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Performance-Based Financing

Hye Ah Lee, Hyejin Han, Seonhwa Lee, Bomi Park, Bo Hyun Park, Won Kyung Lee, Ju Ok Park, Sungok Hong, Young Taek Kim, Hyesook Park
BACKGROUND: It has been suggested that health risks are affected by geographical area, but there are few studies on contextual effects using multilevel analysis, especially regarding unintentional injury. This study investigated trends in unintentional injury hospitalization rates over the past decade in Korea, and also examined community-level risk factors while controlling for individual-level factors. METHODS: Using data from the 2004 to 2013 Korea National Hospital Discharge Survey (KNHDS), trends in age-adjusted injury hospitalization rate were conducted using the Joinpoint Regression Program...
March 13, 2018: BMC Public Health
Kadri Mägi, Marika Lepaste, Monika Szkultecka-Dębek
The aim of this article was to present a general overview of the health care system as well as pricing and reimbursement environment in Estonia. In Estonia the main stakeholders in the pharmaceutical sector are the Ministry of Social Affairs, the State Agency of Medicine, and the Estonian Health Insurance Fund. The national health insurance scheme is public, and approximately 95% of the population is covered by it. It is a social insurance, and universal and equal access to health care based on national health insurance is granted...
March 9, 2018: Value in Health Regional Issues
Elvis Dzelamonyuy Chem, Damian Nota Anong, Jane-Francis K T Akoachere
BACKGROUND: Inappropriate use of antibiotics is a global public health challenge and has been associated with antibiotic resistance. WHO reports show that efforts to promote rational antibiotic use in developing countries are poor. With the growing number of infections with antibiotic resistant bacteria, rational drug use becomes imperative and studies that promote rational drug use are highly necessary. Considering this, we investigated prescribing patterns and predictors of antibiotic prescription in primary health care facilities in Kumbo East (KE) and Kumbo West (KW) health districts in North West Cameroon, to contribute data which could influence policy on antibiotic use...
2018: PloS One
K Rüütel, K Kallavus, I Tomera
OBJECTIVES: In Estonia, a network of anonymous and free of charge HIV testing sites has been operating since 1988. Services are provided by health care organizations and financed by the National Institute for Health Development from the state budget. The objective of this analysis was to assess anonymous HIV testing in Estonia from 2005 to 2015. METHODS: We used data collected from the National Institute for Health Development's annual reports, Health Board and Estonian Health Insurance Fund...
February 2018: HIV Medicine
Keovathanak Khim, Rohan Jayasuriya, Peter Leslie Annear
Since 1999, performance-based financing or pay-for-performance (P4P) methods have been piloted in the Cambodian public health sector, first as one part of external contracting approaches with international nongovernment organizations and from 2009 as a part of internal contracting arrangements between units within the Ministry of Health under a wider public sector administrative reform. This study analyses these reforms and compares outcomes in 3 health districts. The study analysed routine quantitative data for primary care service delivery by using the interrupted time series method...
February 22, 2018: International Journal of Health Planning and Management
Michael Schriver, Vincent Kalumire Cubaka, Sylvere Itangishaka, Laetitia Nyirazinyoye, Per Kallestrup
BACKGROUND: External supervision of primary healthcare facilities in low- and middle-income countries often has a managerial main purpose in which the role of support for professional development is unclear. AIM: To explore how Rwandan primary healthcare supervisors and providers (supervisees) perceive evaluative and formative functions of external supervision. DESIGN: Qualitative, exploratory study. DATA: Focus group discussions: three with supervisors, three with providers, and one mixed (n = 31)...
2018: PloS One
S Lauriks, M C A Buster, M A S de Wit, O A Arah, A W Hoogendoorn, J Peen, N S Klazinga
PURPOSE: The Public Mental Health Care (PMHC) system is a network of public services and care- and support institutions financed from public funds. Performance indicators based on the registration of police contacts could be a reliable and useful source of information for the stakeholders of the PMHC system to monitor performance. This study aimed to provide evidence on the validity of using police contacts as a performance indicator to assess the continuity of care in the PMHC system...
February 15, 2018: Social Psychiatry and Psychiatric Epidemiology
Weiwei Cheng, Guigen Nie
High-performance oscillators, atomic clocks for instance, are important in modern industries, finance and scientific research. In this paper, the authors study the estimation and prediction of long-term stability based on convex optimization techniques and compressive sensing. To take frequency drift into account, its influence on Allan and modified Allan variances is formulated. Meanwhile, expressions for the expectation and variance of discrete-time Hadamard variance are derived. Methods that reduce the computational complexity of these expressions are also introduced...
February 7, 2018: Sensors
Joel Christian Reed
Over the past decade, health systems strengthening (HSS) has become a global health imperative. As an answer to the influence of large-scale initiatives and NGOs, HSS represents a backlash against disease-specific projects and funding. Depicted as a positive evolution, HSS advertises local autonomy, and a turn away from donor-driven agendas. Central to this shift was the hope that 'vertical' funding, especially for HIV/AIDS, could be better used to build up the 'crumbling core' of health infrastructure in sub-Saharan Africa...
February 7, 2018: Global Public Health
Alexandru M Rotar, Alin Preda, Olga Löblová, Vanesa Benkovic, Szymon Zawodnik, Laszlo Gulacsi, Maciej Niewada, Imre Boncz, Guenka Petrova, Maria Dimitrova, Niek Klazinga
This paper aims to provide an overview of the rationalization strategies for the introduction and use of pharmaceuticals, focusing on the role of managed entry agreements (MEA) in Central and Eastern European (CEE) countries, namely Bulgaria, the Czech Republic, Croatia, Hungary, Poland and Romania. We developed a conceptual framework on MEAs that was used as the basis for a standardized assessment questionnaire sent to country experts to capture their perceptions on their countries' rationalization strategies and MEAs...
January 11, 2018: Health Policy
Wu Zeng, Donald S Shepard, Jean de Dieu Rusatira, Aaron P Blaakman, Bernice M Nsitou
Results-based financing (RBF) has been advocated and increasingly scaled up in low- and middle-income countries to increase utilization and quality of key primary care services, thereby reducing maternal and child mortality rates. This pilot RBF study in the Republic of the Congo from 2012 to 2014 used a quasi-experimental research design. The authors conducted pre- and post-household surveys and gathered health facility services data from both intervention and comparison groups. Using a difference-in-differences approach, the study evaluated the impact of RBF on maternal and child health services...
January 16, 2018: Health Policy and Planning
Maria Steenland, Paul Jacob Robyn, Philippe Compaore, Moussa Kabore, Boukary Tapsoba, Aloys Zongo, Ousmane Diadie Haidara, Günther Fink
Performance-based financing (PBF) programs are increasingly implemented in low and middle-income countries to improve health service quality and utilization. In April 2011, a PBF pilot program was launched in Boulsa, Leo and Titao districts in Burkina Faso with the objective of increasing the provision and quality of maternal health services. We evaluate the impact of this program using facility-level administrative data from the national health management information system (HMIS). Primary outcomes were the number of antenatal care visits, the proportion of antenatal care visits that occurred during the first trimester of pregnancy, the number of institutional deliveries and the number of postnatal care visits...
December 2017: SSM—Population Health
Oriane Bodson, Ahmed Barro, Anne-Marie Turcotte-Tremblay, Nestor Zanté, Paul-André Somé, Valéry Ridde
Background: Performance-based financing (PBF) in the health sector has recently gained momentum in low- and middle-income countries (LMICs) as one of the ways forward for achieving Universal Health Coverage. The major principle underlying PBF is that health centers are remunerated based on the quantity and quality of services they provide. PBF has been operating in Burkina Faso since 2011, and as a pilot project since 2014 in 15 health districts randomly assigned into four different models, before an eventual scale-up...
2018: Archives of Public Health, Archives Belges de Santé Publique
Elisabeth Paul, Mohamed Lamine Dramé, Jean-Pierre Kashala, Armand Ekambi Ndema, Marcel Kounnou, Julien Codjovi Aïssan, Karel Gyselinck
BACKGROUND: Performance-based financing (PBF) is often proposed as a way to improve health system performance. In Benin, PBF was launched in 2012 through a World Bank-supported project. The Belgian Development Agency (BTC) followed suit through a health system strengthening (HSS) project. This paper analyses and draws lessons from the experience of BTC-supported PBF alternative approach - especially with regards to institutional aspects, the role of demand-side actors, ownership, and cost-effectiveness - and explores the mechanisms at stake so as to better understand how the "PBF package" functions and produces effects...
April 15, 2017: International Journal of Health Policy and Management
M Joannidis, S J Klein, P Metnitz, A Valentin
In Austria, the reimbursement of intensive care services is based on a Diagnosis-Related Groups (DRG) system which has been adapted to the Austrian framework conditions. Compared to Germany where economic considerations had led to personnel cuts, mandatory targets outlined in both the LKF ("Leistungsorientierte Krankenanstaltenfinanzierung", Performance-oriented Hospital Financing) and ÖSG ("Österreichischer Strukturplan Gesundheit", Austrian Health Care Structure Plan) plans ensure a high level of medical and intensive care...
January 9, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Guido Schmidt-Traub
The independent Technical Review Panel (TRP) of the Global Fund to Fight HIV/AIDS, Tuberculosis and Malaria is a unique mechanism to review funding proposals and to provide recommendations on their funding. Its functioning and performance have received little attention in the scientific literature. We aimed to identify predictors for TRP recommendations, whether these were in line with the Global Fund's ambition to give priority to countries most in need, and whether they correlated with grant performance. We combined data on proposals and applications under the Rolling Continuation Channel, TRP recommendations and grant implementation during the rounds-based mechanism (2002-2010) with country characteristics...
January 4, 2018: Health Policy and Planning
Eva Steinhausen, Bertil Bouillon, Dieter Rixen
PURPOSE: Although they are considered the 'gold standard' of evidence-based medicine, randomized controlled trials are still a rarity in orthopedic surgery. In the management of patients with multiple trauma, there is a current trend toward 'damage control orthopedics', but to date, there is no proof of the superiority of this concept in terms of evidence-based medicine. The purpose of this article is to present unexpected difficulties we encountered in successfully completing our randomized controlled trial and to discuss the problematic differences between theoretically planning a trial and real-life practical experience of implementing the plan, with attention to published strategies...
December 28, 2017: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
Lizzy Mm Boots, Marjolein E de Vugt, Claudia Mj Smeets, Gertrudis Ijm Kempen, Frans Rj Verhey
BACKGROUND: Caring for a family member with dementia puts caregivers at risk of overburdening. Electronic health (eHealth) support for caregivers offers an opportunity for accessible tailored interventions. The blended care self-management program "Partner in Balance" (PiB) for early-stage dementia caregivers was executed in Dutch dementia care organizations. The program combines face-to-face coaching with tailored Web-based modules. Next to an evaluation of program effectiveness, an evaluation of sampling and intervention quality is essential for the generalizability and interpretation of results...
December 19, 2017: Journal of Medical Internet Research
Kelly J Caverzagie, Susan W Lane, Niraj Sharma, John Donnelly, Jeffrey R Jaeger, Heather Laird-Fick, John P Moriarty, Darilyn V Moyer, Sara L Wallach, Richard M Wardrop, Alwin F Steinmann
Graduate medical education (GME) in the United States is financed by contributions from both federal and state entities that total over $15 billion annually. Within institutions, these funds are distributed with limited transparency to achieve ill-defined outcomes. To address this, the Institute of Medicine convened a committee on the governance and financing of GME to recommend finance reform that would promote a physician training system that meets society's current and future needs. The resulting report provided several recommendations regarding the oversight and mechanisms of GME funding, including implementation of performance-based GME payments, but did not provide specific details about the content and development of metrics for these payments...
December 12, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Ashley Warren, Roberto Cordon, Michaela Told, Don de Savigny, Ilona Kickbusch, Marcel Tanner
BACKGROUND: The Global Fund is one of the largest actors in global health. In 2015 the Global Fund was credited with disbursing close to 10 % of all development assistance for health. In 2011 it began a reform process in response to internal reviews following allegations of recipients' misuse of funds. Reforms have focused on grant application processes thus far while the core structures and paradigm have remained intact. We report results of discussions with key stakeholders on the Global Fund, its paradigm of oversight, monitoring, and results in Mozambique...
December 12, 2017: Globalization and Health
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