title: Policy options to contain healthcare costs: a review and classification.
abstract: 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.
authors.affiliation: Celsus, Academy for sustainable Healthcare, IQ Healthcare, Radboud University and Medical Center, P.O. Box 9101, 114 6500 HB Nijmegen, The Netherlands.
authors.forename: Niek
authors.initials: N
authors.lastname: Stadhouders
authors.affiliation: Talma Institute, Health Sciences, VU Amsterdam, De Boelelaan 1081, 1081 HV Amsterdam, The Netherlands.
authors.forename: Xander
authors.initials: X
authors.lastname: Koolman
authors.affiliation: Celsus, Academy for sustainable Healthcare, IQ Healthcare, Radboud University and Medical Center, P.O. Box 9101, 114 6500 HB Nijmegen, The Netherlands.
authors.forename: Marit
authors.initials: M
authors.lastname: Tanke
authors.affiliation: School for Public Health and Primary Care (Caphri) of the Faculty of Health, Medicine and Life Sciences, Department of Health Services Research, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: Maarse
authors.affiliation: Celsus, Academy for sustainable Healthcare, IQ Healthcare, Radboud University and Medical Center, P.O. Box 9101, 114 6500 HB Nijmegen, The Netherlands. Electronic address: pp.jeurissen@minvws.nl.
authors.forename: Patrick
authors.initials: P
authors.lastname: Jeurissen
mesh_terms: D002017:Budgets / Q000379:methods; D003363:Cost Control / Q000379:methods*; D017048:Health Care Costs; D005102:Health Expenditures; D006291:Health Policy / Q000191:economics*; D006801:Humans
keywords: Conceptual framework; Cost containment; Health system convergence; Literature review; Policy evaluation