Policy tools for allocative efficiency of health services / Xingzhu Liu.

Format:

Book

Author/Creator:

Liu, Xingzhu.

Contributor:

World Health Organization.

Language:

English

Subjects (All):

Medical policy.

Medical economics.

Evidence-based medicine.

Physical Description:

1 online resource (168 p.)

Edition:

1st ed.

Place of Publication:

Geneva : World Health Organization, 2003.

Language Note:

English

Summary:

Health care should be provided efficiently, given the potential gains for patients and the population and the high cost of some kinds of care. Emphasizing the most cost-effective services can in principle attain the greatest health gains. Policies are implemented through tools available to policy makers, particularly those in government who can influence not only public expenditure and service delivery but also how private insurers and providers allocate resources among diseases and individuals. Example's of tools that nudge a health system toward greater value for money, while respecting fairness and the wishes of taxpayers, patients and health workers, include specifying coverage by insurance or public provision, promoting or limiting medical procedures, and methods of contracting for service delivery and paying providers. Policy Tools reviews an enormous research literature for evidence that particular policies can improve how efficiently health services are delivered, aiming not only at what policies to recommend but at what it takes to make them effective.

Contents:

Intro

CONTENTS

TABLES, FIGURES, BOXES

FOREWORD

ACKNOWLEDGEMENTS

1. HEALTH SERVICE POLICY AND EFFICIENCY

Policy and the need for evidence

Ideal resources allocation

Allocative efficiency of health interventions

Policy tools for improving allocative efficiency

Organization of this study

2. HEALTH RESOURCES PLANNING

Budgeting input for public provision

Funding inputs for private provision

Strengthening medical education

Strengthening health facilities

Grant incentives for medical professionals to work in underserved areas

Funding the production of cost-effective products

Managing capital and technology

Certificate-of-Need

Capital cap

Capital moratorium

Technology regulation

3. ECONOMIC INCENTIVES FOR PROVIDERS

Fee-for-service

Capitation

Salary

Daily payment

Case payment

Line budget

Global budget

Performance-related pay

Rate setting

Fee structuring

Separating dispensing from prescribing

Payer integration

4. ECONOMIC INCENTIVES FOR USERS

User fees

Cost sharing

Total utilization

Mix of interventions

Cost containment

Equity

Health outcomes

Summary

5. DEFINING BENEFIT PACKAGES

Rationing

Defining essential interventions

Essential packages of services

Essential drug lists

6. INFORMING PROVIDERS

Medical practice guidelines

Prescription formulary

Utilization review

7. MANAGED CARE

Definition and practice

Evidence

Utilization and cost

Quality and health outcome

8. SUMMARY OF POLICY TOOLS

Tool summary

Observations

Combinations of policy tools

Participating in medical decisions

9. TOWARDS A POLICY TOOLKIT

Controlling intervention inputs

Managing intervention provision

Purchasing interventions

Toolkit construction.

10. RECOMMENDATIONS FOR POLICY AND RESEARCH

Capacity strengthening

Policy-oriented actions

ANNEX: PRINCIPLES FOR TOOL DEVELOPMENT

REFERENCE LIST

INDEX

A

B

C

D

E

F

G

H

I

J

L

M

N

O

P

Q

R

S

T

U

V

W

Y

Z.

Notes:

Bibliographic Level Mode of Issuance: Monograph

ISBN:

1-280-06059-X

92-4-068112-4

9786610060597

OCLC:

55664169