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Irene Jansen

Patient-based funding breathes new life into hospitals - The Globe and Mail - 0 views

www.theglobeandmail.com/...singlepage

abf bc

shared by Irene Jansen on 23 Jan 12 - No Cached
  • For the first time on a large scale, a province is beginning to reimburse hospitals based on what they actually do, rather than simply providing them with huge dollops of dollars, no matter what.
  • Early results from B.C.’s bold new program are now in, and they are dramatic.
  • The number of procedures is up, waiting lists are down, and hospital emergency departments covered by the program are processing patients as never before.
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  • At Nanaimo Regional General Hospital, for instance, waiting times in emergency have been cut by 50 per cent, fuelled by incentives as high as $600 for each extra patient admitted to an acute-care bed within 10 hours and lesser amounts for other treatment targets.
  • In Prince George, the number of MRIs, rewarded by $275 per procedure beyond a set baseline total, is targeted to go up by a third this year, representing 1,250 additional screenings.
  • The volume of shoulder surgeries, bringing in nearly $3,000 a pop for added procedures, is scheduled to virtually double, from 63 to 123.
  • A government report on the program’s first year of operation estimates that the influx of only $53-million in new money resulted in 67,000 more emergency patients being treated on time at the 14 hospitals involved, and 36,000 additional procedures performed at B.C.’s 23 largest hospitals.
  • Other aspects of the multipronged program include additional sums going to hospitals for taking on difficult cases and financing the introduction of a surgical quality-care system for B.C. hospitals.
  • Les Vertesi, executive director of the B.C. Health Services Purchasing Organization, which is overseeing the radical shift
  • not all of the $250-million earmarked for the program’s first two years is being claimed, because hospitals continue to struggle to improve capacity
  • Overall, about 17 per cent of hospital funding in B.C. is covered in various ways by the new approach.
  • “Throwing money at the problem may work, but an unintended consequence is that you essentially say to people: You don’t have to perform, until we give you money,” Mr. Lewis said.
  • Dr. Butcher of the Northern Health Authority added there is a risk of hospitals becoming too attached to activity-based funding. “It can artificially change your focus to procedures that generate revenue,” he cautioned, rather than doing what the patient really needs.
  • Not performing up to snuff can result in penalties.
  • Overall, however, patient-focused funding mostly rewards rather than punishes.
Irene Jansen

CMAJ: Overhauling health care Down Under - 0 views

www.cmaj.ca/...g-health-care-down-under.xhtml

australia abf hospitals

shared by Irene Jansen on 31 Jan 12 - No Cached
  • Australia
  • most significant overhaul of health care since universality was introduced in 1975
  • The overhaul culminated with the signing of the National Health Reform Agreement in August 2011 between the Commonwealth and eight state or territorial governments (www.coag.gov.au/docs/national_health_reform_agreement.pdf).
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  • activity-based funding of hospitals
  • It also makes the federal government fully responsible for funding and delivering “aged care;”
  • AU$20 billion boost in funding for public hospitals over the next decade
  • But the final agreement fell short on one of the key objectives identified at the start of the exercise — a blending of federal and state government services and funding
  • Australia’s constitution makes the federal government responsible for national health policy, subsidization of public hospitals and funding of medical services and pharmaceuticals under medicare. State and territorial governments are responsible for public health services, such as dental, maternal and child health care; all direct care, including most acute and psychiatric hospital services; as well as a portion of the funding of public hospitals.
  • Costs have been rising at about a 9% rate for the past five years, while the revenues of state and territorial government have grown by about 6%.
  • The agreement essentially trades an increase in federal funding in exchange for reforms to be undertaken by the states.
Irene Jansen

Mark Stabile and Danielle Martin. Hard Choices Ahead on Health Spending | The Mark - 0 views

www.themarknews.com/...oices-ahead-on-health-spending

cdm abf substitution ltc

shared by Irene Jansen on 14 Feb 12 - No Cached
  • creative and evidence-based health-care policy seems more crucial than ever
  • Hospital spending in Ontario is primed for reform.
  • But home care and other community-based services have not emerged to take the place of expensive hospital care. Caring for our elders in the community is only better and cheaper if we do it well.
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  • Pharmaceutical spending has grown rapidly over the past decade, and as a nation we have no coherent plan in place for getting sufficient value for the money we spend. Ontario has made substantial progress in reducing the costs of generic drugs, but national progress in this area will require co-operation among the provinces.
Irene Jansen

The future of health care in Ontario: assembly-line private clinics < Health care, Onta... - 0 views

cupe.ca/...e-health-care-ontario-assembly

hospitals privatization private clinics abf ontario

shared by Irene Jansen on 14 Feb 12 - No Cached
  • over the last decade health care spending has shrunk as a percentage of total program spending, down from 46 per cent to 42 per cent while Ontario’s population increased.&nbsp; In the same period payments to physicians have increased by 88 per cent and drug costs doubled in the last 20 years.
  • during an Ottawa Citizen live broadcast session health minister Deb Matthews “is effusive about the convenience of private dialysis clinics operating in strip malls and assembly-line eye clinic operations,” says Hurley.
  • In the current system, routine patient surgeries effectively subsidize costlier care for complex patients. Private clinics will skim the least complicated and low-cost patients but likely they will receive the same funding as hospitals that will treat the more complex, high-needs patients.
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  • what’s the impact of moving the routine profitable procedures to clinics and leaving the complex surgeries to under-resourced public hospitals?”
  • Although clinics will, for now be prohibited from making profits
  • “There is no doubt doctors stand to benefit from private clinics as the clinics become cash cows.
  • Surgeries and procedures currently provided in Ontario’s public hospitals are highly regulated under an intense provincial oversight regime. Private, doctor-run clinics are self-regulating. Patient complaints are made to the independent college that polices doctors.&nbsp;
Govind Rao

Is activity-based funding for hospitals really a good idea? - Healthy Debate - 0 views

healthydebate.ca/...activity-based-funding

from heather abf hospital funding

shared by Govind Rao on 17 Feb 15 - No Cached
  • by Ritika Goel (Show all posts by Ritika Goel) February 11, 2015
  • What do you first think of when you learn that a loved one has been hospitalized? Most of us worry about our loved one getting the best treatment, having appropriate follow-up care and being sent home when they are well. As the person’s family doctor, I may connect with the team in the hospital to ensure a smooth transition when it is time for discharge. The last thing I would want for my patient or your loved one is for them to be discharged before it is medically appropriate. As a family physician, I work along with patients in the ongoing management of their chronic diseases as well as providing preventative care services. However, if an elderly patient comes into my office with signs of severe pneumonia, the likelihood is that this patient needs to be hospitalized
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