Risk adjustment and hospital cost-based resource allocation, with an application to El Salvador.
Ignorance about the costs, case loads and case mixes of different hospitals within the public health system constitutes an important obstacle to reforming health care spending in many developing countries.
National (tertiary) hospitals generally receive significantly larger budgets, per patient, than lower-level (district) hospitals.
One reason for these differential allocations is the widely held belief that national hospitals treat persons with more difficult illnesses and persons who are more severely ill than do other, non-national, hospitals.
This belief is but a presumption and one that warrants investigation.
This paper analyzes expenditures among public hospitals in El Salvador over a 12-year period to address this question.
While controlling for patient morbidity, outputs and other characteristics, district hospitals are found to be substantially underfunded relative to national hospitals.
Four policy options to redress this situation are examined.
Mots-clés Pascal : Analyse coût, Ajustement, Risque, Milieu hospitalier, Economie santé, Allocation ressource, Homme, Système santé, Politique sanitaire
Mots-clés Pascal anglais : Cost analysis, Fitting, Risk, Hospital environment, Health economy, Resource allocation, Human, Health system, Health policy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0085006
Code Inist : 002B30A04B. Création : 31/05/1999.