Otolaryngology, ENT Conference

Biography

Dr Andrew Lange is an Otolaryngology resident at Prince of Wales Hospital in Sydney. He has research interests in Head and Neck oncology with a particular focus on funding models and equitable distribution of services. 

Abstract

Abstract

Head and Neck Cancer is a major cause of morbidity and mortality in the community and is a costly disease. According to the Cancer Council in 2014, 4537 head and neck cancers were diagnosed in Australia and 1080 deaths occurred due to this disease in 2016 alone. Due to the complexity of head and neck cases, multidisciplinary care is required to achieve good outcomes, which is an expensive endeavour. Major expenses include the cost of large multi-team and multi-stage surgeries, intensive care stays, prolonged ward stays, prolonged courses of radiotherapy and the cost of associated morbidity and end of life care. Coding accuracy of surgical data has significant implications for sufficient funding in large public Head and Neck units. Lack of funding can lead to poor outcomes for our patients.

Methods: Operation reports for all patients undergoing complex major head and neck surgery in the period 2013-2018 from our center were gathered. Investigators examined each operation report and NSW Health funding codes were reviewed. Inaccuracies in coding were tallied and the cost of corrected codes was calculated for all patients.

Results: Coding inaccuracies for complex major head and neck operations were commonly encountered and funding losses were found in up to 40% of all major head and neck cases. Unclear documentation in operation reports was found to be a common contributor to funding losses.   

Conclusion: Operative coding inaccuracies are a significant source of funding loss for complex head and neck cancer patients. The most common contributor to funding losses was unclear documentation in operation reports. The authors are developing a documentation strategy to prevent funding losses