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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

National Disability Insurance Scheme timeframes and functional outcomes for inpatient rehabilitation patients: a 5-year retrospective audit

David Kellett A B * , Alexandra G. Adams https://orcid.org/0000-0001-6062-8885 C and Michael Pollack https://orcid.org/0000-0001-8587-0934 A B
+ Author Affiliations
- Author Affiliations

A Rankin Park Centre, John Hunter Hospital, Hunter New England Health, Newcastle, NSW, Australia.

B School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia.

C School of Psychological Sciences, University of Newcastle, Newcastle, NSW, Australia.

* Correspondence to: David.Kellett@health.nsw.gov.au

Australian Health Review 48(1) 58-65 https://doi.org/10.1071/AH23216
Submitted: 21 October 2023  Accepted: 21 December 2023  Published: 18 January 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

The aim of this study was to compare National Disability Insurance Scheme (NDIS) timeframes and functional outcomes for a patient population managed in an inpatient hospital rehabilitation unit.

Methods

A retrospective hospital audit was undertaken of adult patients admitted to a tertiary-level, regional inpatient rehabilitation unit between January 2017 and December 2021 who were either referred, or not, to the NDIS. A hospital NDIS patient database, Australasian Rehabilitation Outcome Centre episode data, and patient medical records were analysed. The main outcome measures included actual rehabilitation length of stay versus expected length of stay, and Functional Independence Measure (FIM) efficiency for all inpatients, with NDIS timeframes analysed for the NDIS-referred patient subgroup.

Results

Rehabilitation inpatients referred for NDIS services significantly exceeded expected rehabilitation length of stay compared to those not referred to the NDIS. Furthermore, expected length of stay was significantly exceeded for those patients who required implementation of a NDIS plan to safely transition from hospital. FIM efficiency was significantly lower for patients referred to the NDIS. Recent improvement in timeframes for being accepted as a NDIS participant did not reduce length of stay.

Conclusions

NDIS timeframes for rehabilitation inpatients incur a significant opportunity cost for the provision of efficient inpatient rehabilitation services that are unaccounted for in current benchmarking performance standards.

Keywords: clinical services, disability, health economics, health services research, hospitals, patient-centred care, performance and evaluation, rehabilitation.

References

Mavromaras K, Moskos M, Mahuteau S, et al. Evaluation of the NDIS: final report. Adelaide: Department of Social Services; 2018. Available at https://www.dss.gov.au/sites/default/files/documents/04_2018/ndis_evaluation_consolidated_report_april_2018.pdf

Nevile A, Malbon E, Kay A, Carey G. The implementation of complex social policy: Institutional layering and unintended consequences in the National Disability Insurance Scheme. Aust J Public Adm 2019; 78(4): 562-576.
| Crossref | Google Scholar |

Joint Standing Committee on the National Disability Insurance Scheme. Transitional Arrangements for the NDIS. Canberra: Department of Social Services; 2018.

Rogers B, Legaspi JP, Bastiampillai T. Hospital congestion: a market solution to address delayed transfers of care from hospital beds. Med J Aust 2023; 218(7): 298-300.
| Crossref | Google Scholar | PubMed |

Foster MM, Borg DN, Houston V, Ehrlich C, Harre D, Lau G, et al. Planning with care complexity: Factors related to discharge delays of hospitalised people with disability. Health Soc Care Community 2022; 30(6): e4992-e5000.
| Crossref | Google Scholar | PubMed |

Houston V, Foster M, Borg DN, Nolan M, Seymour-Jones A. From hospital to home with NDIS funded support: Examining participant pathway timeframes against discharge expectations. Aust Social Work 2020; 73(2): 175-190.
| Crossref | Google Scholar |

Foster MM, Bowley J, Houston V, Borg DN. Where to next? An exploration of patients with disability and complex needs who leave acute care hospitals via an interim discharge pathway. Aust Health Rev 2022; 46(3): 355-360.
| Crossref | Google Scholar | PubMed |

Guthrie S, Alexander T. Transition between inpatient rehabilitation and National Disability Insurance Scheme for Traumatic Brain Injury and Spinal Cord Injury. Int J Popul Data Sci 2022; 7(3): 1864.
| Crossref | Google Scholar |

AROC. AN-SNAP v4v5 Rehab Class Calculator. AROC; 2023.