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H Saxenian

Publications and source records attributed to H Saxenian.

4 recordsLinked to original sources
PubMed1995

Investing in health wisely. The role of needs-based technology assessment.

Countries worldwide spend huge sums on health--about $1,700 billion a year, or roughly 8% of global income. But the World Development Report 1993: Investing in Health shows that these monies could be spent much more wisely, in the process doing a great deal to help the world's 1 billion poor. Essential national public health and clinical packages are proposed based on assessment of the burden of disease (measured in disability adjusted life years) and the cost-effectiveness of interventions. Governments can play a central role in improving the health of their citizens: they can foster an environment that enables households to improve health and they can also improve their own spending on health, targeting it to support universal access to essential national public health and clinical packages based on the above methods. This is a good example of the concept of needs-based technology assessment, combining the disciplines of epidemiology, economics, and policy formulation. When applied, it should lead to improved effectiveness, efficiency, and equity.

Cost of Illness↗
PubMed1994

Design, content and financing of an essential national package of health services.

A minimum package of public health and clinical interventions, which are highly cost-effective and deal with major sources of disease burden, could be provided in low-income countries for about US$ 12 per person per year, and in middle-income countries for about $22. Properly delivered, this package could eliminate 21% to 38% of the burden of premature mortality and disability in children under 15 years and 10-18% of the burden in adults. The cost would exceed what governments now spend on health in the poorest countries but would be easily affordable in middle-income countries. Governments should ensure that, at the least, poor populations have access to these services. Additional public expenditure should then go either to extending coverage to the non-poor or to expansion beyond the minimum collection of services to an essential national package of health care, including somewhat less cost-effective interventions against a larger number of diseases and conditions.

Adult↗
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↗