Financing in Australia's public hospital works through the Australian Refined Diagnosis Related Groups (AR-DRGs) with separations to specific DRG groups based on medical diagnosis or surgical procedure, patient's age, mode of separation, clinical complexity and complications. This paper aims at assessing how the AR-DRGs reflect the efficiency and equity of the hospitals resource allocation. Using administrative data of all acute public hospital admissions and length of stay (LOS) as a proxy for hospital costs, this paper showed that patients’ socio-economic (SES) characteristics are a strong determinant of health care utilization. Our results revealed that the lower the SES, the longer the LOS and hence more utilization of the inpatient resources. Therefore, omitting SES from the risk adjusters list and solely focusing on DRG- based compensation penalizes hospitals catering to lower SES populations. Our findings further support the idea of smaller/remote hospitals based on block funding.

澳大利亚公立医院的资金筹措是通过澳大利亚精细诊断相关小组（AR-DRG）进行的，根据医学诊断或外科手术，患者的年龄，分离方式，临床复杂性和并发症，将特定的DRG小组分开。本文旨在评估AR-DRG如何反映医院资源分配的效率和公平性。使用所有急性公立医院入院的行政管理数据和住院时间（LOS）来代替医院费用，本文显示患者的社会经济（SES）特征是医疗保健利用率的重要决定因素。我们的结果表明，SES越低，LOS越长，因此住院资源的利用率越高。因此，从风险调整者列表中忽略SES，而仅专注于基于DRG的补偿，将会对满足较低SES人群的医院造成不利影响。我们的发现进一步支持基于整体资金的小型/远程医院的想法。