Budgetary targets as cost-containment measure in the Swiss healthcare system? Lessons from abroad.
Budgetary target
Comparative health systems
Cost containment
Cost growth
Global budget
Mandatory health insurance
Journal
Health policy (Amsterdam, Netherlands)
ISSN: 1872-6054
Titre abrégé: Health Policy
Pays: Ireland
ID NLM: 8409431
Informations de publication
Date de publication:
06 2020
06 2020
Historique:
received:
08
04
2019
revised:
04
03
2020
accepted:
04
05
2020
pubmed:
1
6
2020
medline:
29
7
2021
entrez:
1
6
2020
Statut:
ppublish
Résumé
Growing healthcare expenditure is a major concern for policy makers and calls for effective cost containment measures. For the decentralized Swiss healthcare system, ranking second among OECD countries in healthcare spending, a group of experts has proposed budgetary targets as key measure. In order to substantiate this proposal, we review the literature and analyse experiences with budgetary targets in comparable social health insurance systems, such as Germany and the Netherlands. Budgetary targets raise the cost responsibility and prompt providers to give greater weight to cost-benefit considerations. Our analysis suggests that the involvement of all principal healthcare players and clear decision-making and negotiating structures are key to successful implementation. Risks of rationing, lower quality incentives or conservation of structures have to be countered with taking into account age-related morbidity and medical progress when setting the budgetary targets. Accompanying measures such as incentive-compatible remuneration schemes and quality monitoring are of paramount importance.
Identifiants
pubmed: 32473748
pii: S0168-8510(20)30106-8
doi: 10.1016/j.healthpol.2020.05.007
pmc: PMC7255250
pii:
doi:
Types de publication
Journal Article
Review
Langues
eng
Pagination
605-614Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
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