Principles of Capital Financing and Capital Charging in Health Care Systems
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World Bank, Washington, DC
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Most health care systems could improve
their efficiency in using physical capital - buildings and
equipment. Health care systems in which assets are provided
by governments or donated by aid organizations generally
have only weak incentives for those assets to be used
efficiently. Wrongly located or inappropriate facilities,
poorly utilized and maintained, are a result. This
Discussion Paper summarizes the principles of effective,
efficient, and equitable capital financing and capital
charging in health care systems. It reviews the options for
putting these principles into practice and refers to the
limited literature on the impacts of those options. The
objectives, principles, and practicalities of implementing
capital charging arrangements are set out. The relative
benefits and costs of points along the following dimensions
are described and summarized: applying capital charges just
to newly acquired assets or also to those already in
existence; using notional or real capital charges; the time
profile of charges; and the asset valuation basis adopted.
Palabras clave
ACCOUNTABILITY, ACCOUNTING, ACCOUNTING STANDARDS, ACCOUNTING SYSTEMS, ACQUISITION COSTS, ACUTE, ADMINISTRATIVE COSTS, ALLOCATIVE EFFICIENCY, ALTERNATIVE USE, ASSET VALUATION, ASSET VALUE, ASSETS, BALANCE SHEET, BOOK VALUE, BUSINESS DECISIONS, CAPITAL ASSETS, CAPITAL INVESTMENTS, CAPITAL PLANNING, CAPITAL RESOURCES, CAPITAL STOCK, COMPETITIVE MARKETS, COST OF CAPITAL, DEBT, DEPRECIATION, DEPRECIATION OF ASSETS, DISCOUNT RATE, DIVIDENDS, EXPENDITURES, GOVERNMENT FINANCE, GOVERNMENT SECURITIES, HEALTH CARE, HEALTH CARE FINANCING, HEALTH CARE MARKETS, HEALTH CARE PROFESSIONALS, HEALTH CARE PROVIDER, HEALTH CARE PROVIDERS, HEALTH CARE PROVISION, HEALTH CARE SERVICES, HEALTH CARE SYSTEMS, HEALTH ECONOMICS, HEALTH SECTOR, HEALTH SERVICES, HEALTH SYSTEM, HOSPITAL COSTS, HOSPITALS, HUMAN DEVELOPMENT, HUMAN RESOURCES, INCOME, INFLATION, INSURANCE, INTEREST COSTS, INTEREST PAYMENTS, INTEREST RATE, INTEREST RATES, INVESTMENT DECISIONS, INVESTMENT PRIORITIES, INVESTMENT PROJECTS, INVESTMENT RETURN, LEVEL PLAYING FIELD, MARKET VALUE, MEDICAL EQUIPMENT, NET REALIZABLE VALUE, NET VALUE, NUTRITION, OPPORTUNITY COST, PATIENTS, PENALTIES, PHYSICAL CAPITAL, PRESENT VALUE, PRIVATE CAPITAL, PRIVATE CAPITAL MARKETS, PUBLIC HEALTH, PUBLIC HEALTH CARE, QUALITY OF HEALTH CARE, RATE OF RETURN, RESOURCE ALLOCATION, STRAIGHT LINE DEPRECIATION, TOTAL COSTS, TRANSACTION COSTS, WORKING CAPITAL