Building resource planning capability in clinical hospital networks using casemix: A conceptual framework

Tight financial conditions, increasingly arduous operating environments, largely fixed prices within financial periods for many service bundles, increasing costs for many hospital services, and increasing demand for many of these services have led health administrators and researchers to explore new methods of improving the delivery of hospital services with focus on cost as well as patient outcomes. Hospitals can obtain material benefits by classifying patients according to their clinical and resource utilisation profiles and using those classifications, generally termed casemix classifications, to more effectively manage resources within hospitals. This paper argues for the use of a casemix based resource planning scheme in surgical hospitals which focuses on higher level planning across the network of actors which support the surgical processes. This is based on an extensive literature review of resource planning in hospital networks, the role of casemix in the funding of Australian public hospitals, and casemix management of hospitals. Furthermore, a conceptual framework is developed for studying the capabilities that drive hospital network resource productivities, which in turn impact on economic and patient outcomes. This framework relates operational resource planning capabilities, dynamic capabilities effecting planning capability changes, and knowledge sharing capabilities to hospital network resource productivities, which in turn impact economic and clinical patient outcomes. Future areas of research are identified.