The Design Of Incentives For Health Care Providers In Developing Countries Contracts Competition And Cost Control

Author : Jeffrey S. Hammer,William Jack
Publisher : World Bank Publications
Page : 22 pages
File Size : 46,7 Mb
Release : 2001
Category : Medical care
ISBN : 8210379456XXX

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The Design of Incentives for Health Care Providers in Developing Countries by Jeffrey S. Hammer,William Jack Pdf

Whatever the theoretical attractiveness of certain policy options, the fact that public employees are people who make independent decisions about their careers and lifestyles can set bounds on how well government agencies can deliver promised services, such as universal health care, including in rural areas. Hammer and Jack examine the design and limitations of incentives for health care providers to serve in rural areas in developing countries. Governments face two problems: it is costly to compensate well-trained urban physicians enough to relocate to rural areas, and it is difficult to ensure quality care when monitoring performance is costly or impossible.

Author : Jeffrey Hammer
Publisher : Unknown
Page : 128 pages
File Size : 51,8 Mb
Release : 1999
Category : Electronic
ISBN : OCLC:913716229

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The Design of Incentives for Health Care Providers in Developing Countries: Contracts, Competition, and Cost Control by Jeffrey Hammer Pdf

February 2001 Whatever the theoretical attractiveness of certain policy options, the fact that public employees are people who make independent decisions about their careers and lifestyles can set bounds on how well government agencies can deliver promised services, such as universal health care, including in rural areas. Hammer and Jack examine the design and limitations of incentives for health care providers to serve in rural areas in developing countries. Governments face two problems: it is costly to compensate well-trained urban physicians enough to relocate to rural areas, and it is difficult to ensure quality care when monitoring performance is costly or impossible. The goal of providing universal primary health care has been hard to meet, in part because of the difficulty of staffing rural medical posts with conscientious caregivers. The problem is providing physicians with incentives at a reasonable cost. Governments are often unable to purchase medical services of adequate quality even from civil servants. Using simple microeconomic models of contracts and competition, Hammer and Jack examine questions about: * The design of rural service requirements and options for newly trained physicians. * The impact of local competition on the desirable level of training for new doctors. * The incentive power that can be reasonably expected from explicit contracts. One problem a government faces is choosing how much training to give physicians it wants to send to rural areas. Training is costly, and a physician relocated to the countryside is outside the government's direct control. Should rural doctors face a ceiling on the prices they charge patients? Can it be enforced? Hammer and Jack discuss factors to consider in determining how to pay rural medical workers but conclude that we might have to set realistic bounds on our expectations about delivering certain kinds of services. If we can identify reasons why the best that can be expected is not particularly good, it might lead us to explore entirely different policy systems. Maybe it is too hard to run certain decentralized systems. Maybe we should focus on less ambitious but more readily achievable goals, such as providing basic infrastructure. This paper--a product of Public Economics, Development Research Group--is part of a larger effort in the group to analyze service delivery in the social sectors. The authors may be contacted at [email protected] or [email protected].

Author : Jeffrey S. Hammer
Publisher : Unknown
Page : 17 pages
File Size : 45,5 Mb
Release : 2016
Category : Electronic
ISBN : OCLC:1290704735

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The Design of Incentives for Health Care Providers in Developing Countries by Jeffrey S. Hammer Pdf

Whatever the theoretical attractiveness of certain policy options, the fact that public employees are people who make independent decisions about their careers and lifestyles can set bounds on how well government agencies can deliver promised services, such as universal health care, including in rural areas. Hammer and Jack examine the design and limitations of incentives for health care providers to serve in rural areas in developing countries. Governments face two problems: It is costly to compensate well-trained urban physicians enough to relocate to rural areas, and it is difficult to ensure quality care when monitoring performance is costly or impossible.The goal of providing universal primary health care has been hard to meet, in part because of the difficulty of staffing rural medical posts with conscientious caregivers. The problem is providing physicians with incentives at a reasonable cost. Governments are often unable to purchase medical services of adequate quality even from civil servants. Using simple microeconomic models of contracts and competition, Hammer and Jack examine questions about:The design of rural service requirements and options for newly trained physicians.The impact of local competition on the desirable level of training for new doctors.The incentive power that can be reasonably expected from explicit contracts.One problem a government faces is choosing how much training to give physicians it wants to send to rural areas. Training is costly, and a physician relocated to the countryside is outside the government's direct control. Should rural doctors face a ceiling on the prices they charge patients? Can it be enforced?Hammer and Jack discuss factors to consider in determining how to pay rural medical workers but conclude that we might have to set realistic bounds on our expectations about delivering certain kinds of services. If we can identify reasons why the best that can be expected is not particularly good, it might lead us to explore entirely different policy systems. Maybe it is too hard to run certain decentralized systems. Maybe we should focus on less ambitious but more readily achievable goals, such as providing basic infrastructure.This paper - a product of Public Economics, Development Research Group - is part of a larger effort in the group to analyze service delivery in the social sectors.

Author : Hammer
Publisher : Unknown
Page : 0 pages
File Size : 45,9 Mb
Release : 2013
Category : Electronic
ISBN : OCLC:1404767273

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The Design of Incentives for Health Care Providers in Developing Countries by Hammer Pdf

Author : Benjamin Loevinsohn
Publisher : World Bank Publications
Page : 226 pages
File Size : 45,7 Mb
Release : 2008-01-01
Category : Medical
ISBN : 9780821375372

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Performance-based Contracting for Health Services in Developing Countries by Benjamin Loevinsohn Pdf

Despite the existence of effective interventions, there are many developing countries which are not on track to achieve the Millennium Development Goals (MDGs) for health. In many countries the delivery of health services is inadequate and one way of improving the situation is to contract with non-state providers. Contracting is a mechanism for a financing entity to procure a defined set of services from a non-state provider. Performance-based contracting is a type of contracting with: (a) a clear set of objectives and indicators; (b) systematic efforts to collect data to judge contractor performance; and (c) some consequences for the contractor, either rewards or sanctions, based on performance. Effective contracting for health services can be facilitated by using a systematic approach, described in this toolkit, that addresses key issues, including how to: 1. have a constructive dialogue with all stakeholders; 2. define the health services in terms of what services are to be delivered, where, the quantity of beneficiaries to be served, equity, and quality of care; 3. design the monitoring and evaluation to judge the performance of contractors; 4. select the contractors in a fair and transparent way; 5. arrange for effective contract management; 6. draft the contract and bidding documents; and 7. carry out the bidding process and successfully manage the contracts. The toolkit also includes a review of 14 evaluated examples of contracting in developing countries which concludes that the current weight of evidence indicates that contracting improves the coverage and quality of services rapidly. The six cases with controlled, before and after evaluations demonstrated large impact with themedian double difference (follow-up minus baseline in the experimental group minus follow-up minus baseline in the control) ranging from 9 to 26 percentage points.

Author : Alexander S. Preker
Publisher : World Bank Publications
Page : 440 pages
File Size : 52,9 Mb
Release : 2007-01-01
Category : Medical
ISBN : 9780821365489

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Public Ends, Private Means by Alexander S. Preker Pdf

Great progress has been made in recent years in securing better access and financial protection against the cost of illness through collective financing of health care. Managing scarce resources effectively and efficiently is an important part of this story. Experience has shown that, without strategic policies and focused spending, the poor are likely to get left out. The use of purchasing to enhance public sector performance is well-documented in other sectors. Extension to the health sector of lessons from this experience is now successfully implemented in many developing countries. Public.

Author : World Bank
Publisher : World Bank Publications
Page : 288 pages
File Size : 48,6 Mb
Release : 2024-06-25
Category : Electronic
ISBN : 9780821354681

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Making services work for poor people by World Bank Pdf

Author : Rena Eichler,Ruth Levine
Publisher : CGD Books
Page : 290 pages
File Size : 42,9 Mb
Release : 2009
Category : Business & Economics
ISBN : 9781933286297

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Performance Incentives for Global Health by Rena Eichler,Ruth Levine Pdf

Health systems in most low-income countries are under-resourced and underused, failing to meet the needs of those who need health care the most. But what if health service providers-or even patients-were rewarded partially on the basis of their performance? Based on a review of experiences to date, the authors of this volume argue that performance incentives have great potential to improve health care for the world's poor. They are one way to use funding dedicated to individual diseases or interventions to strengthen core health system functions. In Part I, Eichler and Levine provide clear guidance about how to design, implement, and evaluate such programs, whether they target health care providers, patients, or both. Part II comprises a set of case studies that examine the use of such incentives to address a range of health conditions and challenges in diverse countries. Performance Incentives for Global Health: Potential and Pitfalls will help policymakers and program managers in developing countries and in the donor community improve health care systems through the strategic use of performance incentives. Book jacket.

Author : Varun Gauri
Publisher : World Bank Publications
Page : 21 pages
File Size : 46,7 Mb
Release : 2001
Category : Atencion de la salud
ISBN : 8210379456XXX

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Are Incentives Everything? by Varun Gauri Pdf

This paper assesses the extent to which provider payment mechanisms can help developing countries address their leading health care problems. It first identifies four key problems in the health care systems in developing countries: 1) public facilities, which provide the bulk of secondary and tertiary health care services in most countries, offer services of poor quality; 2) providers cannot be enticed to rural and urban marginal areas, leaving large segments of the population without adequate access to health care; 3) the composition of health services offered and consumed is sub-optimal; and 4) coordination in the delivery of care, including referrals, second opinions, and teamwork, is inadequate. The paper examines each problem in turn and assesses the extent to which changes in provider payments might address it.

Author : Aline Coudouel,Stefano Paternostro
Publisher : World Bank Publications
Page : 470 pages
File Size : 52,7 Mb
Release : 2005
Category : Social Science
ISBN : 9780821363492

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Analyzing the Distributional Impact of Reforms, 2 by Aline Coudouel,Stefano Paternostro Pdf

"The analysis of the distributional impact of policy reforms on the well-being or welfare of different stakeholder groups, particularly on th e poor and vulnerable, has an important role in the elaboration and implementation of poverty reduction strategies in developing countries. In recent years this type of work has been labeled as Poverty and Social Impact Analysis (PSIA) and is increasingly implemented to promote evidence-based policy choices and foster debate on policy reform options. While information is available on the general approach, techniques, and tools for distributional analysis, each sector displays a series of specific characteristics. These have implications for the analysis of distributional impacts, including the types of impacts and transmission channels that warrant particular attention, the tools and techniques most appropriate, the data source typically utilized, and the range of political economy factors most likely to affect the reform process. This volume provides an overview of the specific issues arising in the analysis of the distributional impacts of policy and institutional reforms in selected sectors. Each chapter offers guidance on the selection of tools and techniques most adapted to the reforms under scrutiny, and offers examples of applications of these approaches. This is a companion to the first volume, which offers guidance on trade, monetary and exchange rate policy, utility provision, agricultural markets, land policy, and education."

Author : J. Luis Guasch,Joseph Kogan
Publisher : World Bank Publications
Page : 30 pages
File Size : 41,9 Mb
Release : 2001
Category : Business enterprises
ISBN : 8210379456XXX

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Inventories in Developing Countries by J. Luis Guasch,Joseph Kogan Pdf

High inventory levels in developing countries increase the cost of doing business and limit productivity and competitiveness. Improvements in infrastructure (roads, ports, and telecommunications) and in market development can help to significantly reduce inventory levels (and thus the cost of doing business), especially when accompanied by effective regulation and the development and deregulation of associated markets.

Author : John D. Pollner
Publisher : World Bank Publications
Page : 130 pages
File Size : 47,8 Mb
Release : 2001
Category : Disaster insurance
ISBN : 8210379456XXX

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Catastrophe Risk Management by John D. Pollner Pdf

In providing support for disaster-prone areas such as the Caribbean, the development community has begun to progress from disaster reconstruction assistance to funding for investment in mitigation as an explicit tool for sustainable development. Now it must enter a new phase, applying risk transfer mechanisms to address the financial risk of exposure to catastrophic events that require funding beyond what can be controlled solely through mitigation and physical measures.

Author : Anonim
Publisher : World Bank Publications
Page : 52 pages
File Size : 41,8 Mb
Release : 2001
Category : China
ISBN : 8210379456XXX

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Implicit Pension Debt, Transition Cost, Options and Impact of China's Pension Reform by Anonim Pdf

China's population is aging rapidly: the old age dependency ratio will rise from 11 percent in 1999 to 25 percent in 2030 and 36 percent in 2050. Currently, three workers support one retiree; without reform, the system dependency ratio will climb to 69 percent in 2030 and 79 percent in 2050. The pension system has been in deficit, with an implicit pension debt in 2000 as high as 71 percent of GDP. The lack of an effective sustainable pension systemn is a serious obstacle to Chinese economic reform.

Author : Estelle James,James H. Smalhout,Dimitri Vittas
Publisher : World Bank Publications
Page : 80 pages
File Size : 54,5 Mb
Release : 2001
Category : Administrative Costs
ISBN : 8210379456XXX

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Administrative Costs and the Organization of Individual Retirement Account Systems by Estelle James,James H. Smalhout,Dimitri Vittas Pdf

Organizing individual retirement accounts through the institutional market and with constrained choice could substantially lower administrative costs. The tradeoff: rebidding problems, weaker performance incentives, inflexibility in the face of unforeseen contingencies, and an increased probability of corruption, collusion, and regulatory capture.

Author : David A. Robalino,Oscar F. Picazo,Albertus Voetberg
Publisher : World Bank Publications
Page : 20 pages
File Size : 43,8 Mb
Release : 2001
Category : Descentralizacion
ISBN : 8210379456XXX

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Does Fiscal Decentralization Improve Health Outcomes? by David A. Robalino,Oscar F. Picazo,Albertus Voetberg Pdf

Decentralization of fiscal responsibilities has emerged as a primary objective on the agendas of national governments, and international organizations alike. Yet there is little empirical evidence on the potential benefits of this intervention. The authors fill in some quantitative evidence. Using panel data on infant mortality rates, GDP per capita, and the share of public expenditures managed by local governments, they find greater fiscal decentralization is consistently associated with lower mortality rates. The results suggest that the benefits of fiscal decentralization are particularly important for poor countries. They suggest also that the positive effects of fiscal decentralization on infant mortality, are greater in institutional environments that promote political rights. Fiscal decentralization also appears to be a mechanism for improving health outcomes in environments with a high level of ethno-linguistic fractionalization, however, the benefits from fiscal decentralization tend to be smaller.