Health Policy

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Niek Stadhouders ; Niek Stadhouders ; Xander Koolman ; Marit Tanke ; Hans Maarse ; Patrick Jeurissen

亮点

  • We identify 2250 cost containment policies from the literature.
  • We categorize 41 policy groups into four primary cost containment targets.
  • Prices and budgets are targeted less often than volumes and market.
  • Differences in policy suggestions between countries contradict health system characteristics.
  • Implementation could cause health system convergence, except for the US.

摘要

Containing health care costs has been a challenge for most OECD member states. We classify 2250 cost containment policies in forty-one groups of policy options. This conceptual framework might act as a toolkit for policymakers that seek to develop strategies for cost control; and for researchers that seek to evaluate them. We found that certain important cost drivers such as wages and capital are being sparsely covered. We distinguish four primary targets to contain costs: volume controls, price controls, budgeting and market oriented policies. Price controls and budgeting, both seen as relatively effective, appear substantially less often in literature than volume controls and market oriented policies. The relative use of each option hardly changed over time, although the health system type did matter. Market oriented policies were more likely to be suggested for countries with public provision of health care, as well as for the US system. In contrast, budgeting policy proposals were more likely to be suggested for countries with market provision systems, such as Canada, Germany and France. Implementation of cost containment policies could lead to convergence of health care systems, except for the US system, if policies are implemented based on the literature.

Cost containment; Conceptual framework; Literature review; Policy evaluation; Health system convergence

10.5

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