The Impact of Resource Allocation and Purchasing Reforms on Equity
This paper introduces a conceptual framework to investigate the equity consequences of resource allocation, strategic purchasing and payment system reforms (RAP) in health, and reviews the empirical literature that has analyzed the impact of these...
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| Format: | Working Paper |
| Language: | English en_US |
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World Bank, Washington, DC
2013
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| Online Access: | http://documents.worldbank.org/curated/en/2004/09/5635378/impact-resource-allocation-purchasing-reforms-equity http://hdl.handle.net/10986/13739 |
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okr-10986-137392021-04-23T14:03:09Z The Impact of Resource Allocation and Purchasing Reforms on Equity Belli, Paolo Carlo ACCESS TO HEALTH SERVICES ADULT MORTALITY BURDEN OF DISEASE CHILD CARE CHILD HEALTH CHILD HEALTH SERVICES COMMUNICABLE DISEASES DEATHS DETERMINANTS OF HEALTH DIARRHEA DISABILITY ECONOMIC DEVELOPMENT EMPLOYMENT EQUITY IN HEALTH EXTERNALITY EXTREME POVERTY FERTILITY FERTILITY RATES HEALTH CARE HEALTH CARE FACILITIES HEALTH CARE FINANCING HEALTH CARE SERVICES HEALTH CARE UTILIZATION HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH IMPACT HEALTH INTERVENTIONS HEALTH OUTCOMES HEALTH POLICY HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SURVEYS HEALTH SYSTEM HEALTH SYSTEMS HOSPITAL CARE HUMAN DEVELOPMENT HUMAN RESOURCES HUMAN RIGHTS IMMUNIZATION IMMUNIZATION RATES IMMUNIZATION SERVICES INCIDENCE ANALYSIS INCOME INFANT MORTALITY INFANT MORTALITY RATE INFANT MORTALITY RATES INFECTION INPATIENT CARE INTERVENTION ISOLATION LESSONS LEARNED LIFE EXPECTANCY LIVE BIRTHS MALNUTRITION MATERNAL AND CHILD HEALTH MEDICAL EQUIPMENT MORBIDITY MORTALITY MOTIVATION NUTRITION OUTPATIENT CARE PATIENTS PRIMARY CARE PRIMARY HEALTH CARE PRIVATE SECTOR PROMOTING HEALTH PUBLIC HEALTH PUBLIC HEALTH INSURANCE PUBLIC HEALTH SYSTEMS PUBLIC SECTOR RESPIRATORY INFECTIONS SERVICE DELIVERY SOCIAL CAPITAL UNDER 5 MORTALITY URBAN POPULATIONS This paper introduces a conceptual framework to investigate the equity consequences of resource allocation, strategic purchasing and payment system reforms (RAP) in health, and reviews the empirical literature that has analyzed the impact of these reforms on equity. In the first part, the paper reviews the existing evidence on the distribution of health and health care utilization across socio-economic groups in developing countries. Such evidence shows a striking consistency in the association between poverty and poor health, and that the distribution of health benefits across socio-economic groups is highly unequal, favoring the wealthier segments of the population. At the same time it shows that the issue of quality of services is as important as the issue of their accessibility. Then the paper addresses the meaning of equity in health care: we argue that the concept of equity and that of an equitable distribution of resources in health are not as straightforward as they appear. In the second part, the paper reviews the core elements of RAP reforms, and it presents a survey of the empirical literature that has investigated the impact of RAP reforms from an equity perspective. We argue that some RAP reform components, such as the new resource allocation mechanisms, bear a strong pro-poor potential, but that other components can lead to the emergence of trade-offs between conflicting objectives, such as efficiency and equity. For instance, the new purchasing contracts and payment systems devised to enhance efficiency can create adverse equity effects. Conceptually, these trade-offs are significant and operating at several levels. 2013-06-04T19:47:55Z 2013-06-04T19:47:55Z 2004-09 http://documents.worldbank.org/curated/en/2004/09/5635378/impact-resource-allocation-purchasing-reforms-equity http://hdl.handle.net/10986/13739 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 ADULT MORTALITY BURDEN OF DISEASE CHILD CARE CHILD HEALTH CHILD HEALTH SERVICES COMMUNICABLE DISEASES DEATHS DETERMINANTS OF HEALTH DIARRHEA DISABILITY ECONOMIC DEVELOPMENT EMPLOYMENT EQUITY IN HEALTH EXTERNALITY EXTREME POVERTY FERTILITY FERTILITY RATES HEALTH CARE HEALTH CARE FACILITIES HEALTH CARE FINANCING HEALTH CARE SERVICES HEALTH CARE UTILIZATION HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH IMPACT HEALTH INTERVENTIONS HEALTH OUTCOMES HEALTH POLICY HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SURVEYS HEALTH SYSTEM HEALTH SYSTEMS HOSPITAL CARE HUMAN DEVELOPMENT HUMAN RESOURCES HUMAN RIGHTS IMMUNIZATION IMMUNIZATION RATES IMMUNIZATION SERVICES INCIDENCE ANALYSIS INCOME INFANT MORTALITY INFANT MORTALITY RATE INFANT MORTALITY RATES INFECTION INPATIENT CARE INTERVENTION ISOLATION LESSONS LEARNED LIFE EXPECTANCY LIVE BIRTHS MALNUTRITION MATERNAL AND CHILD HEALTH MEDICAL EQUIPMENT MORBIDITY MORTALITY MOTIVATION NUTRITION OUTPATIENT CARE PATIENTS PRIMARY CARE PRIMARY HEALTH CARE PRIVATE SECTOR PROMOTING HEALTH PUBLIC HEALTH PUBLIC HEALTH INSURANCE PUBLIC HEALTH SYSTEMS PUBLIC SECTOR RESPIRATORY INFECTIONS SERVICE DELIVERY SOCIAL CAPITAL UNDER 5 MORTALITY URBAN POPULATIONS |
| spellingShingle |
ACCESS TO HEALTH SERVICES ADULT MORTALITY BURDEN OF DISEASE CHILD CARE CHILD HEALTH CHILD HEALTH SERVICES COMMUNICABLE DISEASES DEATHS DETERMINANTS OF HEALTH DIARRHEA DISABILITY ECONOMIC DEVELOPMENT EMPLOYMENT EQUITY IN HEALTH EXTERNALITY EXTREME POVERTY FERTILITY FERTILITY RATES HEALTH CARE HEALTH CARE FACILITIES HEALTH CARE FINANCING HEALTH CARE SERVICES HEALTH CARE UTILIZATION HEALTH ECONOMICS HEALTH EXPENDITURE HEALTH IMPACT HEALTH INTERVENTIONS HEALTH OUTCOMES HEALTH POLICY HEALTH REFORM HEALTH REFORMS HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SURVEYS HEALTH SYSTEM HEALTH SYSTEMS HOSPITAL CARE HUMAN DEVELOPMENT HUMAN RESOURCES HUMAN RIGHTS IMMUNIZATION IMMUNIZATION RATES IMMUNIZATION SERVICES INCIDENCE ANALYSIS INCOME INFANT MORTALITY INFANT MORTALITY RATE INFANT MORTALITY RATES INFECTION INPATIENT CARE INTERVENTION ISOLATION LESSONS LEARNED LIFE EXPECTANCY LIVE BIRTHS MALNUTRITION MATERNAL AND CHILD HEALTH MEDICAL EQUIPMENT MORBIDITY MORTALITY MOTIVATION NUTRITION OUTPATIENT CARE PATIENTS PRIMARY CARE PRIMARY HEALTH CARE PRIVATE SECTOR PROMOTING HEALTH PUBLIC HEALTH PUBLIC HEALTH INSURANCE PUBLIC HEALTH SYSTEMS PUBLIC SECTOR RESPIRATORY INFECTIONS SERVICE DELIVERY SOCIAL CAPITAL UNDER 5 MORTALITY URBAN POPULATIONS Belli, Paolo Carlo The Impact of Resource Allocation and Purchasing Reforms on Equity |
| relation |
Health, Nutrition and Population (HNP)
discussion paper; |
| description |
This paper introduces a conceptual
framework to investigate the equity consequences of resource
allocation, strategic purchasing and payment system reforms
(RAP) in health, and reviews the empirical literature that
has analyzed the impact of these reforms on equity. In the
first part, the paper reviews the existing evidence on the
distribution of health and health care utilization across
socio-economic groups in developing countries. Such evidence
shows a striking consistency in the association between
poverty and poor health, and that the distribution of health
benefits across socio-economic groups is highly unequal,
favoring the wealthier segments of the population. At the
same time it shows that the issue of quality of services is
as important as the issue of their accessibility. Then the
paper addresses the meaning of equity in health care: we
argue that the concept of equity and that of an equitable
distribution of resources in health are not as
straightforward as they appear. In the second part, the
paper reviews the core elements of RAP reforms, and it
presents a survey of the empirical literature that has
investigated the impact of RAP reforms from an equity
perspective. We argue that some RAP reform components, such
as the new resource allocation mechanisms, bear a strong
pro-poor potential, but that other components can lead to
the emergence of trade-offs between conflicting objectives,
such as efficiency and equity. For instance, the new
purchasing contracts and payment systems devised to enhance
efficiency can create adverse equity effects. Conceptually,
these trade-offs are significant and operating at several levels. |
| format |
Publications & Research :: Working Paper |
| author |
Belli, Paolo Carlo |
| author_facet |
Belli, Paolo Carlo |
| author_sort |
Belli, Paolo Carlo |
| title |
The Impact of Resource Allocation and Purchasing Reforms on Equity |
| title_short |
The Impact of Resource Allocation and Purchasing Reforms on Equity |
| title_full |
The Impact of Resource Allocation and Purchasing Reforms on Equity |
| title_fullStr |
The Impact of Resource Allocation and Purchasing Reforms on Equity |
| title_full_unstemmed |
The Impact of Resource Allocation and Purchasing Reforms on Equity |
| title_sort |
impact of resource allocation and purchasing reforms on equity |
| publisher |
World Bank, Washington, DC |
| publishDate |
2013 |
| url |
http://documents.worldbank.org/curated/en/2004/09/5635378/impact-resource-allocation-purchasing-reforms-equity http://hdl.handle.net/10986/13739 |
| _version_ |
1764424224619888640 |