2. Activity based funding –where did it come from ?
Fiscal pressure - Nixon administration - early 70s
Fetter & Thompson, DRGs & US medicare - early 80s
Experimental interest France, Aus, Irl, et al.- early 90s
Tariffs emerge in France, Germany , England - early 00s
Ireland, Aus and France had been developing uses since
late 80s ,
France epidemiol, Irel & Aus budget adjusting
3. Activity based funding –what is it used for?
• To counter inflationary incentives
• To clarify connection between funding and activity
• To link payment to efficiency & quality
4. Activity based funding – does it work?
Partial
Price adjustments continuous
supplementary Payments not uncommon
Parts of the system it doesn’t reach yet
Persisting
5. Where does Qatar come into this?
• Emerging Country with Emerging Health Care System
• Rapid change, rapid technology adoption, leap frog phenomena
• Commonalities with Ireland
Small state
Predominance of public sector supply
AR DRGs
Dynamic population
8. Strategic Development
National Health Strategy 2011-2016
• Comprehensive World Class Health System
• Integrated High Quality Services
• Preventive Healthcare
• Skilled National Workforce
• Standards and Monitoring
• Effective Affordable Services
• High Calibre Research
9. Activity based funding - where does it fit?
• 1.2 National Hospitals Configurations and Role Delineation
• 5.3 Healthcare Facilities Licensing
• 6.1 Budget process for public health sector spending (ABB)
• 6.3 National Health Insurance
• 6.4 Healthcare Infrastructure Masterplan incl private expansion
• 6.5 Capital expenditure to include certificate of needs
Leads to Needs Based, Activity Funded, Planning
10. Health Needs Based, Activity Funded Planning
Clinical Services Config Qual HC Strategic Plan Best Practice Models
Operational PlanClinical Plans Funding / Purchasing Plann
Technology
Epidemiology
Purchasing
Workforce
Needs Vs
Activity
Infrastructure
/ Pop
ABB Model
11. Reference
• Health Economics, Policy and Law (2012), 7: 73–101 &
Cambridge University Press 2012 - O’Reilly J. et. Al. 4
