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Do efficiency gains really translate into more budget for health? An assessment framework and country applications

Efficiency has historically been considered a key mechanism to increase the amount of available revenues to the health sector, enabling countries to expand services and benefits to progress towards universal health coverage (UHC). Country experience indicates, however, that efficiency gains do not a...

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Autores principales: Barroy, Hélène, Cylus, Jonathan, Patcharanarumol, Walaiporn, Novignon, Jacob, Evetovits, Tamás, Gupta, Sanjeev
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428602/
https://www.ncbi.nlm.nih.gov/pubmed/33855342
http://dx.doi.org/10.1093/heapol/czab040
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author Barroy, Hélène
Cylus, Jonathan
Patcharanarumol, Walaiporn
Novignon, Jacob
Evetovits, Tamás
Gupta, Sanjeev
author_facet Barroy, Hélène
Cylus, Jonathan
Patcharanarumol, Walaiporn
Novignon, Jacob
Evetovits, Tamás
Gupta, Sanjeev
author_sort Barroy, Hélène
collection PubMed
description Efficiency has historically been considered a key mechanism to increase the amount of available revenues to the health sector, enabling countries to expand services and benefits to progress towards universal health coverage (UHC). Country experience indicates, however, that efficiency gains do not automatically translate into greater budget for health, to additional revenues for the sector. This article proposes a framework to assess whether and how efficiency interventions are likely to increase budgetary space in health systems Based on a review of the literature and country experiences, we suggest three enabling conditions that must be met in order to transform efficiency gains into budgetary gains for health. First there must be well-defined efficiency interventions that target health system inputs, implemented over a medium-term time frame. Second, efficiency interventions must generate financial gains that are quantifiable either pre- or post-intervention. Third, public financial management systems must allow those gains to be kept within the health sector and repurposed towards priority health needs. When these conditions are not met, efficiency gains do not lead to more budgetary space for health. Rather, the gains may instead result in budget cuts that can be detrimental to health systems’ outputs and ultimately disincentivize further attempts to improve efficiency in the sector. The framework, when applied, offers an opportunity for policymakers to reconcile efficiency and budget expansion goals in health.
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spelling pubmed-84286022021-09-10 Do efficiency gains really translate into more budget for health? An assessment framework and country applications Barroy, Hélène Cylus, Jonathan Patcharanarumol, Walaiporn Novignon, Jacob Evetovits, Tamás Gupta, Sanjeev Health Policy Plan Original Article Efficiency has historically been considered a key mechanism to increase the amount of available revenues to the health sector, enabling countries to expand services and benefits to progress towards universal health coverage (UHC). Country experience indicates, however, that efficiency gains do not automatically translate into greater budget for health, to additional revenues for the sector. This article proposes a framework to assess whether and how efficiency interventions are likely to increase budgetary space in health systems Based on a review of the literature and country experiences, we suggest three enabling conditions that must be met in order to transform efficiency gains into budgetary gains for health. First there must be well-defined efficiency interventions that target health system inputs, implemented over a medium-term time frame. Second, efficiency interventions must generate financial gains that are quantifiable either pre- or post-intervention. Third, public financial management systems must allow those gains to be kept within the health sector and repurposed towards priority health needs. When these conditions are not met, efficiency gains do not lead to more budgetary space for health. Rather, the gains may instead result in budget cuts that can be detrimental to health systems’ outputs and ultimately disincentivize further attempts to improve efficiency in the sector. The framework, when applied, offers an opportunity for policymakers to reconcile efficiency and budget expansion goals in health. Oxford University Press 2021-04-14 /pmc/articles/PMC8428602/ /pubmed/33855342 http://dx.doi.org/10.1093/heapol/czab040 Text en © The Author(s) 2021. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine. https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Original Article
Barroy, Hélène
Cylus, Jonathan
Patcharanarumol, Walaiporn
Novignon, Jacob
Evetovits, Tamás
Gupta, Sanjeev
Do efficiency gains really translate into more budget for health? An assessment framework and country applications
title Do efficiency gains really translate into more budget for health? An assessment framework and country applications
title_full Do efficiency gains really translate into more budget for health? An assessment framework and country applications
title_fullStr Do efficiency gains really translate into more budget for health? An assessment framework and country applications
title_full_unstemmed Do efficiency gains really translate into more budget for health? An assessment framework and country applications
title_short Do efficiency gains really translate into more budget for health? An assessment framework and country applications
title_sort do efficiency gains really translate into more budget for health? an assessment framework and country applications
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8428602/
https://www.ncbi.nlm.nih.gov/pubmed/33855342
http://dx.doi.org/10.1093/heapol/czab040
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