Financial incentives and patient selection: Hospital physicians’ views on cream skimming and economic management focus in Norway

Kjøstolfsen, Gjertrud Hole; Baheerathan, Janusha; Martinussen, Pål E.; Magnussen, Jon

doi:10.1016/j.healthpol.2020.10.011

Cited by 4 publications

(3 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Kurunmäki et al., 2003). Budgeting with surpluses aligns with this finding, and also supports the perception among physicians in Norway that the hospital reform led to both an increased focus on profitable patients and a generally increased focus on economic variables (Kjøstolfsen et al., 2021). Thus, there is a question of whether the perceived impression of focus on profit and economy overstates its real importance in the running of health trusts.…”

Section: Discussionsupporting

confidence: 80%

Budgeting in public hospital trusts: Surplus, optimism, and accuracy

2023

Self Cite

View full text Add to dashboard Cite

Hospitals in Norway are organized as trusts, required to follow the same accounting principles as the private sector, and responsible for funding their own investments. Thus, being able to run with a surplus has been an important part of their management. We analyze hospital budgeting for the whole sector over a 9-year period, looking at the size of the budget surplus, degree of optimism bias, and degree of budget accuracy when comparing to the actual financial results. Our findings indicate that on average, health trusts budget with a relatively small surplus. We find indications for optimism bias, but also examples of pessimism bias. Large health trusts seem to have a higher degree of accuracy of the budgeted results. Trusts that fail to meet budgeted results have a lower budgeted surplus the following period. Capital intensity, an indication of need for new investments, is not associated with budget surplus, degree of optimism, or budget accuracy.

show abstract

Section: Discussionsupporting

confidence: 80%

Budgeting in public hospital trusts: Surplus, optimism, and accuracy

2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Cream-skimming is a practice that involves selecting patients based on characteristics other than their need for care and is well-documented in the literature (Newhouse, 1984; Pauly, 1984; Matsaganis and Glennerster, 1994; Ellis, 1998; Barros, 2003; Freisner and Rosenman, 2009; Berta et al ., 2010; Levaggi and Montefiori, 2011; Cheng et al ., 2015; Yang et al ., 2020; Chen and Lang, 2021; Kjøstolfsen et al ., 2021). Cream-skimming involves selecting patients with lower-than-average costs in a prospective payment system such as a Diagnosis-Related Group (DRG), to maximise financial gains (Yang et al ., 2020).…”

Section: Resultsmentioning

confidence: 99%

Pricing of hospital services: evidence from a thematic review

Sirur,

Pillai K

2024

HEPL

View full text Add to dashboard Cite

The management implications of pricing healthcare services, especially hospitals, have received insufficient scholarly attention. Additionally, disciplinary overlaps have led to scattered academic efforts in this domain. This study performs a thematic synthesis of the literature and applies retrospective analysis to hospital service pricing articles to address these issues. The study's inputs were sourced from well-known online repositories, using a structured search string and PRISMA flow chart to select the pertinent documents. Our thematic analysis of pricing literature encompasses: (a) comprehension of hospital service pricing nature; (b) pricing objectives, strategies and practices differentiation; (c) presentation of factors impacting hospital service pricing. We observe that hospital pricing is an intricate and unclear matter. The terms ‘pricing strategies’ and ‘pricing practices’ are often used interchangeably in academic literature. Hospital service pricing is influenced by costs, demand and supply factors, market structure, pricing regulation and third-party reimbursements. The study's findings provide policy implications for service pricing in hospitals, in addition to suggesting avenues for future research on hospital pricing.

show abstract

“…I en analyse av sykehuslegers syn på finansieringssystemet viser Kjøstolfsen et al (2021) at naer halvparten av sykehuslegene mener at ISF oppmuntrer til å selektere lønnsomme pasienter. Andelen som mener at slik seleksjon skjer i praksis, er lavere (tre av ti), men andelen som mener det er for sterkt søkelys på økonomi i helseforetakene, er til gjengjeld stor (åtte av ti).…”

Section: Avvikling Av Innsatsstyrt Finansieringunclassified

Nye finansieringsmodeller for spesialisthelsetjenesten – forslagene i NOU 2023: 8

Magnussen

2023

Magma

View full text Add to dashboard Cite

Artikkelen beskriver og diskuterer tre forslag til endring av dagens modell for finansiering av helseforetakene. Det første forslaget innebærer en avvikling av ordningen med innsatsstyrt finansiering (ISF) til fordel for en modell som kombinerer rammebudsjett og toppfinansiering. Det andre forslaget innebærer innføring av øremerkede samhandlingsbudsjetter som disponeres i fellesskap av kommuner og helseforetak. Det siste forslaget innebærer en omlegging av finansiering av sykehusbygg som vil gi lettere tilgang på likviditet og øremerkede tilskudd til dekning av deler av helseforetakenes kapitalkostnader. Disse forslagene diskuteres i lys av tilgjengelig empiri. Det argumenteres for at forslagene vil vri insentivene i retning av større vekt på kvalitet og tilgjengelighet og samtidig mindre vekt på effektivitet og behandlingsvolum.

show abstract

Financial incentives and patient selection: Hospital physicians’ views on cream skimming and economic management focus in Norway

Cited by 4 publications

References 20 publications

Budgeting in public hospital trusts: Surplus, optimism, and accuracy

Budgeting in public hospital trusts: Surplus, optimism, and accuracy

Pricing of hospital services: evidence from a thematic review

Nye finansieringsmodeller for spesialisthelsetjenesten – forslagene i NOU 2023: 8

Contact Info

Product

Resources

About