A Framework for Purchasing Health Care Labor
Health care labor is central to managing and delivering health services. Because recruitment and retention policies are key issues for purchasers, gaining insights into labor-purchasing mechanisms may permit them to be addressed more effectively. T...
| Main Authors: | , |
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| Format: | Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2013
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| Subjects: | |
| Online Access: | http://documents.worldbank.org/curated/en/2004/09/5643425/framework-purchasing-health-care-labor http://hdl.handle.net/10986/13754 |
| Summary: | Health care labor is central to managing
and delivering health services. Because recruitment and
retention policies are key issues for purchasers, gaining
insights into labor-purchasing mechanisms may permit them to
be addressed more effectively. This paper is intended to
provide a brief introduction to health care labor purchasing
and the mechanisms through which it can have an impact on
the delivery of health services and on health system
performance. A framework is developed to foster
understanding of health labor purchasing mechanisms. This
framework examines the different types and characteristics
of the purchasers and providers. It also examines the terms
of labor purchasing, that is, working conditions (career
development, contract duration, working time and shift work,
work autonomy and separation), remuneration and benefits.
These elements determine, to a large extent, workers'
behavioral responses such as willingness to apply for and
accept employment and job satisfaction. In turn, these
behavioral responses are likely to affect performance.
Finally, contextual and policy factors related to the health
care system and the labor market that affect labor
purchasing, health services delivery, and health system
performance, are also considered in the framework. Under
this category, we review the public-private mix, the
purchaser-provider split, contracting in and out, purchaser
power, and provider power. The framework presented in this
paper encompasses a wide diversity of elements, but the role
of yet more factors should also be investigated. For
instance, the role of cultural or political factors is
likely to affect labor purchasing. The effects of migration
on labor purchasing should also be considered. A better
understanding of the interaction between the elements of the
framework would reinforce the analysis. |
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