Spending Wisely : Buying Health Services for the Poor.

Intro -- Contents -- Acknowledgments -- Acronyms and Abbreviations -- Introduction -- Part I: The Conceptual Framework -- Part II: Making Strategic Purchasing Pro-Poor -- Part III: Purchasing Health Services -- Part IV: Purchasing Inputs -- Part V: Supply, Demand, And Markets -- Part VI: Legal And Regulatory Issues -- PART I. THE CONCEPTUAL FRAMEWORK -- 1. Managing Scarcity through Strategic Purchasing of Health Care -- The Evolution of Health Systems and Collective Financing of Health Care -- Reform Trends in Public Spending on Health Care -- Continued Need for Strong Public Policy in Managing Scarce Resources -- The Purchaser-Provider Split -- Getting Value for Public Money Spent on Health Care -- Forthcoming Books on Resource Allocation and Purchasing in the Health Sector -- References -- 2. For Whom to Buy? Are Free Government Health Services the Best Way to Reach the Poor? -- The Beneficiaries of Government Health Service Expenditures -- Focusing Government Services on the Poor -- Encouraging the Better-Off to Pay for Their Own Services -- Conclusions -- Notes -- References -- 3. What to Buy? Revisiting Priority Setting in Health Care -- Some Approaches to Priority Setting -- Economic Evaluation -- Equity Issues -- Practical Constraints -- Conclusions -- References -- 4. From Whom to Buy? Selecting Providers -- Defining and Identifying Eligible Providers and Matching the Intervention -- Can the Purchaser Buy the Desired Intervention from the Eligible Providers? -- References -- 5. How to Pay? Understanding and Using Payment Incentives -- Payment System Types and a Conceptual Framework for Incentives -- Which Payment System Should Be Chosen? -- Discussion -- Notes -- References -- 6. At What Price? Affordable and Realistic Fees -- Overview of Provider Payment Methods -- Calculating Costs-Methods and Information Available.

Characteristics of Purchasers and Providers -- Conclusions -- Notes -- References -- PART II. MAKING STRATEGIC PURCHASING PRO-POOR -- 7. The Equity Dimensions of Purchasing -- The Evidence -- What Does An "Equitable Distribution of Health and Health Benefits" Mean? -- Defining Variables: Resource Allocation and Purchasing Reforms -- Conclusions and Recommendations -- Notes -- References -- 8. Reversing the Law of Inverse Care -- The Inverse Care Law At Work in Rich and Poor Countries -- The Infrastructure of Inequity -- Methodological Issues: How to Construct Resource Allocation for Equity in Access -- References -- 9. Risk Pooling and Purchasing -- Approaches to Risk Pooling -- Practical Issues -- Conclusions -- Note -- References -- PART III. PURCHASING HEALTH SERVICES -- 10. Paying for Public Health Services: Financing and Utilization -- Who Should Pay for Public Health Services? -- How Should Providers Be Paid? -- Toward Better Financing and Payment Policies -- References -- 11. Buying Results: Contracting for Primary Health Care Delivery -- Why Contract-Ideology or Pragmatism? -- Approaches to Contracting -- Study Methodology -- Results: Contracting Can Quickly Improve Service Delivery -- Methodological Limitations of This Review -- Is Contracting a Sustainable Approach? -- Recommendations -- Note -- References -- 12. Purchasing Hospital Services: Key Questions for Policymakers -- Key Criteria for Effective Purchasing Decisions -- For Whom to Buy? -- What to Buy? -- From Whom to Buy -- How to Pay? -- At What Price? -- Moving Forward -- Notes -- References -- PART IV. PURCHASING INPUTS -- 13. Paying for Health Care Labor -- Purchasing Health Care Labor -- Framework for Purchasing Health Labor -- Conclusions -- Note -- References -- 14. Purchasing Pharmaceuticals -- Pharmaceutical RAP in Developing Countries.

Core Policy RAP Strategies to Increase Access to Drugs -- Organizational and Institutional Arrangements -- From Passive to Active Purchasing of Pharmaceuticals -- Notes -- References -- 15. Paying for Capital -- The Commercial Model -- Capital Financing -- Capital Charging -- New Assets or All? -- Notional Versus Real Capital Charges -- Time Profiles of Capital Charges -- Asset Valuation -- Conclusions -- Notes -- References -- 16. Paying for Knowledge and Research -- Priority Areas for R&amp -- D -- RAP for R&amp -- D -- Notes -- References -- 17. Using Resource Profiles -- Classification of Resources and Typical Imbalances Data -- Construction of Health Care Resource Profiles -- Discussion -- References -- PART V. SUPPLY, DEMAND, AND MARKETS -- 18. Single-Payer Health Insurance -- Differences Between Single- and Multiple-Payer Systems -- Two Options for Reforming Single-Payer Insurance Systems -- Considerations Specific to Low- and Middle-Income Countries -- Conclusions -- Notes -- References -- 19. Multiple Payers in Health Care: A Framework for Assessment -- Theoretical Background -- Complementary Agents: Their Objectives and Constraints -- Conclusions -- Notes -- References -- 20. Influencing the Demand Side of Purchasing -- Demand-Side Barriers -- Policy Discussion and Research Implications -- Notes -- References -- PART VI. LEGAL AND REGULATORY ISSUES -- 21. Law and Regulation -- A Typology of RAP Arrangements -- Regulating What Is Purchased -- Regulating the Choice of Providers -- Regulating the Purchasing Transaction -- References -- 22. Quality-Based Purchasing in the United States: Applications in Developing Countries? -- Call to Action for U.S. Employers -- Quality-Based Purchasing By Employers -- Barriers to Quality-Based Purchasing -- Employer Activists -- Generic Employer Strategies to Promote Health Accountability for Quality.

Impact of Employer Strategies on Quality -- Conclusions -- Notes -- References -- About the Coeditors and Contributors -- Index -- TABLES -- 2.1 How Much Do the Poor Gain from Government Health Service Expenditures in Africa? -- 2.2 Financial Subsidy from Government Health Services Accruing to Poorest and Richest 20 Percent of the Population -- 2.3 Distribution of Benefits of Three Government Maternal and Child Health Programs across Socioeconomic Classes -- 4.1 Modalities between Purchaser and Provider Market Structures -- 5.1 Basis for Allocating Resources by Line Items in Former Soviet Union Republics -- 5.2 Impact of Selected Payment Incentives -- 7.1 Intracountry Disparities in Mortality of Children under Five Years of Age -- 7.2 Equity and (Re)distribution of Health Resources -- 7.3 Components of Resource Allocation and Purchasing Reforms -- 7.4 The Impact of the Municipal Common Fund (MCF) in Chile -- 7.5 Average Change in Service Coverage Indicators in Cambodia (first 2-1/2 years of reforms) -- 8.1 Mortality and Full Immunization for Children under Five Years by Income Quintile, In Selected Low- and Middle-Income Countries -- 11.1 Some Service Delivery Arrangements -- 11.2 Summary of Contracting Experiences -- 12.1 Hospital Inpatient Utilization within Regional Facilities -- 12.2 Regional Outpatient Activity -- 12.3 Care Delivery Matrix -- 13.1 Types of Purchasers -- 17.1 Selected Health Care Expenditures and Resource Measures in Five Middle-Income Latin American Countries -- 17.2 Selected Health Care Expenditures and Resource Measures in Five Low-Income African Countries -- 18.1 Single-Payer Health Insurance Systems, Four Models -- 19.1 Complementary Agents: Objectives and Examples -- 19.2 Complementary Agents and Single- vs. Multiple-Payer Systems -- 20.1 Reasons for Not Seeking Care in Obstetric Emergencies in Bangladesh.

20.2 Types of Intervention to Correct Demand Barriers -- 22.1 Framework for Conceptualizing Employer Quality-Based Purchasing Strategies -- 22.2 Leapfrog Group Strategies -- BOX -- 1.1 Contractor versus Government Performance in Industrial and Middle-Income Countries -- FIGURES -- 1.1 Functional Differentiation of Health Systems -- 1.2 Incidence of Spending on Public Services -- 1.3 Outcomes Are Worse for Poor People -- 1.4 Recent Reforms -- 5.1 Dimensions of Developing a Payment System -- 5.2 How to Calculate per-Diem Payments -- 5.3 Case-Mix Adjusted per Case Payment -- 5.4 Economics of per-Case Payment -- 5.5 Economics of Capitation Payment -- 6.1 Traditional Accounting versus ABC -- 7.1 Share of the Public Subsidy for Curative Care by Income Group -- 7.2 Beneficiaries of Public Subsidy by Type and Level of Care -- 9.1 The Integration Pyramid -- 9.2 The Tradeoff between Equity and Efficiency Gains and Declines in Managerial Efficiency -- 11.1 Double Differences (in percentage points) in Coverage Rates from Studies with Controlled, Before-and-After Methodology -- 12.1 Where Best to Buy What? -- 13.1 Framework for Purchasing Health Care Labor -- 13.2 Terms of Purchasing and Health Services -- 14.1 Pharmaceutical Spending -- 14.2 Countries with a National Essential Drugs List, December 1999 -- 14.3 Competition as a Price Inhibitor: The Example of Antiretrovirals -- 15.1 Depreciated Replacement Cost Valuation of Assets -- 17.1 Selected Health Care Expenditures and Resource Measures for Five Middle-Income Latin American Countries -- 19.1 Health Outcomes Due to Provider Effort -- 20.1 Supply and Demand for Health Care.

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Electronic reproduction. Ann Arbor, Michigan : ProQuest Ebook Central, 2024. Available via World Wide Web. Access may be limited to ProQuest Ebook Central affiliated libraries.