The Impact of Resource Allocation and Purchasing Reforms on Equity

Vista sencilla de ítem
dc.creatorBelli, Paolo Carlo
dc.date2013-06-04T19:47:55Z
dc.date2013-06-04T19:47:55Z
dc.date2004-09
dc.date.accessioned2026-07-01T01:27:56Z
dc.descriptionThis paper introduces a conceptual framework to investigate the equity consequences of resource allocation, strategic purchasing and payment system reforms (RAP) in health, and reviews the empirical literature that has analyzed the impact of these reforms on equity. In the first part, the paper reviews the existing evidence on the distribution of health and health care utilization across socio-economic groups in developing countries. Such evidence shows a striking consistency in the association between poverty and poor health, and that the distribution of health benefits across socio-economic groups is highly unequal, favoring the wealthier segments of the population. At the same time it shows that the issue of quality of services is as important as the issue of their accessibility. Then the paper addresses the meaning of equity in health care: we argue that the concept of equity and that of an equitable distribution of resources in health are not as straightforward as they appear. In the second part, the paper reviews the core elements of RAP reforms, and it presents a survey of the empirical literature that has investigated the impact of RAP reforms from an equity perspective. We argue that some RAP reform components, such as the new resource allocation mechanisms, bear a strong pro-poor potential, but that other components can lead to the emergence of trade-offs between conflicting objectives, such as efficiency and equity. For instance, the new purchasing contracts and payment systems devised to enhance efficiency can create adverse equity effects. Conceptually, these trade-offs are significant and operating at several levels.
dc.formatapplication/pdf
dc.formattext/plain
dc.identifierhttp://documents.worldbank.org/curated/en/2004/09/5635378/impact-resource-allocation-purchasing-reforms-equity
dc.identifierhttps://hdl.handle.net/10986/13739
dc.identifierhttps://doi.org/10.1596/13739
dc.identifier.urihttp://hdl.handle.net/123456789/418329
dc.languageEnglish
dc.languageen_US
dc.publisherWorld Bank, Washington, DC
dc.relationHealth, Nutrition and Population (HNP) discussion paper;
dc.rightsCC BY 3.0 IGO
dc.rightshttp://creativecommons.org/licenses/by/3.0/igo/
dc.rightsWorld Bank
dc.subjectACCESS TO HEALTH SERVICES
dc.subjectADULT MORTALITY
dc.subjectBURDEN OF DISEASE
dc.subjectCHILD CARE
dc.subjectCHILD HEALTH
dc.subjectCHILD HEALTH SERVICES
dc.subjectCOMMUNICABLE DISEASES
dc.subjectDEATHS
dc.subjectDETERMINANTS OF HEALTH
dc.subjectDIARRHEA
dc.subjectDISABILITY
dc.subjectECONOMIC DEVELOPMENT
dc.subjectEMPLOYMENT
dc.subjectEQUITY IN HEALTH
dc.subjectEXTERNALITY
dc.subjectEXTREME POVERTY
dc.subjectFERTILITY
dc.subjectFERTILITY RATES
dc.subjectHEALTH CARE
dc.subjectHEALTH CARE FACILITIES
dc.subjectHEALTH CARE FINANCING
dc.subjectHEALTH CARE SERVICES
dc.subjectHEALTH CARE UTILIZATION
dc.subjectHEALTH ECONOMICS
dc.subjectHEALTH EXPENDITURE
dc.subjectHEALTH IMPACT
dc.subjectHEALTH INTERVENTIONS
dc.subjectHEALTH OUTCOMES
dc.subjectHEALTH POLICY
dc.subjectHEALTH REFORM
dc.subjectHEALTH REFORMS
dc.subjectHEALTH SECTOR
dc.subjectHEALTH SERVICES
dc.subjectHEALTH STATUS
dc.subjectHEALTH SURVEYS
dc.subjectHEALTH SYSTEM
dc.subjectHEALTH SYSTEMS
dc.subjectHOSPITAL CARE
dc.subjectHUMAN DEVELOPMENT
dc.subjectHUMAN RESOURCES
dc.subjectHUMAN RIGHTS
dc.subjectIMMUNIZATION
dc.subjectIMMUNIZATION RATES
dc.subjectIMMUNIZATION SERVICES
dc.subjectINCIDENCE ANALYSIS
dc.subjectINCOME
dc.subjectINFANT MORTALITY
dc.subjectINFANT MORTALITY RATE
dc.subjectINFANT MORTALITY RATES
dc.subjectINFECTION
dc.subjectINPATIENT CARE
dc.subjectINTERVENTION
dc.subjectISOLATION
dc.subjectLESSONS LEARNED
dc.subjectLIFE EXPECTANCY
dc.subjectLIVE BIRTHS
dc.subjectMALNUTRITION
dc.subjectMATERNAL AND CHILD HEALTH
dc.subjectMEDICAL EQUIPMENT
dc.subjectMORBIDITY
dc.subjectMORTALITY
dc.subjectMOTIVATION
dc.subjectNUTRITION
dc.subjectOUTPATIENT CARE
dc.subjectPATIENTS
dc.subjectPRIMARY CARE
dc.subjectPRIMARY HEALTH CARE
dc.subjectPRIVATE SECTOR
dc.subjectPROMOTING HEALTH
dc.subjectPUBLIC HEALTH
dc.subjectPUBLIC HEALTH INSURANCE
dc.subjectPUBLIC HEALTH SYSTEMS
dc.subjectPUBLIC SECTOR
dc.subjectRESPIRATORY INFECTIONS
dc.subjectSERVICE DELIVERY
dc.subjectSOCIAL CAPITAL
dc.subjectUNDER 5 MORTALITY
dc.subjectURBAN POPULATIONS
dc.titleThe Impact of Resource Allocation and Purchasing Reforms on Equity

Archivos

Colecciones

AgroKnow