Programme Budgeting – Testing The Approach in Scotland

This paper describes the pilot application of Programme Budgeting and Marginal Analysis (PBMA) in Scotland. Within the Health Care Quality Strategy for NHSScotland one of the three quality ambitions is concerned with providing a more efficient and effective health service. This paper supports this ambition by discussing how outcome measures could be used, along with cost data disaggregated in this way, to inform discussions around the value for money associated with different programmes.


Appendix D: Diagnoses or Specialty groups in 'Other' PBC category

SMR01 - Acute activity

PBC ICD10 code Description
23X - Other Q893 Situs inversus
Q898 Other specified congenital malformations
Q899 Congenital malformation, unspecified
Q929 Trisomy and partial trisomy of autosomes, unspecified
Q933 Deletion of short arm of chromosome 4
Q935 Other deletions of part of a chromosome
Q959 Balanced rearrangement and structural marker, unspecified
Q969 Turner's syndrome, unspecified
Q979 Sex chromosome abnormality, female phenotype, unspecified
Q984 Klinefelter's syndrome, unspecified
Q998 Other specified chromosome abnormalities
Q999 Chromosomal abnormality, unspecified
R53X Malaise and fatigue
R54X Senility
R571 Hypovolaemic shock
R578 Other shock
R579 Shock, unspecified
R58X Haemorrhage, not elsewhere classified
R590 Localized enlarged lymph nodes
R591 Generalized enlarged lymph nodes
R599 Enlarged lymph nodes, unspecified
R600 Localized oedema
R601 Generalized oedema
R609 Oedema, unspecified
R620 Delayed milestone
R628 Other lack of expected normal physiological development
R629 Lack of expected normal physiologic development unspec
R681 Nonspecific symptoms peculiar to infancy
R682 Dry mouth, unspecified
R683 Clubbing of fingers
R688 Other specified general symptoms and signs
R760 Raised antibody titre
R788 Finding of oth spec subs not normally found in blood
R798 Other specified abnormal findings of blood chemistry
R799 Abnormal finding of blood chemistry, unspecified
R897 Abn finds specs oth organs abn histol finds
R898 Other abnormal findings in specimens from other organs
R938 Abn finds on diag imaging of other spec body structures
R948 Abn results of function studies of other organs and systems
R960 Instantaneous death
Z090 Follow-up examination after surgery for other conditions
Z091 Follow-up examination after radiotherapy for oth conditions
Z092 Follow-up examination after chemotherapy for oth conditions
Z097 Follow-up exam after combined treatment for other conditions
Z098 Follow-up exam after other treatment for other conditions
23X Other cont. Z099 Follow-up exam after unspec treatment for other conditions
Z451 Adjustment and management of infusion pump
Z452 Adjustment and management of vascular access device
Z458 Adjustment and management of other implanted devices
Z459 Adjustment and management of unspecified implanted device
Z468 Fitting and adjustment of other specified devices
Z469 Fitting and adjustment of unspecified device
Z480 Attention to surgical dressings and sutures
Z488 Other specified surgical follow-up care
Z489 Surgical follow-up care, unspecified
Z501 Other physical therapy
Z508 Care involving use of other rehabilitation procedures
Z509 Care involving use of rehabilitation procedure, unspecified
Z514 Preparatory care for subsequent treatment NEC
Z518 Other specified medical care
Z519 Medical care, unspecified
Z530 Procedure not carried out because of contraindication
Z531 Proc not carried out; pat's decision reasons belief/gp press
Z532 Proc not carried out because pat's dec oth unspec reasons
Z538 Procedure not carried out for other reasons
Z539 Procedure not carried out, unspecified reason
Z540 Convalescence following surgery
Z548 Convalescence following other treatment
Z549 Convalescence following unspecified treatment
Z758 Oth probs related to med facilities and other health care
Z768 Persons encountering health servs in oth spec circumstances
Z769 Person encountering health services in unspec circumstances
Z900 Acquired absence of part of head and neck
Z910 Personal hist of allergy oth than to drugs and biol subs
Z911 Personal hist noncompliance with med treatment and regimen
Z912 Personal history of poor personal hygiene
Z988 Other specified postsurgical states
U - Unclassified H031 Involvement of eyelid in other infectious diseases EC
R69X Unknown and unspecified causes of morbidity
R99X Other ill-defined and unspecified causes of mortality

SMR01_E - Geriatric Long Stay

PBC ICD10 code Description
23X - Other R53X Malaise and fatigue
R54X Senility
R58X Haemorrhage
R600 Localized oedema
R609 Oedema
R798 Other specified abnormal findings of blood chemistry
Z501 Other physical therapy
Z508 Care involving use of other rehabilitation procedures
Z509 Care involving use of rehabilitation procedure
Z514 Preparatory care for subsequent treatment NEC
Z539 Procedure not carried out
Z540 Convalescence following surgery
Z549 Convalescence following unspecified treatment
U - Unclassified B967 Clostridium perfringens as cause of dis class to other chaps
R69X Unknown and unspecified causes of morbidity
R99X Other ill-defined and unspecified causes of mortality

SMR04 - Mental Health & Learning Disabilites

PBC ICD10 code Description
U - Unclassified F03x Invalid code
F550 Invalid code
F552 Invalid code
F610 Invalid code

Outpatient activity

PBC Specialty
23X - Other General Surgery (exc Vascular Surgery)
Ear, Nose & Throat
Surgical Paediatrics
General Medicine
Rehabilitation Medicine
Medical Paediatrics
Geriatric Assessment
Medical Other (includes Allergy; Clinical Pharmacology & Therapeutics; Endocrinology; GUM; Homoeopathy; Immunology; Nuclear Medicine; Palliative Medicine)
General Practice
Clinical Genetics
Acute Other (Chiropody; surgical Podiatry)
Allied Health Professionals (AHP) includes Audiometry; Chiropody; Clinical Psychology; Dental Ancillary Staff; Diagnostic Radiology; Dietetics; Electrocardiography; Electroencephalography; Hearing Aids; Industrial Therapy; Nuclear Medicine; Occupational Therapy; Optical Dispensing (by Hosp Opticians); Orthoptics; Physiotherapy; Radiotherapy; Sight Testing (by Hosp Opticians); Speech Therapy; Surgical Appliances; Ultrasonics

Maternity Services
Currently all costs and activity have been allocated to the 'Other' PBC category.

Accident and Emergency Services
Currently all costs and activity have been allocated to the 'Other' PBC category.

Community Services
Currently all costs and activity (except Community Dental) have been allocated to the 'Other' PBC category.

Contact

Email: Marjorie Marshall

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