Payment by results: a guide for emergency physicians

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5 Payment by Results

There is a wide range of mechanisms that can be used to pay for hospital care. In the United Kingdom, hospitals have historically been paid a fixed budget based on the previous years’ costs and activity, sometimes adjusted for planned changes in services (Raftery et al 1996). During the first internal market in the 1990s, purchasers mostly used block contracts – a negotiated amount that was pai...

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Payment by results, a system for paying healthcare trusts, is intended as a fair and consistent basis for hospital funding. It relies on a national tariff structured around a case-mix measure known as healthcare resource groups. It is often argued that if payment by results works as planned, the National Health Service will become more efficient and productive. However, the use of a case-mix me...

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The commentaries on our original paper are interesting and informative. That of Malcomson illustrates nicely the costing and case-mix issues that are critical to the successful design of activity-based funding arrangements. The second commentary describes some more general issues and the scope for reformers to learn from international experience. The policy documents put out by the English Depa...

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ژورنال

عنوان ژورنال: Emergency Medicine Journal

سال: 2007

ISSN: 1472-0205,1472-0213

DOI: 10.1136/emj.2007.050906