Gugushvili, Alexi (2007): The advantages and disadvantages of needs-based resource allocation in integrated health systems and market systems of health care provider reimbursement.
Download (115kB) | Preview
This paper reviews the vital health care resource allocation in integrated systems and contrasts it with the market-based health care resource provisions. It is believed that among several alternatives a method of centrally managed needs-based resource distribution is best suited for universally appraised code of “equal treatment of equals”. However, the main problem hides in identification and measurement of “need” and in economic effectiveness of the methodology. Supposedly, from the 1980s, as an innovative approach, the market system of health care provider reimbursement had to resolve the problems associated with centralised needs-based resource allocation, maintaining the main achievements and improving the effectiveness of the systematic distribution. Nonetheless, as this paper shows, so far there is little evidence that the market-based health care provider reimbursement advances the allocative performance of various health care systems.
|Item Type:||MPRA Paper|
|Original Title:||The advantages and disadvantages of needs-based resource allocation in integrated health systems and market systems of health care provider reimbursement|
|Keywords:||Health systems; Resource allocation; Health care needs; Marketisation of health|
|Subjects:||I - Health, Education, and Welfare > I1 - Health > I11 - Analysis of Health Care Markets
D - Microeconomics > D6 - Welfare Economics > D63 - Equity, Justice, Inequality, and Other Normative Criteria and Measurement
H - Public Economics > H5 - National Government Expenditures and Related Policies > H51 - Government Expenditures and Health
I - Health, Education, and Welfare > I1 - Health > I18 - Government Policy ; Regulation ; Public Health
|Depositing User:||Alexi Gugushvili|
|Date Deposited:||30. May 2007|
|Last Modified:||29. Mar 2014 13:43|
1. Al, M.J., Feenstra T., Brouwer W.B.F. (2004). “Decision makers’ views on health care objectives and budget constraints: results from a pilot study.” Health Policy. 70, pp. 33-48. 2. Bardsley, M., Coles, J., and Jenkins, L. (ed.) (1989) DRGs and health care. The management of case mix. King’s Fund Publishing Office. 3. Besley, T., Gouveia, M. and Drèze, J. (1994). “Alternative Systems of Health Care Provision.” Economic Policy. 9 (19), pp. 199-258. 4. Carr-Hill, R.A., Jamison, J.Q., O’Reilly, D., Stevenson, M.R., Reid. J. Merriman, B. (2002). “Risk adjustment for hospital use using social security data: cross sectional small area analysis”. BMJ. 324, 16 Feb 1-4. 5. Carr-Hill R.A, Sheldon T. (1992). “Rationality and the use of formulae in the allocation of resources to health care”. Journal of Public Health Medicine. 14 (2), pp. 117-26. 6. Coast, J., Bevan, G. and Frankel S. (1996). “An equitable basis for priority setting?” In: Coast, J., Donovan, J., and Frankel, S. (eds). (1996). Priority setting: the health care debate. Chichester: Wiley, pp. 141-66. 7. Creese, A. (1997). “Editorials: User fees.” BMJ, 315, pp. 202-203. 8. Culyer, A.J. (1992). “The morality of efficiency in health care: some uncomfortable implications.” Health Economics. 1, pp. 7-18. 9. Department of Health and Social Security (1976). Sharing resources for health in England: Report of the Resource Allocation Working Party. London: Her Majesty’s Stationary Office. 10. Donaldson C, Mooney G. (1991). “Needs assessment, priority setting, and contracts for health care: an economic view”. BMJ. 303, pp. 1529-1530. 11. Enthoven, A.C. (1993). “The history and principles of managed competition”. Health Affairs (Supplement). 12, pp. 24-48. 12. Evans, R.G., Barer, M.L., Stoddart, G.L. (1993). “User fees for health care: why bad idea keep coming back”. Toronto: CIAR program in Population Health, Working Paper 26. 13. Eyles, J., Birch, S., Chambers, S. Hurley, J., and Hutchison, B. (1991). “A needs-based methodology for allocating health care resources in Ontario, Canada: Development and an application”. Social Science and Medicine. 33 (4), pp. 489-500. 13. Frankel S. (1991). “Health needs, health-care requirements, and the myth of infinite demand”. Lancet 337 1588-1590. 14. Gay E.G. and Kronedfeld J.J. (1990). “Regulation, retrenchment – the DRG experience: problems from changing reimbursement practice”. Social Science and Medicine. 31 (10), pp. 1103-1118. 15. Grumbach, K., Vranizan, K., and Bindman, A.B. (1997). “Physician supply and access to care in urban communities”. Health Affairs. 16 (1), pp. 71-86. 16. Judge, K. and Mays, N. (1994). “A new approach to weighted capitation”. BMJ. 309, 22 Oct, 1031-1032. 17. King’s Fund. (2005) Payment by Results. Available at: http://www.kingsfund.org.uk/resources/briefings/payment_by.html 18. Koivasulo, M. (2003). “Euroean health policies – moving towards markets in health?” Eurohealth. 9 (4), pp. 1-4. 19. Light, D.W. (2000). “Sociological perspectives on competition in health care”. Journal of Health Politics, Policy and Law. 25 (5), pp. 969-974. 20. Litaker, D. and Love, T.E. (2005). “Health care resource allocation and individuals’ health care needs: examining the degree of fit.” Health Policy. 73, pp. 183-193. 21. Lowe, A. (2000). “Accounting in health care: some evidence on the impact of casemix systems”. British Accounting Review. 32, pp. 189-211. 22. Manning, W.G, and Marquis M. S. (1996). “Health insurance: the tradeoff between risk pooling and moral hazard.” Journal of Health Economics. 15 (5), pp. 609-639. 23. Marini, G, and Street, A, (2006). “A transaction costs analysis of changing contractual relations in the English NHS”. Health Policy. Dec. 11 [Electronic publication ahead of print edition]. Available at: http://www.sciencedirect.com 24. McMillan, J. (2002). “Allocation of resources.” Surgery (Oxford). 20 (5), pp. 117-120. 25. Midwinter, A. (2002). “Territorial resource allocation in the UK: a rejoinder on needs assessment”. Regional Studies. 35 (5) pp. 563-577. 26. Miller, M.K. and Stokes, C.S. (1978). Health Status, health resources, and consolidated structural parameters: implications for public health care policy. Journal of Health and Social Behavior. 19 (3), pp. 263-279. 27. Mooney, G. (2006). “Communitarian claims as an ethical basis for allocating health care resources”. Social Science and Medicine. 47 (9), pp. 1171-1180. 28. Oliver, A. (2005). “The English National Health Service: 1979-2005”. Health Economics. 14, pp. S75-S99. 29. Petrou, S. and Wolstenholme, J. (2000) “A review of alternative approaches to healthcare resource allocation”. Pharmacoeconomics. 18 (1), pp. 33-43. 30. Ranade, W. (ed) (1998). Markets and health care: a comparative analysis. Essex: Longman. 31. Retzlaff-Roberts, D., Chang, C.F., Rubin, R.M. (2004). “Technical efficiency in the use of health care resources: a comparison of OECD countries”. Health Policy. 69, pp. 55-72. 32. Rice, N., Dixon, P., Lloyd, D.C.E.F, Roberts, D. (2000). “Derivation of a needs based capitation formula for allocating prescribing budgets to health authorities and primary care groups in England: regression analysis”. BMJ. 320, 29 Jan. pp. 284-8. 33. Rice, N. and Smith, P.C. (2001). “Ethics of Geographical equity in health care”. Journal of Medical Ethics. 27, pp. 256-261. 34. Saltman, R.B. and Figueras, J. (1997). European health care reform: analysis of current strategies. World Health Organisation, Regional Office for Europe. WHO regional publications. European series, No 72. Copenhagen. 35. Sullivan, K. (1997). Strangled competition II: the quality of health care under managed competition – the promise and the reality. St. Paul, MN: Coact Foundation. 36. Szende, A., and Mogyorosy, Z. (2004). “Health care provider payment mechanisms in the new EU members of Central Europe and the Baltic states: Current reforms, incentives, and challenges”. European Journal of Health Economics. 5, pp. 259-262. 37. Ven, W.P.M.M., van de. (1996). “Market-oriented health care reforms: trends and future options”. Social Science and Medicine. 43 (5), pp. 655-666. 38. Vladeck, B. C. (1984). “Comment on hospital reimbursement under medicare”. The Milbank Memorial Fund Quarterly. 62, pp. 269-278. 39. Williams, I. and Bryan, S. (2007). “Understanding the limited impact of economic evaluation in health care resource allocation: A conceptual framework”. Health Policy. 80, pp. 135-143. 40. Wright, J., Williams, R. and Wilkinson, J.R. (1998). “Development and importance of health needs assessment”. BMJ. 316, 25 Apr. pp. 1310-1313.