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Author: Jeffrey S. Hammer Publisher: World Bank Publications ISBN: Category : Medical care Languages : en Pages : 22
Book Description
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 S. Hammer Publisher: World Bank Publications ISBN: Category : Medical care Languages : en Pages : 22
Book Description
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 S. Hammer Publisher: ISBN: Category : Languages : en Pages : 17
Book Description
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: Jeffrey Hammer Publisher: ISBN: Category : Languages : en Pages :
Book Description
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: Benjamin Loevinsohn Publisher: World Bank Publications ISBN: 0821375377 Category : Medical Languages : en Pages : 226
Book Description
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: Varun Gauri Publisher: World Bank Publications ISBN: Category : Atencion de la salud Languages : en Pages : 21
Book Description
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: Alexander S. Preker Publisher: World Bank Publications ISBN: 0821365487 Category : Medical Languages : en Pages : 440
Book Description
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: OECD Publisher: OECD Publishing ISBN: 9264805907 Category : Languages : en Pages : 447
Book Description
This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.
Author: Marc J. Roberts Publisher: Oxford University Press, USA ISBN: 019537150X Category : Medical Languages : en Pages : 345
Book Description
This book provides a multi-disciplinary framework for developing and analyzing health sector reforms, based on the authors' extensive international experience. It offers practical guidance - useful to policymakers, consultants, academics, and students alike - and stresses the need to take account of each country's economic, administrative, and political circumstances. The authors explain how to design effective government interventions in five areas - financing, payment, organization, regulation, and behavior - to improve the performance and equity of health systems around the world.
Author: J. Luis Guasch Publisher: World Bank Publications ISBN: Category : Business enterprises Languages : en Pages : 30
Book Description
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: Jeffrey S. Hammer
Author: Jeffrey S. Hammer
Author: Jeffrey S. Hammer
Author: Hammer
Author: Jeffrey Hammer
Author: Benjamin Loevinsohn
Author: Varun Gauri
Author: Alexander S. Preker
Author: OECD
Author: Marc J. Roberts
Author: J. Luis Guasch