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Incentives for cost-effective behavior: a Dutch experience.

L M Groot

    Health Policy (Amsterdam, Netherlands)
    |March 11, 1987
    PubMed
    Summary
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    Het Ziekenhuiswezen·1962

    The Dutch government

    Area of Science:

    • Health economics
    • Healthcare management
    • Public health policy

    Background:

    • Rising healthcare costs prompted the Dutch government to implement hospital budgeting in 1983.
    • The system fixed budgets based on assessed real costs from 1983.
    • A distinction was made between global external budgets and specific internal budgets.

    Purpose of the Study:

    • To analyze the influence of the hospital budgeting process on physicians' situations and attitudes.
    • To examine the impact of budgeting on hospital organization and administration.
    • To assess the effects of budgeting on patient care quality.

    Main Methods:

    • Analysis of the Dutch hospital budgeting system introduced in 1983.
    • Examination of the administrative and organizational changes resulting from budgeting.

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  • Evaluation of the impact on physicians' roles and responsibilities.
  • Assessment of the relationship between resource allocation, quality, and efficiency.

    • Main Results:

    • Budgeting necessitates improved data collection and physician involvement in administration.
    • Physicians become more integrated into the hospital organization, with budget responsibility extended to all specialists.
    • Linking quality with efficiency in resource allocation is crucial under budget constraints.
    • Coordination between hospital budgets and specialist fees requires enhancement.

    Conclusions:

    • The Dutch hospital budgeting system significantly impacts administrative processes, physician roles, and organizational integration.
    • Effective resource allocation under budgeting requires a focus on both quality and efficiency.
    • Future healthcare reforms may involve incorporating capitation and salary elements into physician payment systems.