Impact of Hospital Provider Payment Reforms in Croatia

Bogut, Martina; Voncina, Luka; Yeh, Ethan

Impact of Hospital Provider Payment Reforms in Croatia

Autores

Bogut, Martina

Voncina, Luka

Yeh, Ethan

Descripción

Croatia began to implement case-based provider payment reforms in hospitals beginning in 2002, starting with broad-based categories according to therapeutic procedures. In 2009, formal diagnostic related groups were introduced, known locally as dijagnosticko terapijske skupine. This study examines the efficiency and quality impacts of these provider payment reforms globally on the Croatian health system by analyzing data on five procedures in acute health care for 10 years, between January 2000 and December 2009. The five procedures are cataracts, pneumonia, coronary bypass, appendectomy, and hip replacement. Using data from the Croatian Institute for Health Insurance, this study finds that both broad-based and detailed case-based payment systems have improved efficiency as measured by a reduction in average length of stay, with little impact on the number of cases. These provider payment reforms have had no adverse impact on quality as measured by readmissions. While it is still too early to quantify the impact of Croatia's introduction of formal diagnostic related groups, it appears that the introduction of both broad and detailed case-based payment systems has improved efficiency in acute hospital care.

Palabras clave

ACUTE CARE, ADEQUATE FINANCIAL RESOURCES, AGE GROUPS, AGING, BIOCHEMISTRY, BUDGET CEILING, CATARACT, CATARACT SURGERY, CATARACTS, CHRONIC DISEASES, CHRONIC LUNG, CLINICAL CARE, CLINICAL PRACTICE, CLINICAL PRACTICES, CLINICS, DENTAL MEDICINE, DIAGNOSES, DIAGNOSIS, DIAGNOSIS RELATED GROUPS, DIAGNOSTIC PROCEDURES, DIAGNOSTIC TESTS, DIAGNOSTICS, DISCHARGE PATIENTS, DISEASE, DISEASES, ECONOMIC REVIEW, EMERGENCY MEDICINE, EXPENDITURES, FEE-FOR-SERVICE, FLAT RATE, GLAUCOMA, GYNECOLOGY, HEALTH CARE, HEALTH CARE COSTS, HEALTH CARE INSTITUTIONS, HEALTH CARE LAW, HEALTH CARE RESOURCES, HEALTH CARE SYSTEM, HEALTH ECONOMICS, HEALTH FINANCING, HEALTH FINANCING REFORM, HEALTH INSURANCE, HEALTH ORGANIZATION, HEALTH OUTCOMES, HEALTH POLICIES, HEALTH POLICY, HEALTH REFORMS, HEALTH SERVICE, HEALTH SERVICES, HEALTH SPENDING, HEALTH SYSTEM, HEALTH WORKFORCE, HEALTHCARE, HOSPITAL ADMISSIONS, HOSPITAL BEDS, HOSPITAL BUDGETS, HOSPITAL CARE, HOSPITAL FUNDING, HOSPITAL OWNERSHIP, HOSPITAL SERVICES, HOSPITAL SYSTEM, HOSPITALIZATION, HOSPITALS, HUMAN DEVELOPMENT, ILLNESSES, INCOME, INFECTIONS, INPATIENT CARE, INPATIENT TREATMENT, LUNG DISEASES, MEDICAL ASSOCIATION, MEDICAL ASSOCIATIONS, MEDICAL CARE, MEDICAL EDUCATION, MEDICAL REHABILITATION, MEDICAL SERVICES, MEDICARE, MENTAL ILLNESSES, NATIONAL HEALTH, NEGATIVE EFFECTS, NUTRITION, OBSTETRICS, PATIENT, PATIENTS, PEDIATRICS, PHARMACEUTICALS, PHARMACY, PNEUMONIA, POLICY DISCUSSIONS, POLICY RESEARCH, PROVIDER PAYMENT, PUBLIC HEALTH, PUBLIC HEALTH CARE, PUBLIC HEALTH SERVICES, QUALITY OF CARE, SOCIAL WELFARE, SURGERY, TREATMENT