Budgetary targets as cost-containment measure in the Swiss healthcare system? Lessons from abroad
| Autor: | Carsten Colombier, Thomas Braendle |
|---|---|
| Přispěvatelé: | Centre for Economic Development and Institutions, Swiss Federal Office of Metrology (METAS) |
| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
Cost Control
media_common.quotation_subject Cost growth Global budget Article [SHS]Humanities and Social Sciences 03 medical and health sciences 0302 clinical medicine Order (exchange) Germany Health care Remuneration Humans Quality (business) 030212 general & internal medicine Social determinants of health Comparative health systems media_common Netherlands Public economics business.industry 030503 health policy & services Health Policy Mandatory health insurance Rationing 3. Good health Negotiation Incentive Cost containment Business Health Expenditures 0305 other medical science Budgetary target Switzerland |
| Zdroj: | Health Policy Health Policy, Elsevier, 2020, 124, pp.605-614. ⟨10.1016/j.healthpol.2020.05.007⟩ Health Policy (Amsterdam, Netherlands) |
| ISSN: | 0168-8510 |
| DOI: | 10.1016/j.healthpol.2020.05.007⟩ |
| Popis: | Highlights • We provide a comparative analysis of social health systems with budgetary targets. • Targets raise the providers’ cost responsibility and their awareness for cost-benefit considerations. • Clear negotiating structures and including principal healthcare players are key to success. • Adjusting targets to morbidity and medical progress is necessary to avoid side-effects. • Accompanying measures such as incentive-compatible remuneration schemes and quality monitoring are important. Growing healthcare expenditure is a major concern for policy makers and calls for effective cost containment measures. For the decentralized Swiss healthcare system, ranking second among OECD countries in healthcare spending, a group of experts has proposed budgetary targets as key measure. In order to substantiate this proposal, we review the literature and analyse experiences with budgetary targets in comparable social health insurance systems, such as Germany and the Netherlands. Budgetary targets raise the cost responsibility and prompt providers to give greater weight to cost-benefit considerations. Our analysis suggests that the involvement of all principal healthcare players and clear decision-making and negotiating structures are key to successful implementation. Risks of rationing, lower quality incentives or conservation of structures have to be countered with taking into account age-related morbidity and medical progress when setting the budgetary targets. Accompanying measures such as incentive-compatible remuneration schemes and quality monitoring are of paramount importance. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect