Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions

Detalhes bibliográficos
Autor(a) principal: Ferreira, Diogo
Data de Publicação: 2019
Outros Autores: Marques, Rui Cunha, Nunes, Alexandre Morais
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.5/28820
Resumo: Health care systems worldwide have faced a problem of resources scarcity that, in turn, should be allocated to the health care providers according to the corresponding population needs. Such an allocation should be as much as effective and efficient as possible to guarantee the sustainability of those systems. One alternative to reach that goal is through (prospective) payments due to the providers for their clinical procedures. The way that such payments are computed is frequently unknown and arguably far from being optimal. For instance, in Portugal, public hospitals are clustered based on criteria related to size, consumed resources, and volume of medical acts, and payments associated with the inpatient services are equal to the smallest unitary cost within each cluster. First, there is no reason to impose a single benchmark for each inefficient hospital. Second, this approach disregards dimen sions like quality (and access) and the environment, which are paramount for fair comparisons and benchmarking exercises. This paper proposes an innovative tool to achieve best-practices tariff. This tool merges both quality and financial sustain ability concepts, attributing a hospital-specific tariff that can be different from hospital to hospital. That payment results from the combination of costs related to a set of potential benchmarks, keeping quality as high as possible and higher than a user-predefined threshold, and being able to generate considerable cost savings. To obtain those coefficients we propose and detail a log-linear piecewise frontier function as well as a dual–primal approach for unique solutions.
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spelling Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutionsPay for performance; Best practice tariff; Hospital; Services; Loglinear piecewise frontier functions; Unique solutions-based log-data envelopment analysis.Health care systems worldwide have faced a problem of resources scarcity that, in turn, should be allocated to the health care providers according to the corresponding population needs. Such an allocation should be as much as effective and efficient as possible to guarantee the sustainability of those systems. One alternative to reach that goal is through (prospective) payments due to the providers for their clinical procedures. The way that such payments are computed is frequently unknown and arguably far from being optimal. For instance, in Portugal, public hospitals are clustered based on criteria related to size, consumed resources, and volume of medical acts, and payments associated with the inpatient services are equal to the smallest unitary cost within each cluster. First, there is no reason to impose a single benchmark for each inefficient hospital. Second, this approach disregards dimen sions like quality (and access) and the environment, which are paramount for fair comparisons and benchmarking exercises. This paper proposes an innovative tool to achieve best-practices tariff. This tool merges both quality and financial sustain ability concepts, attributing a hospital-specific tariff that can be different from hospital to hospital. That payment results from the combination of costs related to a set of potential benchmarks, keeping quality as high as possible and higher than a user-predefined threshold, and being able to generate considerable cost savings. To obtain those coefficients we propose and detail a log-linear piecewise frontier function as well as a dual–primal approach for unique solutions.Repositório da Universidade de LisboaFerreira, DiogoMarques, Rui CunhaNunes, Alexandre Morais2023-10-03T10:46:24Z2019-06-192019-06-19T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.5/28820engFerreira, D.C., Marques, R.C. & Nunes, A.M. Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions. Oper Res Int J 21, 2101–2146 (2021). https://doi.org/10.1007/s12351-019-00502-310.1007/s12351-019-00502-3info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-08T01:31:44Zoai:www.repository.utl.pt:10400.5/28820Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:33:53.546977Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions
title Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions
spellingShingle Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions
Ferreira, Diogo
Pay for performance; Best practice tariff; Hospital; Services; Loglinear piecewise frontier functions; Unique solutions-based log-data envelopment analysis.
title_short Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions
title_full Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions
title_fullStr Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions
title_full_unstemmed Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions
title_sort Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions
author Ferreira, Diogo
author_facet Ferreira, Diogo
Marques, Rui Cunha
Nunes, Alexandre Morais
author_role author
author2 Marques, Rui Cunha
Nunes, Alexandre Morais
author2_role author
author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Ferreira, Diogo
Marques, Rui Cunha
Nunes, Alexandre Morais
dc.subject.por.fl_str_mv Pay for performance; Best practice tariff; Hospital; Services; Loglinear piecewise frontier functions; Unique solutions-based log-data envelopment analysis.
topic Pay for performance; Best practice tariff; Hospital; Services; Loglinear piecewise frontier functions; Unique solutions-based log-data envelopment analysis.
description Health care systems worldwide have faced a problem of resources scarcity that, in turn, should be allocated to the health care providers according to the corresponding population needs. Such an allocation should be as much as effective and efficient as possible to guarantee the sustainability of those systems. One alternative to reach that goal is through (prospective) payments due to the providers for their clinical procedures. The way that such payments are computed is frequently unknown and arguably far from being optimal. For instance, in Portugal, public hospitals are clustered based on criteria related to size, consumed resources, and volume of medical acts, and payments associated with the inpatient services are equal to the smallest unitary cost within each cluster. First, there is no reason to impose a single benchmark for each inefficient hospital. Second, this approach disregards dimen sions like quality (and access) and the environment, which are paramount for fair comparisons and benchmarking exercises. This paper proposes an innovative tool to achieve best-practices tariff. This tool merges both quality and financial sustain ability concepts, attributing a hospital-specific tariff that can be different from hospital to hospital. That payment results from the combination of costs related to a set of potential benchmarks, keeping quality as high as possible and higher than a user-predefined threshold, and being able to generate considerable cost savings. To obtain those coefficients we propose and detail a log-linear piecewise frontier function as well as a dual–primal approach for unique solutions.
publishDate 2019
dc.date.none.fl_str_mv 2019-06-19
2019-06-19T00:00:00Z
2023-10-03T10:46:24Z
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dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.5/28820
url http://hdl.handle.net/10400.5/28820
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Ferreira, D.C., Marques, R.C. & Nunes, A.M. Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions. Oper Res Int J 21, 2101–2146 (2021). https://doi.org/10.1007/s12351-019-00502-3
10.1007/s12351-019-00502-3
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