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Biomedical subjects

H Barnum

Publications and source records attributed to H Barnum.

5 recordsLinked to original sources
PubMed1987

Evaluating healthy days of life gained from health projects.

This paper draws attention to the importance of incorporating weights for time preference and productivity in using the concept of healthy days of life lost to evaluate healthy projects. Two alternative health strategies are defined for Ghana and evaluated, over a range of discount rates from 0 to 20%, with regard to the present value of productive life saved. It is found that the relative ranking of the projects is sensitive to the choice of discount rates. The sensitivity of disease rankings to the underlying morbidity and fatality rates is also examined and the results underline the importance of obtaining better epidemiological baseline data and information on project effectiveness if the potential usefulness of the healthy days of life approach to project evaluation is to be fully realized.

Adolescent↗
PubMedDate not supplied

Incentives and provider payment methods.

The mode of payment creates powerful incentives affecting provider behavior and the efficiency, equity and quality outcomes of health finance reforms. This article examines provider incentives as well as administrative costs, and institutional conditions for successful implementation associated with provider payment alternatives. The alternatives considered are budget reforms, capitation, fee-for-service, and case-based reimbursement. We conclude that competition, whether through a regulated private sector or within a public system, has the potential to improve the performance of any payment method. All methods generate both adverse and beneficial incentives. Systems with mixed forms of provider payment can provide tradeoffs to offset the disadvantages of individual modes. Low-income countries should avoid complex payment systems requiring higher levels of institutional development.

Argentina↗