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

Bibliographic Data

ID16763142
AuthorsHélène Barroy (0000-0002-4771-3222, World Health Organization, corresponding author), Jonathan Cylus (0000-0001-8269-1578, London Hubs Coordinator, European Observatory on Health Systems and Policies, London School of Hygiene and Tropical Medicine, Cowdray House, COW 4.02, London WC2A 2AE, UK), Walaiporn Patcharanarumol (0000-0003-1798-8767, International Health Policy Program, Ministry of Public Health, Tiwanond Road, Amphur Muang, Nonthaburi 11000, Thailand), Jacob Novignon (0000-0002-4718-9328, Kwame Nkrumah University of Science and Technology, Accra Road, Kumasi, Ghana), Tamas Evetovits (0000-0003-2344-351X, Regional Office for Europe, World Health Organization, UN City, Marmorvej 51, 2100 København, Denmark), Sanjeev Gupta (0000-0002-9660-6597, Center for Global Development)
Year2021
Volume36
Issue8
Pages1307-1315
Publication date2021-09-09
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueHealth Policy and Planning (JOURNAL)
Journal identifiersISSN: 0268-1080 • E-ISSN: 1460-2237
PublisherOxford University Press (PUBLISHER • GB)
DOI10.1093/heapol/czab040
PMID33855342
OpenAlexW3155242539
LanguageEN
Citations received2
References cited18

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

Business · Economic growth · Economics · Health care · Order (exchange) · Psychological intervention · Public economics · Revenue · Finance · Global Health Care Issues · Global Maternal and Child Health · Healthcare Systems and Reforms · Medicine · Health Policy

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  • Health systems development in Thailand

    Open Access•Viroj Tangcharoensathien, Woranan Witthayapipopsakul et al.•The Lancet•2018

  • Improving fiscal space for health from the perspective of efficiency in low- and middle-income countries

    Open Access•Wu Zeng, Yao Yao et al.•Journal of Global Health•2020

  • The prospects of creating ‘fiscal space’ for the health sector

    Open Access•Peter S Heller, Peter Heller•Health Policy and Planning•2006

  • The Ghana Community-based Health Planning and Services Initiative for scaling up service delivery innovation

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Unique citing works2
Citations per year0,5
Citation span2022 - 2022 (1)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 2
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