Pathways to DRG-based hospital payment systems in Japan, Korea, and Thailand.

Countries in Asia are working towards achieving universal health coverage while ensuring improved quality of care. One element is controlling hospital costs through payment reforms. In this paper we review experiences in using Diagnosis Related Groups (DRG) based hospital payments in three Asian countries and ask if there is an "Asian way to DRGs".

Trends in Health Financing: The Move from Passive to Strategic Purchasing in Middle- and Low-Income Countries.

Strategic purchasing is not new, rather it first started in Western Europe in the 1960s, as an approach to improving health system responsiveness, as well as for them more effective matching of supply and demand. In the 1960s some Western European facilities were affected by empty beds, others by overcrowding. Doctors were not showing up for work, due to the establishment of dual practice.

Emerging challenges in implementing universal health coverage in Asia.

As countries in Asia converge on the goal of universal health coverage (UHC), some common challenges are emerging. One is how to ensure coverage of the informal sector so as to make UHC truly universal; a second is how to design a benefit package that is responsive and appropriate to current health challenges, yet fiscally sustainable; and a third is how to ensure "supply-side readiness", i.e.

The role of purchasing in hospital performance.

In this article the authors review the core messages on getting value for public money spent on healthcare presented in a recent World Bank publication, Spending Wisely: Buying Health Services for the Poor, edited by the same authors. The authors discuss how interest of the poor would often be better served through a fundamental shift in the way public money is spent on the health services--notably by moving away from passive budgeting within the public sector towards strategic purchasing or contracting of services from non-governmental providers. The shift from hiring staff in the public sector and producing services "in house" to strategic purchasing of non governmental providers--outsourcing--has been at the centre of a lively debate on collective financing of healthcare during recent years.

Supplemental health insurance: did Croatia miss an opportunity?

Croatia continues to face a health-funding crisis. A recent supplemental health insurance law increases revenues through first increasing co-payments, then raising the payroll tax to cover those co-payments. This public finance "slight-of-hand" will not solve the system's structural issues and may worsen system performance both in terms of efficiency and equity.