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  1. The influence of budget-holding on cost containment and work procedures in primary care clinics.

    Article - En anglais

    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

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 96-0374818

    Code Inist : 002B30A01B. Création : 10/04/1997.