Allstract-In 1990, Kupat Holim Clalit (KHC), Israel's largest health insurance fund. initiated a demonstration program for transforming primary care clinics in the Negev district of southern Israel into autonomous budget-holding units.
Four program components were implemented in nine clinics :
allocation of a fixed budget ;
expansion of day-to-day decision-making authority ;
establishment of a computerized information system for producing monthly reports on expenditure ;
and provision of incentives for budgetary responsibility (returning part of a clinic's savings for use at its discretion).
The demonstration program had three objectives :
Budgetary control and cost containment ; improvement of services and increased client satisfaction ; and improvement in the motivation, initiative, responsibility, and satisfaction of clinic staff.
This report presents interim findings from an evaluation study of the budget-holding program conducted in 1991-1992.
The report considers three questions : How was the demonstration program implemented ?
Did work procedures in the clinics change following implementation of the program ?
How did budget-holding influence levels of expenditure in the clinics ?
The program components were implemented gradually in the nine clinics during 1991--1992.
Not all, however, were fully implemented. (...)
Mots-clés Pascal : Service santé, Budget, Décentralisation, Contrôle coût, Economie santé, Système santé, Soin santé primaire, Evaluation, Israël, Asie
Mots-clés Pascal anglais : Health service, Budget, Decentralization, Cost control, Health economy, Health system, Primary health care, Evaluation, Israel, Asia
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0374818
Code Inist : 002B30A01B. Création : 10/04/1997.