3 research outputs found
Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions
Health care systems worldwide have faced a problem of resources scarcity that, in
turn, should be allocated to the health care providers according to the corresponding
population needs. Such an allocation should be as much as effective and efficient as
possible to guarantee the sustainability of those systems. One alternative to reach
that goal is through (prospective) payments due to the providers for their clinical
procedures. The way that such payments are computed is frequently unknown and
arguably far from being optimal. For instance, in Portugal, public hospitals are
clustered based on criteria related to size, consumed resources, and volume of
medical acts, and payments associated with the inpatient services are equal to the
smallest unitary cost within each cluster. First, there is no reason to impose a single
benchmark for each inefficient hospital. Second, this approach disregards dimen sions like quality (and access) and the environment, which are paramount for fair
comparisons and benchmarking exercises. This paper proposes an innovative tool to
achieve best-practices tariff. This tool merges both quality and financial sustain ability concepts, attributing a hospital-specific tariff that can be different from
hospital to hospital. That payment results from the combination of costs related to a
set of potential benchmarks, keeping quality as high as possible and higher than a
user-predefined threshold, and being able to generate considerable cost savings. To
obtain those coefficients we propose and detail a log-linear piecewise frontier
function as well as a dual–primal approach for unique solutions.info:eu-repo/semantics/publishedVersio