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Main Title: Paying for hospital care: the experience with implementing activity-based funding in five European countries
Author(s): O'Reilly, Jacqueline
Busse, Reinhard
Häkkinen, Unto
Or, Zeynep
Street, Andrew
Wiley, Miriam
Type: Article
Language Code: en
Abstract: Following the US experience, activity-based funding has become the most common mechanism for reimbursing hospitals in Europe. Focusing on five European countries (England, Finland, France, Germany and Ireland), this paper reviews the motivation for introducing activity-based funding, together with the empirical evidence available to assess the impact of implementation. Despite differences in the prevailing approaches to reimbursement, the five countries shared several common objectives, albeit with different emphasis, in moving to activity-based funding during the 1990s and 2000s. These include increasing efficiency, improving quality of care and enhancing transparency. There is substantial cross-country variation in how activity-based funding has been implemented and developed. In Finland and Ireland, for instance, activity-based funding is principally used to determine hospital budgets, whereas the models adopted in the other three countries are more similar to the US approach. Assessing the impact of activity-based funding is complicated by a shortage of rigorous empirical evaluations. What evidence is currently available, though, suggests that the introduction of activity-based funding has been associated with an increase in activity, a decline in length of stay and/or a reduction in the rate of growth in hospital expenditure in most of the countries under consideration.
Issue Date: 2012
Date Available: 27-Nov-2017
DDC Class: 610 Medizin und Gesundheit
Journal Title: Health economics, policy and law
Publisher: Cambridge University Press
Publisher Place: Cambridge
Volume: 7
Issue: 1
Publisher DOI: 10.1017/s1744133111000314
Page Start: 73
Page End: 101
EISSN: 1744-134X
ISSN: 1744-1331
Notes: Dieser Beitrag ist mit Zustimmung des Rechteinhabers aufgrund einer (DFG geförderten) Allianz- bzw. Nationallizenz frei zugänglich.
This publication is with permission of the rights owner freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
Appears in Collections:FG Management im Gesundheitswesen » Publications

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