Tuesday, February 19, 2008

[EQ] Paying the Patient: Improving health using financial incentives

Paying the Patient: Improving health using financial incentives

 

Karen Jochelson UK King’s Fund, December 2007

 

Available online at: http://www.kingsfund.org.uk/publications/other_work_by_our_staff/paying_the.html


PDF: http://www.kingsfund.org.uk/document.rm?id=7298

 

“…..The paper identifies programmes based on positive incentives that reward individuals directly for a desired behaviour or outcome and those based on negative incentives that discipline an individual by withdrawing a reward. It finds that financial incentives are effective in encouraging people to perform clearly defined, time-limited, simple behavioural tasks, such as keeping appointments, and also in encouraging participation in lifestyle programmes, but that the healthier behaviour is not maintained. Financial incentives are not effective when the behaviour change required is complex, for example, giving up smoking….”

 

“…..Internationally, new models of health care are emerging that rely on financial incentives to encourage individuals to become more responsible for their health. PruHealth and Discovery, health insurers based in England and South Africa respectively, offer clients reduced premiums if they participate in health-promoting activities such as exercise or screening programmes. The company believes that its members are healthier, and make fewer health claims as a result. Definity Health, part of the US UnitedHealth Group, rewards members who successfully manage chronic conditions with credits for health care.

 

German social insurance companies reward members who take part in health screening or have a healthy lifestyle, with points redeemable for retail goods, cash or reduced premiums (Schmidt 2007). Incentive schemes are also emerging for the very poor. In the United States, recent changes to insurance and welfare law have led to new Medicaid programmes, which reward participation in health screening or disease management programmes with small financial payments that recipients can use to buy health-related products, and at least one programme offers both the incentive and a threat of reduced health benefits if individuals fail to comply.

 

The idea is that incentives will encourage healthier lifestyles and reduce health care costs (Greene 2007; Rudowitz and Schneider 2006; Silow-Carroll and Alteras 2007). In several Latin American and Caribbean countries, the poorest families receive a ‘co-responsibility’ payment in return for participating in antenatal and child health care programmes and ensuring their children attend school; this has extremely positive results for children’s health outcomes…”

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

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[EQ] The Health Systems Assessment Approach: A How-To Manual

            The Health Systems Assessment Approach: A How-To Manual

Mursaleena Islam, Editor, 2007
U.S. Agency for International Development in collaboration with Health Systems 20/20, Partners for Health Reformplus, Quality Assurance Project, and Rational Pharmaceutical Management Plus. Arlington, VA: Management Sciences for Health

Available online as PDF file [374p.] at: http://healthsystems2020.org/files/528_file_Manual_Complete.pdf

“……This approach is designed to provide a rapid and yet comprehensive assessment of key health systems functions. The approach is organized around technical modules that guide data collection, and cover the following areas—

• Governance

• Health financing

• Health service delivery

• Human resources

• Pharmaceutical management

• Health information systems


Each module provides guidance for the user according to an indicator-based approach. The assessment approach is flexible and may encompass all modules for a more comprehensive view of the health care system or may focus on selected modules, according to the objectives of the assessment. A required core module provides basic background information on a country’s key health indices and other important data related to its economy, health system organization, and

population. ….”

Download the Manual by Chapter

 

Introduction http://healthsystems2020.org/files/570_file_00_Introduction.pdf


Chapter 1.
Health Systems Strengthening: An Introduction
http://healthsystems2020.org/files/571_file_01_Chapter_1.pdf

 

Chapter 2. Overview of the Approach
http://healthsystems2020.org/files/572_file_02_Chapter_2.pdf

 

Chapter 3. Planning and Conduction the Assessment

http://healthsystems2020.org/files/573_file_03_Chapter_3.pdf

 

Chapter 4. Synthesizing Findings and Developing Recommendations
http://healthsystems2020.org/files/574_file_04_Chapter_4.pdf

 

Chapter 5. Core Module
http://healthsystems2020.org/files/575_file_05_Chapter_5.pdf

 

Chapter 6. Governance Module
http://healthsystems2020.org/files/576_file_06_Chapter_6.pdf

 

Chapter 7. Health Financing Module
http://healthsystems2020.org/files/577_file_07_Chapter_7.pdf

 

Chapter 8. Health Service Deilvery Module
http://healthsystems2020.org/files/578_file_08_Chapter_8.pdf

 

Chapter 9. Human Resources Module
http://healthsystems2020.org/files/579_file_09_Chapter_9.pdf

 

Chapter 10. Pharmaceutical Management Module
http://healthsystems2020.org/files/580_file_10_Chapter_10.pdf

 

Chapter 11. Health Information System Module
http://healthsystems2020.org/files/581_file_11_Chapter_11.pdf

 

 

 

 


*      *      *     * 

This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area] 

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

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[EQ] Quality and Efficiency in Swedish Health Care - Regional Comparisons

Quality and Efficiency in Swedish Health Care – Regional Comparisons.

 

Swedish Association of Local Authorities and Regions (SALAR) and the Swedish National

Board of Health and Welfare (NBHW)

 

Available online as PDF file [190p.] at:
http://www.socialstyrelsen.se/NR/rdonlyres/9F559A98-E4F8-432B-85B8-8A3B96908488/9909/20081313.pdf

 

 

The series compares healthcare quality and efficiency in the 21 Swedish county councils and healthcare regions by using a set of national performance indicators.

 

The purpose of publishing comparative data about healthcare performance is twofold:

·         First, the comparisons are a way of informing and stimulating public debate on healthcare quality and efficiency. The public, as both patients and citizens, has a right to know about the results of the healthcare services that are available to it.

·         The second purpose is to stimulate and support local and regional efforts to improve healthcare services in terms of clinical quality and medical outcomes, as well as patient experience and efficient resource use. In county councils and healthcare regions, political representatives, managers and staff of primary care clinics and hospitals can use the comparisons to locate and pinpoint the strengths and weaknesses of their healthcare systems. Comparisons are a powerful way of driving performance improvement.

 

Contents

Introduction

A - Medical Results

MORTALITY, HOSPITALISATION AND VACCINATION

DRUG CONSUMPTION

CANCER SURVIVAL RATE

MATERNAL AND NEONATAL CARE

DIABETES CARE

STROKE CARE

CARDIAC CARE

ORTHOPAEDIC CARE

OTHER TREATMENTS

B - Patient Experience

C - Time-related Availability

PRIMARY CARE

SPECIALISED CARE

D - Costs

COST PER CAPITA

COST PER CARE EVENT OR VISIT

COST-EFFECTIVE TREATMENT OPTIONS – CHOOSING AMONG

EQUIVALENT DRUGS OR BETWEEN DAY-CASE AND INPATIENT SURGERY

Appendix. Description of Indicators

 

 

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This message from the Pan American Health Organization, PAHO/WHO, is part of an effort to disseminate
information Related to: Equity; Health inequality; Socioeconomic inequality in health; Socioeconomic
health differentials; Gender; Violence; Poverty; Health Economics; Health Legislation; Ethnicity; Ethics;
Information Technology - Virtual libraries; Research & Science issues.  [DD/ IKM Area]

“Materials provided in this electronic list are provided "as is". Unless expressly stated otherwise, the findings
and interpretations included in the Materials are those of the authors and not necessarily of The Pan American
Health Organization PAHO/WHO or its country members”.

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    IMPORTANT: This transmission is for use by the intended recipient and it may contain privileged, proprietary or confidential information. If you are not the intended recipient or a person responsible for delivering this transmission to the intended recipient, you may not disclose, copy or distribute this transmission or take any action in reliance on it. If you received this transmission in error, please notify us immediately by email to infosec@paho.org, and please dispose of and delete this transmission. Thank you.