Impact of Hospital Provider Payment Reforms in Croatia

Bogut, Martina ; Voncina, Luka ; Yeh, Ethan

关键词: ACUTE CARE;    ADEQUATE FINANCIAL RESOURCES;    AGE GROUPS;    AGING;    BIOCHEMISTRY;   

DOI  :  10.1596/1813-9450-5992
RP-ID  :  WPS5992

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

Croatia began to implement case-basedprovider payment reforms in hospitals beginning in 2002,starting with broad-based categories according totherapeutic procedures. In 2009, formal diagnostic relatedgroups were introduced, known locally as dijagnostickoterapijske skupine. This study examines the efficiency andquality impacts of these provider payment reforms globallyon the Croatian health system by analyzing data on fiveprocedures in acute health care for 10 years, betweenJanuary 2000 and December 2009. The five procedures arecataracts, pneumonia, coronary bypass, appendectomy, and hipreplacement. Using data from the Croatian Institute forHealth Insurance, this study finds that both broad-based anddetailed case-based payment systems have improved efficiencyas measured by a reduction in average length of stay, withlittle impact on the number of cases. These provider paymentreforms have had no adverse impact on quality as measured byreadmissions. While it is still too early to quantify theimpact of Croatia's introduction of formal diagnosticrelated groups, it appears that the introduction of bothbroad and detailed case-based payment systems has improvedefficiency in acute hospital care.