How to reform western care payment systems according to physicians, policy makers, healthcare executives and researchers: a discrete choice experiment.

Background: Many developed countries are reforming healthcare payment systems in order to limit costs and improve clinical outcomes. Knowledge on how different groups of professional stakeholders trade off the merits and downsides of healthcare payment systems is limited.

Methods: Using a discrete choice experiment we asked a sample of physicians, policy makers, healthcare executives and researchers from Canada, Europe, Oceania, and the United States to choose between profiles of hypothetical outcomes on eleven healthcare performance objectives which may arise from a healthcare payment system reform.

Evidence-based health care policy in reimbursement decisions: lessons from a series of six equivocal case-studies.

Context: Health care technological evolution through new drugs, implants and other interventions is a key driver of healthcare spending. Policy makers are currently challenged to strengthen the evidence for and cost-effectiveness of reimbursement decisions, while not reducing the capacity for real innovations. This article examines six cases of reimbursement decision making at the national health insurance authority in Belgium, with outcomes that were contested from an evidence-based perspective in scientific or public media.

Healthcare payment reforms across western countries on three continents: lessons from stakeholder preferences when asked to rate the supportiveness for fulfilling patients' needs.

Unlabelled: To test the hypothesis that care typology-being complex and highly unpredictable versus being clear-cut and highly predictable-guides healthcare payment preferences of physicians, policy makers, healthcare executives, and researchers. We collected survey data from 942 stakeholders across Canada, Europe, Oceania, and the United States. A total of 48 international societies invited their members to participate in our study.

Care pathways lead to better teamwork: results of a systematic review.

Care pathways are often said to promote interprofessional teamwork. As no systematic review on pathway effectiveness has ever focused on how care pathways promote teamwork, the objective of this review was to study this relationship. We performed an extensive search of electronic databases and identified 26 relevant studies.

Pay-for-performance step-by-step: introduction to the MIMIQ model.

Objectives: Pay-for-performance is increasingly used as a system intervention to support quality improvement. Programs are however developed, implemented and evaluated in a heterogeneous way. This is partly due to the broad and disparate theoretical and empirical foundation of P4P practice, which is rapidly evolving.

Systematic review: Effects, design choices, and context of pay-for-performance in health care.

Background: Pay-for-performance (P4P) is one of the primary tools used to support healthcare delivery reform. Substantial heterogeneity exists in the development and implementation of P4P in health care and its effects. This paper summarizes evidence, obtained from studies published between January 1990 and July 2009, concerning P4P effects, as well as evidence on the impact of design choices and contextual mediators on these effects.

Key interventions and outcomes in joint arthroplasty clinical pathways: a systematic review.

Unlabelled: SUMMARY RATIONALE, AIMS AND OBJECTIVES: Clinical pathways are globally used to improve quality and efficiency of care. Total joint arthroplasty patients are one of the primary target groups for clinical pathway development. Despite the worldwide use of clinical pathways, it is unclear which key interventions multidisciplinary teams select as pathway components, which outcomes they measures and what the effect of this complex intervention is.

Using hospital administrative data to evaluate the knowledge-to-action gap in pressure ulcer preventive care.

Rationale, Aims And Objectives: Issues of overuse, underuse and misuse are paramount and lead to avoidable morbidity and mortality. Although evidence-based practice is advocated, the widespread implementation of this kind of practice remains a challenge. This is also the case for evidence-based practice related to the prevention of pressure ulcers, which varies widely in process and outcome in Belgian hospital care.

Development and validation of nursing resource weights for the Belgian Nursing Minimum Dataset in general hospitals: a Delphi questionnaire survey approach.

Background: Internationally, nursing is not well represented in hospital financing systems. In Belgium a nursing weight system exists to adjust budget allocation for differences in nurse staffing requirements, but there is a need for revision. Arguments include the availability of a nursing minimum dataset and the adverse consequences of the current historically based nursing weight system.

Adjusting for nursing care case mix in hospital reimbursement: a review of international practice.

The purpose of this study was to examine and review the different ways in which nursing care can be accounted for in a general hospital reimbursement system. The study is based on a literature review and a survey of international experts. It provides a typology of nursing care adjustment methods, using current and past practices of 14 Western countries as key examples.

Revision of the Belgian Nursing Minimum Dataset: From data to information.

The Ministry of Public Health commissioned a research project to the Catholic University of Leuven and the University Hospital of Liège to revise the Belgian Nursing Minimum Dataset (B-NMDS). The study started in 2000 and will end with the implementation of the revised B-NMDS in January 2007. The study entailed four major phases.