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NHS Update : Foundation Trusts & hospital PFIs | 17 comments (17 topical, editorial, 0 hidden)
Re: NHS Update : Foundation (none / 0)
Agnes, please correct me if I'm wrong with this comment, because I have been away from the NHS for a number of years.  The old, old system was that hospitals were paid based upon a fixed and budeted payment.  That payment was not based upon the actual volume of cases done in the calendar year.  (I believe the budget was adjusted over time as populations shifted, but that didn't help a hospital with an increased workload in a particular year.)

Also in a particular year, a hospital could get hit with an unfavorable case mix in terms of cost.  In other words, they might do 1000 cases just like last year, but the current year's case mix could have very high cost cases, requiring expensive surgeries and long hospital stays.

That approach obviously had significant faults.  Was the PbR required to fix this?  (It's possible there was some fix before now that addressed this issue.  But it sounds like this is similar to the DRG concept in the US.)

by wchurchill on Wed May 3rd, 2006 at 08:55:38 PM EST
Re: PbR and DRGs (none / 0)
Seen from France the US and UK and health care systems are very much alike, in broad terms. The reform currently being implemented in France aims at ultimately (target 2012) getting rid of the fixed and annually budgeted payment, whatever the actual expenses, with public  and not for profit private hospitals being compensated for losses so that their budget is structurally balanced.
The widening gap with private for profit hospitals which have been paid on a DRG basis for a long time now prompted a will to harmonise public and private hospital funding schemes. My understanding is that the same is going on in the UK with the PbR system.

Whether this will prove to be in the interest of patients is another debate.

When through hell, just keep going. W. Churchill

by Agnes a Paris on Thu May 4th, 2006 at 08:51:47 AM EST
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NHS Update : Foundation Trusts & hospital PFIs | 17 comments (17 topical, 0 editorial, 0 hidden)
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