Final Report on RREF 2001 - Department of Health

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Part B: Development of Options for a Revised RREF The scaled scores on the different variables can be added together to give a combined score for each LGA. In a RREF option with 6 variables, the maximum score for any LGA would be 54; with 4 variables, it would be 36. The combined score for each LGA can then be readily expressed as a percentage of the maximum possible score. Statistical transformation is a second method of standardising scores to a mean of 100 and a specified standard deviation. This method preserves the relative position of each LGA, but produces different results for variables where the distributions are skewed in different ways. In the case of most of the variables under consideration for weighting the RREF, there is no need to transform the distributions. This option is also less transparent and actual values of data for LGAs are obscured at an earlier stage in the scaling and weighting process. 3.2 OPTIONS FOR SCALING NEED VARIABLES FOR INCLUSION IN THE RREF The options for scaling the variables identified for inclusion in the RREF are summarised below. The Consultations sought views on these options. What are the options for scaling the variables Do the rationales for inclusion set out in the profiles of variables cover all relevant issues? • Scaling variables into deciles and scoring 0 to 9, from lowest to highest need, is the identified option. • Each LGA to receive a score on each variable to reflect relative need • Do you agree with the rationales for inclusion of median household income, language other than English spoken at home, Koori population and ARIA as weighting variables? • As Life Expectancy correlates highly with median household income, and because of the ambivalent relationship of Life Expectancy to need for HACC services, should Life Expectancy be included as a variable? • Should the shortfall in residential care be included as a variable for weighting, based on operational rather than approved beds? 3.3 FURTHER ISSUES AND PREFERRED OPTIONS Using a scale from 0 to 9 was accepted as providing a common ruler for all the need variables Scaled scores of LGAs on individual variables were seen to accord with views of need in the field. There was very keen interest in having access to these data for use in regional planning, with data on these basic need indicators to be combined with more local quantitative data, including data from the HACC MDS, and qualitative information. 3.4 RESOLUTION OF SCALING OF NEED VARIABLES Scaling the five need variables 0 to 9 was adopted as the preferred option. The data on need variables and the scaled scores is included in Appendix 3 and is to be made available by DHS for use in regional planning of HACC services. <strong>Final</strong> <strong>Report</strong> July 2001 42
Step 4: Options for weighting need variables Part B: Development of Options for a Revised RREF 4.1 WEIGHTING OF NEED VARIABLES IN RELATED FORMULAS Weighting to take account of the relative effects of different variables is one of the most difficult tasks for any resource allocation formula. Ideally, the effect of each variable on overall need would be assessed through statistical analysis of the relationships between the variables and a summary measure of need, or at least the cost or time of service required to meet need. The following examples demonstrate how different formulas have dealt with this issue. In the Resident Classification Scale The relationship between a number of resident characteristics that affect need for care and the cost and time inputs from care staff has been analysed and each question on the RCS carries a different weighting that reflects its effect on care needs. Each resident then receives an RCS score that takes account of their care needs, as measured and weighted by the questions on the RCS score. No such summary measure of need for HACC services is available by LGA however. No measure of need for post acute services was available for the development of the Post Acute Care Resource Allocation Model, nor was a measure of need for disability services available for the Disability Program resource allocation formula. Instead, as with the 1992 RREF, these two formulas have adopted arbitrary weightings on the recommendation of advisory groups involved in developing the formula. In the 1992 RREF • The only weighting was for rurality. • While density of population was measured, the decision to weight this variable by 10, 20 or 30% was essentially an arbitrary response to the view that rurality affected the need for services, but there was no clear evidence that did so by a factor of as much as 30%. • Although most of the LGAs in rural Victoria received the full 30% weighting, the effect on overall resource allocation was only 6.8% as these LGAs accounted for only a small share of the total RREF base population. In the PACRAM • The PACRAM Reference Group recognised that older age and socio-economic status affected the need for post acute services • The decision was made to double the weighting for these two variables in the PACRAM formula. However, there was no clear evidence to say that the two variables should be given the same extra weight or that they should be given twice as much weight as all the other variables. In the Disability Program • The Disability Program formula applies only to the population to age 65. <strong>Final</strong> <strong>Report</strong> July 2001 43
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FINAL REPORT REVIEW OF THE RELATIVE
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STEP 3: OPTIONS FOR SCALING NEED VA
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ABBREVIATIONS AND NOTE ON TERMINOLO
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Frequently Asked Questions A number
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DACS • 2.5% of children in the 0-
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LGA Median H’hold Inc. YLD Lang o
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Department of Human Services 1999b.
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Final Report on RREF 2001 - Department of Health

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