title: Will paying the piper change the tune?
abstract: Most provincial governments are considering or introducing changes to hospital funding. Ten years of rapidly increasing expenditures have left them still facing complaints of waiting lists and waiting times. Activity-based funding (ABF) would supplement traditional negotiated global budgets, reimbursing a predetermined amount for each case treated - essentially, a "fee schedule" - thus providing incentives and resources to increase throughput of certain "hot button" procedures and services and to improve efficiency.Maybe. ABF-type systems in other countries date back over 20 years; the results are very mixed. What is clear is that information and reporting requirements are substantial. A host of perverse incentives lurk in ABF. Most Canadian hospitals and provincial governments do not now have the necessary data systems, so are wise to proceed cautiously.
authors.affiliation: Assistant Professor, Centre for Health Services and Policy Research, School of Population and Public Health, University of British Columbia, Vancouver, BC.
authors.forename: Jason M
authors.initials: JM
authors.lastname: Sutherland
authors.forename: Morris L
authors.initials: ML
authors.lastname: Barer
authors.forename: Robert G
authors.initials: RG
authors.lastname: Evans
authors.forename: R Trafford
authors.initials: RT
authors.lastname: Crump