Download or read book Implementation of Casemix System as Prospective Provider Payment Method in Social Health Insurance a Case Study of Acheh Provincial Health Insurance written by Prof Dr Syed Mohamed Aljunid and published by Partridge Publishing Singapore. This book was released on 2022-11-20 with total page 147 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Government of Aceh Province in Indonesia has established the Social Health Insurance (SHI) called Jaminan Kesehatan Aceh (JKA) in 2006 that provide health coverage to all 4.6 million population of the province. Fee-for-service was initially used as the provider payment method in the programme until 2013. In 2014, in line with the National Health Insurance of Indonesia (Jaminan Kesehatan Nasional JKN), INA-CBG (Indonesia Case-Based Group) casemix system was adopted by JKA to replace the Fee-for-Service method. This book presents outcome of the evaluation done using a combination of qualitative and quantitative methods on the implementation of JKA programme. The quantitative study was conducted to assess income of three selected hospitals (Type B, C and D) reimbursed using INA-CBG groups covering more than 17,000 cases. Quantitative data analysis revealed that overall, the hospitals received 32.4% higher income when reimbursed with casemix system (INA-CBG) as compared to fee-for-service. Type D hospital is the biggest gainer with 81.0% increase in income. In conclusion, the use of Casemix (INA-CBG) as a prospective payment method has benefitted the hospitals a lot. It is hope that additional resources gained through this programme will allow the hospitals to provide optimum care to the population.
Download or read book Using Casemix System for Hospital Reimbursement in Social Health Insurance Programme written by Syed Aljunid and published by . This book was released on 2020-11-26 with total page 216 pages. Available in PDF, EPUB and Kindle. Book excerpt: Social Health Insurance (SHI) is one of the vehicles in achieving Universal Health Coverage. However, in many low- and middle-income countries, implementation of SHI failed to provide efficient and effective coverage due to poor provider payment method. Indonesia has introduced social health insurance in 2014. With the population of more than 270 million, Indonesia is the biggest country in the world that implemented SHI with casemix system (INA-CBG) as the prospective provider payment method. In this book, we presented an outcome of a study implemented in the largest hospital in Jakarta, Indonesia that compared the impact of using casemix system as provider payment method with fee-for-service. A total 32,227 outpatients and 8,270 inpatients medical records were reviewed and included in the study. In addition, a survey was also conducted among billing administrators to assess the cost of the billing process and their perceptions on the two reimbursement methods. The total hospital charges, length of stay of inpatients, rate of unnecessary admissions and cost of billing process were among the indicators of efficiency compared in the study between the two provider payment methods. The book provides comprehensive evidence to confirm the advantages of casemix system as an efficient provider payment method in SHI programme.
Download or read book Designing and Implementing Health Care Provider Payment Systems written by Jack Langenbrunner and published by World Bank Publications. This book was released on 2009-01-01 with total page 348 pages. Available in PDF, EPUB and Kindle. Book excerpt: Strategic purchasing of health services involves a continuous search for the best ways to maximize health system performance by deciding which interventions should be purchased, from whom these should be purchased, and how to pay for them. In such an arrangement, the passive cashier is replaced by an intelligent purchaser that can focus scarce resources on existing and emerging priorities rather than continuing entrenched historical spending patterns.Having experimented with different ways of paying providers of health care services, countries increasingly want to know not only what to do when paying providers, but also how to do it, particularly how to design, manage, and implement the transition from current to reformed systems. 'Designing and Implementing Health Care Provider Payment Systems: How-To Manuals' addresses this need.The book has chapters on three of the most effective provider payment systems: primary care per capita (capitation) payment, case-based hospital payment, and hospital global budgets. It also includes a primer on a second policy lever used by purchasers, namely, contracting. This primer can be especially useful with one provider payment method: hospital global budgets. The volume's final chapter provides an outline for designing, launching, and running a health management information system, as well as the necessary infrastructure for strategic purchasing.
Download or read book Case based Payment Systems for Hospital Funding in Asia An Investigation of Current Status and Future Directions written by OECD and published by OECD Publishing. This book was released on 2015-11-02 with total page 138 pages. Available in PDF, EPUB and Kindle. Book excerpt: The report focuses on a review of the implementation experience of case-based and DRG mechanisms in the Asia and Pacific region, drawing particularly on research in Australia, Japan, New Zealand, the Republic of Korea, Singapore and Thailand.
Download or read book Report to Congress written by United States. Health Care Financing Administration and published by . This book was released on 1989 with total page 72 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Options for Health Insurance written by United States. Congress. House. Committee on Ways and Means. Subcommittee on Health and published by . This book was released on 1992 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Initiation of Prospective Payment System Into Home Care written by Debora R. Fisher and published by . This book was released on 1997 with total page 330 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Role of Social Health Insurance in Health Financing System written by Xiao Xian Huang and published by . This book was released on 2011 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: It has been widely recognized that poor health is an important cause of poverty, especiallyamong the low- and middle- income countries. One of the reasons is the absence of publicfinancial protection against the medical consumption risk in these countries. This Phd dissertationis dedicated to discern the role that health insurance could play in the organization of healthfinancial protection system. The dissertation is composed of two parts. The first part discusses theproblems linking to the financing to medical consumption from a global point of view. Chapter 1brings theoretical discussions on three topics: 1) the specialties of medical consumption risks andthe difficulties in using private health insurance to manage medical consumption risks. 2) Therole of government and market in the distribution of health resources. 3) The options for theorganization of health financing system. Chapter 2 conducts a statistical comparison on theperformance of health financing systems in the countries of different social-Economic background.The discussion is carried out around three aspects of health financing: the availability of resources,the organization of health financing, and the coverage of financial protection. The second part ofthe dissertation studies the evolution of heath financing system in a specific country: China. Threechapters are assigned to this part. Chapter 3 introduces the history of Chinese health financingsystem since 1950s. It helps us to understand the challenges in health financing brought byeconomic reform. Chapter 4 carries out an empirical study on the distribution of health financingburden in China in the 1990s. It illustrates the direct results of the decline of public financing andincrease of direct payment. Chapter 5 presents health insurance reform that launched by thegovernment since the end of 1990s. An impact analysis is conducted on an original dataset of 24township hospitals in Weifang prefecture in the north of the China. The objective is to estimatethe impact of the implementation of New Rural Medical Cooperation System (NRMCS) on theactivities and financial structure of township hospitals. At last, we conclude that social healthinsurance (SHI) permits a sharing of health financial responsibilities between the service provider,the patient-Consumer, and the service purchaser. It can not only involve both public and privateagents into the collection of funds for health financing system, but also make each party moreaccountable due to the risks they bear from the result of medical consumption. Meanwhile it isnecessary to note that SHI is just one option among others to organize health financing system.The implementation of SHI requires a certain level of social-Economic development. SHI does notsystematically bring better performance on health financing if it is not accompanied by thereforms on provider payment or on service delivery system. Government commitment andinstitutional capacity are also key factors for the good function of the system.
Download or read book Magician of 1919 written by Jeremy Lim and published by . This book was released on 2014-01-01 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: Interest in Singapore's healthcare system has soared because of the country's impressive health statistics. However, how Singapore achieves these impressive results is made even more remarkable when we consider that the country spends only 4% of its GDP on healthcare, which is comparably half of what the UK spends. This book explains how Singapore manages to achieve such an impressive degree of efficiency in the delivery of quality healthcare services.
Download or read book Dorland s Dictionary of Medical Acronyms and Abbreviations written by Dorland and published by Elsevier Health Sciences. This book was released on 2015-07-24 with total page 481 pages. Available in PDF, EPUB and Kindle. Book excerpt: Medical acronyms and abbreviations offer convenience, but those countless shortcuts can often be confusing. Now a part of the popular Dorland's suite of products, this reference features thousands of terms from across various medical specialties. Its alphabetical arrangement makes for quick reference, and expanded coverage of symbols ensures they are easier to find. Effective communication plays an important role in all medical settings, so turn to this trusted volume for nearly any medical abbreviation you might encounter. - Symbols section makes it easier to locate unusual or seldom-used symbols. - Convenient alphabetical format allows you to find the entry you need more intuitively. - More than 90,000 entries and definitions. - Many new and updated entries including terminology in expanding specialties, such as Nursing; Physical, Occupational, and Speech Therapies; Transcription and Coding; Computer and Technical Fields. - New section on abbreviations to avoid, including Joint Commission abbreviations that are not to be used. - Incorporates updates suggested by the Institute for Safe Medication Practices (ISMP).
Download or read book Diagnosis Related Groups DRGs and the Medicare Program written by and published by . This book was released on 1983 with total page 100 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Health Financing in Indonesia written by and published by World Bank Publications. This book was released on 2009-01-01 with total page 202 pages. Available in PDF, EPUB and Kindle. Book excerpt: In 2004 the Indonesian government made a commitment to provide its entire population with health insurance coverage through a mandatory public health insurance scheme. It has moved boldly already provides coverage to an estimated 76.4 million poor and near poor, funded through the public budget. Nevertheless, over half the population still lacks health insurance coverage, and the full fiscal impacts of the government's program for the poor have not been fully assessed or felt. In addition, significant deficiencies in the efficiency and equity of the current health system, unless addressed will exacerbate cost pressures and could preclude the effective implementation of universal coverage (Ue and the desired result of improvements in population health outcomes and financial protection. For Indonesia to achieve UC, systems' performance must be improved and key policy choices with respect to the configuration of the health financing system must be made. Indonesia's health system performs well with respect to some health outcomes and financial protection, but there is potential for significant improvement. High-level political decisions are necessary on key elements of the health financing reform package. The key transitional questions to get there include: [ the benefits that can be afforded and their impacts on health outcomes and financial protection; [ how the more than 50 percent of those currently without coverage will be insured; [ how to pay medical care providers to assure access, efficiency, and quality; [ developing a streamlined and efficient administrative structure; [ how to address the current supply constraints to assure availability of promised services; [ how to raise revenues to finance the system, including the program for the poor as well as currently uninsured groups that may require government subsidization such as the more than 60 million informal sector workers, the 85 percent of workers in firms of less than five employees, and the 70 percent of the population living in rural areas.
Download or read book Injury Research written by Guohua Li and published by Springer Science & Business Media. This book was released on 2012-01-06 with total page 672 pages. Available in PDF, EPUB and Kindle. Book excerpt: Injury is recognized as a major public health issue worldwide. In most countries, injury is the leading cause of death and disability for children and young adults age 1 to 39 years. Each year in the United States, injury claims about 170,000 lives and results in over 30 million emergency room visits and 2.5 million hospitalizations. Injury is medically defined as organ/tissue damages inflicted upon oneself or by an external agent either accidentally or deliberately. Injury encompasses the undesirable consequences of a wide array of events, such as motor vehicle crashes, poisoning, burns, falls, and drowning, medical error, adverse effects of drugs, suicide and homicide. The past two decades have witnessed a remarkable growth in injury research, both in scope and in depth. To address the tremendous health burden of injury morbidity and mortality at the global level, the World Health Organization in 2000 created the Department of Injury and Violence Prevention, which has produced several influential reports on violence, traffic injury, and childhood injury. The biennial World Conference on Injury Control and Safety Promotion attracts a large international audience and has been successfully convened nine times in different countries. In the United States, the National Center for Injury Prevention and Control became an independent program of the federal Centers for Disease Prevention and Control in 1997. Since then, each state health department has created an office in charge of injury prevention activities and over a dozen universities have established injury control research centers. This volume will fill an important gap in the scientific literature by providing a comprehensive and up-to-date reference resource to researchers, practitioners, and students working on different aspects of the injury problem and in different practice settings and academic fields.
Download or read book Are You Being Served written by Samia Amin and published by World Bank Publications. This book was released on 2007-12-28 with total page 454 pages. Available in PDF, EPUB and Kindle. Book excerpt: This publication presents tools and techniques for measuring service delivery in health and education and people's experiences from the field in deploying these methods. It begins by providing an introduction to the different methodological tools available for evaluating the performance of the health and education sectors. Country specific experiences are then explored to highlight lessons on the challenges, advantages and disadvantages of using different techniques to measure quality in a variety of different contexts and of using the resulting data to affect change. This book is a valuable resource for those who seek to enhance capacity for the effective measurement of service delivery in order to improve accountability and governance and enhance the quality of service delivery in developing countries.
Download or read book Dictionary of Medical Acronyms and Abbreviations written by Stanley Jablonski and published by Hanley & Belfus. This book was released on 2004-09 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: This dictionary lists acronyms and abbreviations occurring with a reasonable frequency in the literature of medicine and the health care professions. Abbreviations and acronyms are given in capital letters, with no punctuation, and with concise definitions. The beginning sections also include symbols, genetic symbols, and the Greek alphabet and symbols.
Download or read book Information on Health Care Services written by and published by . This book was released on 1995 with total page 62 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book EBOOK Diagnosis Related Groups in Europe Moving towards transparency efficiency and quality in hospitals written by Reinhard Busse and published by McGraw-Hill Education (UK). This book was released on 2011-11-16 with total page 490 pages. Available in PDF, EPUB and Kindle. Book excerpt: Diagnosis Related Group (DRG) systems were introduced in Europe to increase the transparency of services provided by hospitals and to incentivise greater efficiency in the use of resources invested in acute hospitals. In many countries, these systems were also designed to contribute to improving – or at least protecting – the quality of care. After more than a decade of experience with using DRGs in Europe, this book considers whether the extensive use of DRGs has contributed towards achieving these objectives. Written by authors with extensive experience of these systems, this book is a product of the EuroDRG project and constitutes an important resource for health policy-makers and researchers from Europe and beyond. The book is intended to contribute to the emergence of a ‘common language’ that will facilitate communication between researchers and policy-makers interested in improving the functioning and resourcing of the acute hospital sector. The book includes: A clearly structured introduction to the main ‘building blocks’ of DRG systems An overview of key issues related to DRGs including their impact on efficiency, quality, unintended effects and technological innovation in health care 12 country chapters - Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Portugal, Spain and Sweden Clearly structured and detailed information about the most important DRG system characteristics in each of these countries Useful insights for countries and regions in Europe and beyond interested in introducing, extending and/ or optimising DRG systems within the hospital sector
