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Vos, L.; Duckers, M.L.A.; Wagner, C.; Merode, G.G. van (2010)

Does case-mix based reimbursement stimulate the development of process-oriented care delivery?

Article / Letter to editor
Objectives Reimbursement based on the total care of a patient during an acute episode of Illness is believed to stimulate management and clinicians to reduce quality problems like waiting times and poor coordination of care delivery Although many studies already show that this kind of case-mix based reimbursement leads to more efficiency it remains unclear whether care coordination improved as well This study aims to explore whether case-mix based reimbursement stimulates development of care coordination by the use of care programmes and a process-oriented way of working Methods Data for this study were gathered during the winter of 2007/2008 in a survey involving all Dutch hospitals Descriptive and structural equation modelling (SEM) analyses were conducted Results SEM reveals that adoption of the case-mix reimbursement within hospitals budgeting processes stimulates hospitals to establish care programmes by the use of process-oriented performance measures However the...Show moreObjectives Reimbursement based on the total care of a patient during an acute episode of Illness is believed to stimulate management and clinicians to reduce quality problems like waiting times and poor coordination of care delivery Although many studies already show that this kind of case-mix based reimbursement leads to more efficiency it remains unclear whether care coordination improved as well This study aims to explore whether case-mix based reimbursement stimulates development of care coordination by the use of care programmes and a process-oriented way of working Methods Data for this study were gathered during the winter of 2007/2008 in a survey involving all Dutch hospitals Descriptive and structural equation modelling (SEM) analyses were conducted Results SEM reveals that adoption of the case-mix reimbursement within hospitals budgeting processes stimulates hospitals to establish care programmes by the use of process-oriented performance measures However the implementation of care programmes is not (yet) accompanied by a change in focus from function (the delivery of independent care activities) to process (the delivery of care activities as being connected to a chain of interdependent care activities) Conclusion This study demonstrates that hospital management can stimulate the development of care programmes by the adoption of case-mix reimbursement within hospitals budgeting processes Future research is recommended to confirm this finding and to determine whether the establishment of care programmes will in time indeed lead to a more process-oriented view of professionals (C) 2010 Elsevier Ireland Ltd All rights reservedShow less
Reimbursement Process orientation Hospital budgeting Operations management Care programmes health-care quality tests organization netherlands normality systems design impact
All authors
Vos, L.; Duckers, M.L.A.; Wagner, C.; Merode, G.G. van
Date
2010-11-30
Journal
Health Policy
Volume
98
Issue
1
Pages
74 - 80
DOI
doi:10.1016/j.healthpol.2010.06.005