Purchasing Inpatient and Outpatient Care through Hospitals

After considering the fulfillment of some basic criteria making purchasing a tool for effectiveness, a framework allows to review how to best buy hospital services. Who should benefit most from hospital care financing ? The answer to this question...

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Main Author:	de Roodenbeke, Eric
Format:	Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2013
Subjects:	ACCESS TO HEALTH SERVICES ACCOUNTABILITY ACCOUNTING BASIC HEALTH BEDS CAPITATION CASH FLOW CHILD HEALTH CHRONIC DISEASES CLINICS COMMUNICABLE DISEASES COUNTRYSIDE CRITICAL CARE DAY CARE DEATHS DEVELOPMENT GOALS DRUGS ECONOMIC STATUS EPIDEMIOLOGICAL TRANSITION EQUITY IN HEALTH EXPENDITURES FEE FOR SERVICE FEES FOR SERVICE FIXED COSTS GENDER HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE EXPENDITURES HEALTH CARE FACILITIES HEALTH CARE FINANCING HEALTH CARE PROFESSIONALS HEALTH FINANCING HEALTH HAZARDS HEALTH INFORMATION HEALTH MAINTENANCE ORGANIZATIONS HEALTH NEEDS HEALTH POLICY HEALTH SECTOR HEALTH STATUS HEALTH SURVEYS HEALTH SYSTEM HEALTH SYSTEMS HOSPITAL ADMISSIONS HOSPITAL CARE HOSPITAL COSTS HOSPITAL MANAGEMENT HOSPITAL OUTPATIENT SERVICES HOSPITAL SERVICES HOSPITAL UTILIZATION HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATIONS IMMUNODEFICIENCY INCOME INFANT MORTALITY INFORMATION SYSTEMS INPATIENT CARE LESSONS LEARNED MAJOR HAZARDS MALARIA MEDICAL EQUIPMENT MEDICAL RECORDS NUTRITION OBSTETRICAL CARE OCCUPANCY OCCUPANCY RATES OPERATING COSTS OUTPATIENT CARE OUTPATIENT SERVICES PATIENT SATISFACTION PATIENTS PHYSICIANS POPULATION GROUPS POSTNATAL CARE PREGNANT WOMEN PRESCRIPTIONS PRIMARY CARE PRIMARY HEALTH CARE PRIVATE SECTOR PROMOTING HEALTH PUBLIC PUBLIC HEALTH PUBLIC HEALTH AUTHORITIES PUBLIC HEALTH NEEDS PUBLIC HEALTH SERVICES PUBLIC HOSPITALS PUBLIC SECTOR PURCHASING QUALITY OF CARE RURAL AREAS SERVICE DELIVERY SURGERY TEACHING HOSPITALS TOWNS TRADITIONAL MEDICINE TRAFFIC URBAN AREAS URBAN POPULATION WORKERS WORLD HEALTH ORGANIZATION
Online Access:	http://documents.worldbank.org/curated/en/2004/09/5643367/purchasing-inpatient-outpatient-care-through-hospitals http://hdl.handle.net/10986/13728

id	okr-10986-13728
recordtype	oai_dc
spelling	okr-10986-137282021-04-23T14:03:09Z Purchasing Inpatient and Outpatient Care through Hospitals de Roodenbeke, Eric ACCESS TO HEALTH SERVICES ACCOUNTABILITY ACCOUNTING BASIC HEALTH BEDS CAPITATION CASH FLOW CHILD HEALTH CHRONIC DISEASES CLINICS COMMUNICABLE DISEASES COUNTRYSIDE CRITICAL CARE DAY CARE DEATHS DEVELOPMENT GOALS DRUGS ECONOMIC STATUS EPIDEMIOLOGICAL TRANSITION EQUITY IN HEALTH EXPENDITURES FEE FOR SERVICE FEES FOR SERVICE FIXED COSTS GENDER HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE EXPENDITURES HEALTH CARE FACILITIES HEALTH CARE FINANCING HEALTH CARE PROFESSIONALS HEALTH FINANCING HEALTH HAZARDS HEALTH INFORMATION HEALTH MAINTENANCE ORGANIZATIONS HEALTH NEEDS HEALTH POLICY HEALTH SECTOR HEALTH STATUS HEALTH SURVEYS HEALTH SYSTEM HEALTH SYSTEMS HOSPITAL ADMISSIONS HOSPITAL CARE HOSPITAL COSTS HOSPITAL MANAGEMENT HOSPITAL OUTPATIENT SERVICES HOSPITAL SERVICES HOSPITAL UTILIZATION HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATIONS IMMUNODEFICIENCY INCOME INFANT MORTALITY INFORMATION SYSTEMS INPATIENT CARE LESSONS LEARNED MAJOR HAZARDS MALARIA MEDICAL EQUIPMENT MEDICAL RECORDS NUTRITION OBSTETRICAL CARE OCCUPANCY OCCUPANCY RATES OPERATING COSTS OUTPATIENT CARE OUTPATIENT SERVICES PATIENT SATISFACTION PATIENTS PHYSICIANS POPULATION GROUPS POSTNATAL CARE PREGNANT WOMEN PRESCRIPTIONS PRIMARY CARE PRIMARY HEALTH CARE PRIVATE SECTOR PROMOTING HEALTH PUBLIC PUBLIC HEALTH PUBLIC HEALTH AUTHORITIES PUBLIC HEALTH NEEDS PUBLIC HEALTH SERVICES PUBLIC HOSPITALS PUBLIC SECTOR PURCHASING QUALITY OF CARE RURAL AREAS SERVICE DELIVERY SURGERY TEACHING HOSPITALS TOWNS TRADITIONAL MEDICINE TRAFFIC URBAN AREAS URBAN POPULATION WORKERS WORLD HEALTH ORGANIZATION After considering the fulfillment of some basic criteria making purchasing a tool for effectiveness, a framework allows to review how to best buy hospital services. Who should benefit most from hospital care financing ? The answer to this question will rely on an investigation of hospital services utilization, and on a better understanding of patients profiles. This type of investigation is a baseline for further decisions on what to buy. A purchaser should wonder: to what public health priorities hospital responds best and how efficient and equitable is hospital care? But hospitals have also a unique role in helping people facing major hazards, in providing some essential public health services and in enabling training: these services should be considered when purchasing. Hospitals represent a large diversity of organizations. Having that in mind makes it easier to figure out from whom to buy. The potential provision of care depends on the level of the provider but is also related to hospitals status taking into consideration productivity. It is also worthwhile to investigate insurance's role in the provision of care. Payment mechanisms have a strong influence on performance, for that reason the major alternative schemes have to be considered, each of them having advantages and limits. But hospital cash flow is also a specific issue that should not be ignored. The price paid has to be determined before making an agreement. This should lead to cautious estimates of cost of services as the information systems are often weak. Moreover it might be worthwhile to play with margin to favor internal cross subsidies. The co-payments as well as the opportunity cost have to be included to understand how to get best from pricing. Dealing with subsidies is a cornerstone when seeking better performance while purchasing hospital services. How subsidies are going to be channeled and for what kind of services will determine if purchasing is really effective. 2013-05-30T20:49:38Z 2013-05-30T20:49:38Z 2004-09 http://documents.worldbank.org/curated/en/2004/09/5643367/purchasing-inpatient-outpatient-care-through-hospitals http://hdl.handle.net/10986/13728 English en_US Health, Nutrition and Population (HNP) discussion paper; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English en_US
topic	ACCESS TO HEALTH SERVICES ACCOUNTABILITY ACCOUNTING BASIC HEALTH BEDS CAPITATION CASH FLOW CHILD HEALTH CHRONIC DISEASES CLINICS COMMUNICABLE DISEASES COUNTRYSIDE CRITICAL CARE DAY CARE DEATHS DEVELOPMENT GOALS DRUGS ECONOMIC STATUS EPIDEMIOLOGICAL TRANSITION EQUITY IN HEALTH EXPENDITURES FEE FOR SERVICE FEES FOR SERVICE FIXED COSTS GENDER HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE EXPENDITURES HEALTH CARE FACILITIES HEALTH CARE FINANCING HEALTH CARE PROFESSIONALS HEALTH FINANCING HEALTH HAZARDS HEALTH INFORMATION HEALTH MAINTENANCE ORGANIZATIONS HEALTH NEEDS HEALTH POLICY HEALTH SECTOR HEALTH STATUS HEALTH SURVEYS HEALTH SYSTEM HEALTH SYSTEMS HOSPITAL ADMISSIONS HOSPITAL CARE HOSPITAL COSTS HOSPITAL MANAGEMENT HOSPITAL OUTPATIENT SERVICES HOSPITAL SERVICES HOSPITAL UTILIZATION HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATIONS IMMUNODEFICIENCY INCOME INFANT MORTALITY INFORMATION SYSTEMS INPATIENT CARE LESSONS LEARNED MAJOR HAZARDS MALARIA MEDICAL EQUIPMENT MEDICAL RECORDS NUTRITION OBSTETRICAL CARE OCCUPANCY OCCUPANCY RATES OPERATING COSTS OUTPATIENT CARE OUTPATIENT SERVICES PATIENT SATISFACTION PATIENTS PHYSICIANS POPULATION GROUPS POSTNATAL CARE PREGNANT WOMEN PRESCRIPTIONS PRIMARY CARE PRIMARY HEALTH CARE PRIVATE SECTOR PROMOTING HEALTH PUBLIC PUBLIC HEALTH PUBLIC HEALTH AUTHORITIES PUBLIC HEALTH NEEDS PUBLIC HEALTH SERVICES PUBLIC HOSPITALS PUBLIC SECTOR PURCHASING QUALITY OF CARE RURAL AREAS SERVICE DELIVERY SURGERY TEACHING HOSPITALS TOWNS TRADITIONAL MEDICINE TRAFFIC URBAN AREAS URBAN POPULATION WORKERS WORLD HEALTH ORGANIZATION
spellingShingle	ACCESS TO HEALTH SERVICES ACCOUNTABILITY ACCOUNTING BASIC HEALTH BEDS CAPITATION CASH FLOW CHILD HEALTH CHRONIC DISEASES CLINICS COMMUNICABLE DISEASES COUNTRYSIDE CRITICAL CARE DAY CARE DEATHS DEVELOPMENT GOALS DRUGS ECONOMIC STATUS EPIDEMIOLOGICAL TRANSITION EQUITY IN HEALTH EXPENDITURES FEE FOR SERVICE FEES FOR SERVICE FIXED COSTS GENDER HEALTH CARE HEALTH CARE DELIVERY HEALTH CARE EXPENDITURES HEALTH CARE FACILITIES HEALTH CARE FINANCING HEALTH CARE PROFESSIONALS HEALTH FINANCING HEALTH HAZARDS HEALTH INFORMATION HEALTH MAINTENANCE ORGANIZATIONS HEALTH NEEDS HEALTH POLICY HEALTH SECTOR HEALTH STATUS HEALTH SURVEYS HEALTH SYSTEM HEALTH SYSTEMS HOSPITAL ADMISSIONS HOSPITAL CARE HOSPITAL COSTS HOSPITAL MANAGEMENT HOSPITAL OUTPATIENT SERVICES HOSPITAL SERVICES HOSPITAL UTILIZATION HOSPITALS HUMAN DEVELOPMENT HUMAN RESOURCES IMMUNIZATIONS IMMUNODEFICIENCY INCOME INFANT MORTALITY INFORMATION SYSTEMS INPATIENT CARE LESSONS LEARNED MAJOR HAZARDS MALARIA MEDICAL EQUIPMENT MEDICAL RECORDS NUTRITION OBSTETRICAL CARE OCCUPANCY OCCUPANCY RATES OPERATING COSTS OUTPATIENT CARE OUTPATIENT SERVICES PATIENT SATISFACTION PATIENTS PHYSICIANS POPULATION GROUPS POSTNATAL CARE PREGNANT WOMEN PRESCRIPTIONS PRIMARY CARE PRIMARY HEALTH CARE PRIVATE SECTOR PROMOTING HEALTH PUBLIC PUBLIC HEALTH PUBLIC HEALTH AUTHORITIES PUBLIC HEALTH NEEDS PUBLIC HEALTH SERVICES PUBLIC HOSPITALS PUBLIC SECTOR PURCHASING QUALITY OF CARE RURAL AREAS SERVICE DELIVERY SURGERY TEACHING HOSPITALS TOWNS TRADITIONAL MEDICINE TRAFFIC URBAN AREAS URBAN POPULATION WORKERS WORLD HEALTH ORGANIZATION de Roodenbeke, Eric Purchasing Inpatient and Outpatient Care through Hospitals
relation	Health, Nutrition and Population (HNP) discussion paper;
description	After considering the fulfillment of some basic criteria making purchasing a tool for effectiveness, a framework allows to review how to best buy hospital services. Who should benefit most from hospital care financing ? The answer to this question will rely on an investigation of hospital services utilization, and on a better understanding of patients profiles. This type of investigation is a baseline for further decisions on what to buy. A purchaser should wonder: to what public health priorities hospital responds best and how efficient and equitable is hospital care? But hospitals have also a unique role in helping people facing major hazards, in providing some essential public health services and in enabling training: these services should be considered when purchasing. Hospitals represent a large diversity of organizations. Having that in mind makes it easier to figure out from whom to buy. The potential provision of care depends on the level of the provider but is also related to hospitals status taking into consideration productivity. It is also worthwhile to investigate insurance's role in the provision of care. Payment mechanisms have a strong influence on performance, for that reason the major alternative schemes have to be considered, each of them having advantages and limits. But hospital cash flow is also a specific issue that should not be ignored. The price paid has to be determined before making an agreement. This should lead to cautious estimates of cost of services as the information systems are often weak. Moreover it might be worthwhile to play with margin to favor internal cross subsidies. The co-payments as well as the opportunity cost have to be included to understand how to get best from pricing. Dealing with subsidies is a cornerstone when seeking better performance while purchasing hospital services. How subsidies are going to be channeled and for what kind of services will determine if purchasing is really effective.
format	Publications & Research :: Working Paper
author	de Roodenbeke, Eric
author_facet	de Roodenbeke, Eric
author_sort	de Roodenbeke, Eric
title	Purchasing Inpatient and Outpatient Care through Hospitals
title_short	Purchasing Inpatient and Outpatient Care through Hospitals
title_full	Purchasing Inpatient and Outpatient Care through Hospitals
title_fullStr	Purchasing Inpatient and Outpatient Care through Hospitals
title_full_unstemmed	Purchasing Inpatient and Outpatient Care through Hospitals
title_sort	purchasing inpatient and outpatient care through hospitals
publisher	World Bank, Washington, DC
publishDate	2013
url	http://documents.worldbank.org/curated/en/2004/09/5643367/purchasing-inpatient-outpatient-care-through-hospitals http://hdl.handle.net/10986/13728
_version_	1764424218204700672

Purchasing Inpatient and Outpatient Care through Hospitals

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