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Hospital response to Activity-Based Funding and price incentives

Evidence from Ireland

Bibliographic Data

ID21468136
AuthorsGintare Valentelyte (0000-0001-9188-3854, Health Research Board, corresponding author), Conor Keegan (0000-0003-1367-1156, Economic and Social Research Institute), Jan Sørensen (0000-0003-0857-9267)
Year2023
Volume137
Pages104915
Publication date2023-11-01
Open AccessYes
TypeARTICLE
VenueHealth Policy (JOURNAL)
Journal identifiersISSN: 0168-8510 • E-ISSN: 1872-6054
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.healthpol.2023.104915
PMID37741112
OpenAlexW4386788132
LanguageEN
Citations received3
References cited27

Activity-Based Funding (ABF) is a funding policy incentivising hospitals to deliver more efficient care. ABF can be complemented by additional price incentives to further drive hospital efficiency. In 2016, ABF was introduced for public patients admitted to Irish public hospitals. Additionally, a price incentive to perform laparoscopic cholecystectomy as day-case surgery was introduced in 2018. Private patient activity in public hospitals was subject to neither ABF nor price incentive. Using national Hospital In-Patient-Enquiry activity data 2013-2019, we evaluated the impact of ABF and the price incentive for laparoscopic cholecystectomy surgery in Ireland. We exploit variation in hospital payment for public and private patients treated in public acute Irish hospitals and employ a Propensity Score Matching Difference-in-Differences approach. We estimate the funding change impacts across outcomes measuring the proportion of day-case admissions and length of stay. We found no significant impact for either outcomes linked to ABF introduction. Similarly, no impacts linked to the price incentive were observed. It appears providers of laparoscopic cholecystectomy in Irish public hospitals did not react to the new funding mechanisms. The implementation of the funding policies did not improve hospital efficiency. Further strengthening of these new funding mechanisms are required to deliver more efficient care

Business · Economics · Incentive · Public economics · Global Health Care Issues · Healthcare Policy and Management · Medicine · Primary Care and Health Outcomes

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Citations per year3
Citation span2025 - 2026 (2)
Highly citedNo

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