relative Stay Index (RSI) model, it has identified
widespread variation in acute patient length of stay (LOS) between
many of Victoria's largest public hospitals. This indicates
inefficiencies—lost opportunities to free up hospital beds, to
treat more patients and to reduce significant unnecessary costs.
Even after adjusting for patient characteristics and peer-grouping
hospitals, potentially almost 145 000 extra bed days could be made
available and $125 million per year could be directed to other
The reasons for differences in LOS performance, even among
similar hospitals, vary and are not always captured by performance
data. However, public hospitals can improve LOS performance by
implementing better practice around patient management, from
admission through to discharge.
The data used in this audit comes from DHHS and yet it is not
using it to identify what is significant variation in hospital
efficiency. As the health system manager, DHHS should use its data
and—in collaboration with hospital management—actively seek to
understand, explain and reduce LOS variances.