A preliminary casemix classification system for Home and Community Care Clients in Western Australia

Abstract

The objective of the study was to examine the feasibility of using routinely available assessment, Minimum Data Set (MDS), socio-economic, geographic and unit cost data to define a discrete number of clinically meaningful, costhomogeneous Home and Community Care (HACC) client groups. Participants included new and existing Western Australian (WA) HACC beneficiaries from 1 January to 31 September 2001. Seventy two HACC agencies from metropolitan and rural regions participated, which represented 29% of the sector. A total of 9,404 quarterly periods of care contributed to the exploratory classification analysis and 12,697 to the confirmatory analysis. The final structure contained nine terminal nodes, achieved an R 2 of 23.7%, and was robust to fluctuations in cost. Higher costs were associated with increased functional dependency and the need for clinical services. The classification is empirically grounded, simple and robust, and has a number of potential policy and practice applications. Further refinement is required to improve its suitability as a funding tool.