IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v323y2023ics0277953623001697.html
   My bibliography  Save this article

Does prospective payment influence quality of care? A systematic review of the literature

Author

Listed:
  • Pott, Clara
  • Stargardt, Tom
  • Frey, Simon

Abstract

In the light of rising health expenditures, the cost-efficient provision of high-quality inpatient care is on the agenda of policy-makers worldwide. In the last decades, prospective payment systems (PPS) for inpatient care were used as an instrument to contain costs and increase transparency of provided services. It is well documented in the literature that prospective payment has an impact on structure and processes of inpatient care. However, less is known about its effect on key outcome indicators of quality of care.

Suggested Citation

  • Pott, Clara & Stargardt, Tom & Frey, Simon, 2023. "Does prospective payment influence quality of care? A systematic review of the literature," Social Science & Medicine, Elsevier, vol. 323(C).
    • Handle: RePEc:eee:socmed:v:323:y:2023:i:c:s0277953623001697
    DOI: 10.1016/j.socscimed.2023.115812
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277953623001697
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.socscimed.2023.115812?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Cheng, Shou-Hsia & Chen, Chi-Chen & Tsai, Shu-Ling, 2012. "The impacts of DRG-based payments on health care provider behaviors under a universal coverage system: A population-based study," Health Policy, Elsevier, vol. 107(2), pages 202-208.
    2. Sood, Neeraj & Huckfeldt, Peter J. & Grabowski, David C. & Newhouse, Joseph P. & Escarce, José J., 2013. "The effect of prospective payment on admission and treatment policy: Evidence from inpatient rehabilitation facilities," Journal of Health Economics, Elsevier, vol. 32(5), pages 965-979.
    3. Karen S Palmer & Thomas Agoritsas & Danielle Martin & Taryn Scott & Sohail M Mulla & Ashley P Miller & Arnav Agarwal & Andrew Bresnahan & Afeez Abiola Hazzan & Rebecca A Jeffery & Arnaud Merglen & Ahm, 2014. "Activity-Based Funding of Hospitals and Its Impact on Mortality, Readmission, Discharge Destination, Severity of Illness, and Volume of Care: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-1, October.
    4. Lorenzo Cappellari & Anna De Paoli & Gilberto Turati, 2016. "Do market incentives for hospitals affect health and service utilization?: evidence from prospective pay system–diagnosis-related groups tariffs in Italian regions," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 179(4), pages 885-905, October.
    5. David Dranove, 1987. "Rate-Setting by Diagnosis Related Groups and Hospital Specialization," RAND Journal of Economics, The RAND Corporation, vol. 18(3), pages 417-427, Autumn.
    6. Moreno-Serra, Rodrigo & Wagstaff, Adam, 2010. "System-wide impacts of hospital payment reforms: Evidence from Central and Eastern Europe and Central Asia," Journal of Health Economics, Elsevier, vol. 29(4), pages 585-602, July.
    7. Leemore S. Dafny, 2005. "How Do Hospitals Respond to Price Changes?," American Economic Review, American Economic Association, vol. 95(5), pages 1525-1547, December.
    8. Jegers, Marc & Kesteloot, Katrien & De Graeve, Diana & Gilles, Willem, 2002. "A typology for provider payment systems in health care," Health Policy, Elsevier, vol. 60(3), pages 255-273, June.
    9. Eberhard Feess & Helge Müller & Ansgar Wohlschlegel, 2019. "Reimbursement schemes for hospitals: the impact of case and firm characteristics," Applied Economics, Taylor & Francis Journals, vol. 51(15), pages 1647-1665, March.
    10. Shen, Yu-Chu, 2003. "The effect of financial pressure on the quality of care in hospitals," Journal of Health Economics, Elsevier, vol. 22(2), pages 243-269, March.
    11. Jennifer Mellor & Michael Daly & Molly Smith, 2017. "Does It Pay to Penalize Hospitals for Excess Readmissions? Intended and Unintended Consequences of Medicare's Hospital Readmissions Reductions Program," Health Economics, John Wiley & Sons, Ltd., vol. 26(8), pages 1037-1051, August.
    12. Grégoire de Lagasnerie & Valérie Paris & Michael Mueller & Ankit Kumar, 2015. "Tapering payments in hospitals: Experiences in OECD countries," OECD Health Working Papers 78, OECD Publishing.
    13. Galina Besstremyannaya, 2016. "Differential Effects of Declining Rates in a Per Diem Payment System," Health Economics, John Wiley & Sons, Ltd., vol. 25(12), pages 1599-1618, December.
    14. Cutler, David M, 1995. "The Incidence of Adverse Medical Outcomes under Prospective Payment," Econometrica, Econometric Society, vol. 63(1), pages 29-50, January.
    15. Kim, Seung Ju & Han, Kyu-Tae & Kim, Sun Jung & Park, Eun-Cheol & Park, Hye Ki, 2016. "Impact of a diagnosis-related group payment system on cesarean section in Korea," Health Policy, Elsevier, vol. 120(6), pages 596-603.
    16. Hodgkin, Dominic & McGuire, Thomas G., 1994. "Payment levels and hospital response to prospective payment," Journal of Health Economics, Elsevier, vol. 13(1), pages 1-29, March.
    17. Campbell, S. M. & Roland, M. O. & Buetow, S. A., 2000. "Defining quality of care," Social Science & Medicine, Elsevier, vol. 51(11), pages 1611-1625, December.
    18. David Moher & Alessandro Liberati & Jennifer Tetzlaff & Douglas G Altman & The PRISMA Group, 2009. "Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement," PLOS Medicine, Public Library of Science, vol. 6(7), pages 1-6, July.
    19. Kaestner, Robert & Guardado, Jose, 2008. "Medicare reimbursement, nurse staffing, and patient outcomes," Journal of Health Economics, Elsevier, vol. 27(2), pages 339-361, March.
    20. Gao, Chen & Xu, Fei & Liu, Gordon G., 2014. "Payment reform and changes in health care in China," Social Science & Medicine, Elsevier, vol. 111(C), pages 10-16.
    21. Grabowski, David C. & Afendulis, Christopher C. & McGuire, Thomas G., 2011. "Medicare prospective payment and the volume and intensity of skilled nursing facility services," Journal of Health Economics, Elsevier, vol. 30(4), pages 675-684, July.
    22. Lindberg, G.L. & Lurie, N. & Bannick-Mohrland, S. & Sherman, R.E. & Farseth, P.A., 1989. "Health care cost containment measures and mortality in Hennepin County's Medicaid elderly and all elderly," American Journal of Public Health, American Public Health Association, vol. 79(11), pages 1481-1485.
    23. Maria Daniela Giammanco, 1999. "The Short-Term Response of Hospitals to the Introduction of the DRG Based Prospective Payment System: Some Evidence from Italy," Giornale degli Economisti, GDE (Giornale degli Economisti e Annali di Economia), Bocconi University, vol. 58(1), pages 27-62, April.
    24. Sutherland, Jason M. & Liu, Guiping & Crump, R. Trafford & Law, Michael, 2016. "Paying for volume: British Columbia’s experiment with funding hospitals based on activity," Health Policy, Elsevier, vol. 120(11), pages 1322-1328.
    25. Hamada, Hironori & Sekimoto, Miho & Imanaka, Yuichi, 2012. "Effects of the per diem prospective payment system with DRG-like grouping system (DPC/PDPS) on resource usage and healthcare quality in Japan," Health Policy, Elsevier, vol. 107(2), pages 194-201.
    26. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
    27. Shmueli, Amir & Intrator, Orna & Israeli, Avi, 2002. "The effects of introducing prospective payments to general hospitals on length of stay, quality of care, and hospitals' income: the early experience of Israel," Social Science & Medicine, Elsevier, vol. 55(6), pages 981-989, September.
    28. Ellis, Randall P. & McGuire, Thomas G., 1986. "Provider behavior under prospective reimbursement : Cost sharing and supply," Journal of Health Economics, Elsevier, vol. 5(2), pages 129-151, June.
    29. Lang, Hui-Chu & Chi, Chunhuei & Liu, Chi-Ming, 2004. "Impact of the case payment reimbursement method on the utilization and costs of laparoscopic cholecystectomy," Health Policy, Elsevier, vol. 67(2), pages 195-206, February.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Moreno-Serra, Rodrigo & Wagstaff, Adam, 2010. "System-wide impacts of hospital payment reforms: Evidence from Central and Eastern Europe and Central Asia," Journal of Health Economics, Elsevier, vol. 29(4), pages 585-602, July.
    2. Bäuml, Matthias & Kümpel, Christian, 2020. "Hospital responses to the introduction of reimbursements by treatment intensity in a (presumably lump sum) DRG system," hche Research Papers 22, University of Hamburg, Hamburg Center for Health Economics (hche).
    3. Damrongplasit, Kannika & Atalay, Kadir, 2021. "Payment mechanism and hospital admission: New evidence from Thailand healthcare reform," Social Science & Medicine, Elsevier, vol. 291(C).
    4. Galina Besstremyannaya, 2013. "Heterogeneous hospital response to a per diem prospective payment system," Working Papers w0193, New Economic School (NES).
    5. Li‐Lin Liang, 2015. "Do Diagnosis‐Related Group‐Based Payments Incentivise Hospitals to Adjust Output Mix?," Health Economics, John Wiley & Sons, Ltd., vol. 24(4), pages 454-469, April.
    6. Karen S Palmer & Thomas Agoritsas & Danielle Martin & Taryn Scott & Sohail M Mulla & Ashley P Miller & Arnav Agarwal & Andrew Bresnahan & Afeez Abiola Hazzan & Rebecca A Jeffery & Arnaud Merglen & Ahm, 2014. "Activity-Based Funding of Hospitals and Its Impact on Mortality, Readmission, Discharge Destination, Severity of Illness, and Volume of Care: A Systematic Review and Meta-Analysis," PLOS ONE, Public Library of Science, vol. 9(10), pages 1-1, October.
    7. Cooper, Zack & Gibbons, Stephen & Skellern, Matthew, 2018. "Does competition from private surgical centres improve public hospitals' performance? Evidence from the English National Health Service," Journal of Public Economics, Elsevier, vol. 166(C), pages 63-80.
    8. Meng, Zhaolin & Hui, Wen & Cai, Yuanyi & Liu, Jiazhou & Wu, Huazhang, 2020. "The effects of DRGs-based payment compared with cost-based payment on inpatient healthcare utilization: A systematic review and meta-analysis," Health Policy, Elsevier, vol. 124(4), pages 359-367.
    9. Sood, Neeraj & Alpert, Abby & Barnes, Kayleigh & Huckfeldt, Peter & Escarce, José J., 2017. "Effects of payment reform in more versus less competitive markets," Journal of Health Economics, Elsevier, vol. 51(C), pages 66-83.
    10. Clara Pott & Tom Stargardt & Udo Schneider & Simon Frey, 2021. "Do discontinuities in marginal reimbursement affect inpatient psychiatric care in Germany?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 22(1), pages 101-114, February.
    11. Gaughan, James & Gutacker, Nils & Grašič, Katja & Kreif, Noemi & Siciliani, Luigi & Street, Andrew, 2019. "Paying for efficiency: Incentivising same-day discharges in the English NHS," Journal of Health Economics, Elsevier, vol. 68(C).
    12. David Meltzer & Jeanette Chung, 2002. "Effects of Competition Under Prospective Payment on Hospital Costs Among High- and Low-Cost Admissions: Evidence from California, 1983 and 1993," NBER Chapters, in: Frontiers in Health Policy Research, Volume 5, pages 53-102, National Bureau of Economic Research, Inc.
    13. Cheng, Shou-Hsia & Chen, Chi-Chen & Tsai, Shu-Ling, 2012. "The impacts of DRG-based payments on health care provider behaviors under a universal coverage system: A population-based study," Health Policy, Elsevier, vol. 107(2), pages 202-208.
    14. Fengrong Liu & Jiayu Chen & Chaozhu Li & Fenghui Xu, 2023. "Cost Sharing and Cost Shifting Mechanisms under a per Diem Payment System in a County of China," IJERPH, MDPI, vol. 20(3), pages 1-12, January.
    15. Matthias Bäuml & Christian Kümpel, 2021. "Hospital responses to the refinement of reimbursements by treatment intensity in DRG systems," Health Economics, John Wiley & Sons, Ltd., vol. 30(3), pages 585-602, March.
    16. Galina Besstremyannaya, 2014. "The adverse effects of value-based purchasing in health care: dynamic quantile regression with endogeneity," Discussion Papers 14-006, Stanford Institute for Economic Policy Research.
    17. Galina Besstremyannaya, 2015. "The adverse effects of incentives regulation in health care: a comparative analysis with the U.S. and Japanese hospital data," Working Papers w0218, Center for Economic and Financial Research (CEFIR).
    18. Galina Besstremyannaya, 2015. "The adverse effects of incentives regulation in health care: a comparative analysis with the U.S. and Japanese hospital data," Working Papers w0218, New Economic School (NES).
    19. Wu, Jing & He, Xiaoning & Feng, Xing Lin, 2022. "Can case-based payment contain healthcare costs? - A curious case from China," Social Science & Medicine, Elsevier, vol. 312(C).
    20. P. Choné & F. Evain & L. Wilner & E. Yilmaz, 2013. "Introducing activity-based payment in the hospital industry: Evidence from French data," Documents de Travail de l'Insee - INSEE Working Papers g2013-11, Institut National de la Statistique et des Etudes Economiques.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:323:y:2023:i:c:s0277953623001697. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.