Will Paying the Piper Change the Tune? Healthcare Policy Vol. 6 No. 4 2011

摘要

Most provincial governments are considering or introducing changes to hospital funding. Ten years of rapidly increasing expenditures have left them still facing complaints of waiting lists and waiting times. Activity-based funding (ABF) would supplement traditional negotiated global budgets, reimbursing a predetermined amount for each case treated – essentially, a "fee schedule" – thus providing incentives and resources to increase throughput of certain "hot button" procedures and services and to improve efficiency. Maybe. ABF-type systems in other countries date back over 20 years; the results are very mixed. What is clear is that information and reporting requirements are substantial. A host of perverse incentives lurk in ABF. Most Canadian hospitals and provincial governments do not now have the necessary data systems, so are wise to proceed cautiously.