Abstract
Only a small portion of today's existing research has made use of rigorous empirical methods to convincingly isolate the impact on the health sector of the new provider-payment arrangements from those which resulted from other changes occurring at the same time. Throughout the 1990s and early 2000s, several transitional countries in Central and Eastern Europe and Central Asia (ECA) aimed at reforming their provider-payment systems in order to achieve the general objectives of protecting health-spending levels and improving the overall performance of the health sector. We use such reforms as a natural experiment to investigate, empirically, the system-wide impacts of introducing patient-based (casemix) and fee-for-service methods for hospital reimbursement (compared to line-item budgets) on a set of outcomes including hospital-activity rates, capacity utilization, national-health spending, and mortality amenable to healthcare.
Highlights
A small portion of today's existing research has made use of rigorous empirical methods to convincingly isolate the impact on the health sector of the new provider-payment arrangements from those which resulted from other changes occurring at the same time
Throughout the 1990s and early 2000s, several transitional countries in Central and Eastern Europe and Central Asia (ECA) aimed at reforming their provider-payment systems in order to achieve the general objectives of protecting health-spending levels and improving the overall performance of the health sector
Our results indicate that patientbased/casemix payment reduces the average length-ofstay by approximately 4%, and the bed-occupancy rate by 5%
Summary
System-wide impacts of provider-payment reforms: evidence from the health sectors of Central and Eastern Europe and Central Asia. Address: 1Centre for Health Economics, University of York, York, UK, 2Department of Economics, University of York, York, UK and 3Development Research Group, The World Bank, Washington, DC, USA. Published: 5 November 2009 BMC Health Services Research 2009, 9(Suppl 1):A2 doi:10.1186/1472-6963-9-S1-A2. Patient Classification Systems International: 2009 Case Mix Conference Jason Sutherland, Penny Weeks and John Hamilton Meeting abstracts - A single PDF containing all abstracts in this Supplement is available here.
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