Public Hospital Resource Allocations in El Salvador: Accounting for the Case Mix of Patients

National hospitals in developing countries command a disproportionate share of medical care budgets, justified on the grounds that they have a more difficult patient case mix and higher occupancy rates than decentralized district hospitals or clinics. This paper empirically tests the hypothesis by d...

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Bibliographic Details
Published in:Health policy and planning 1998-09, Vol.13 (3), p.296-310
Main Authors: Fiedler, John L, Schmidt, Robert M, Wight, Jonathan B
Format: Article
Language:English
Subjects:
Bed Occupancy - statistics & numerical data
Budgets
Case mix systems
Client Characteristics
Developing Countries
Diagnosis-Related Groups - classification
Diagnosis-Related Groups - statistics & numerical data
Efficiency, Organizational
El Salvador
El Salvador - epidemiology
Factors
Health administration
Health Care Costs
Health expenditure
Health Expenditures - statistics & numerical data
Health planning
Health policy
Health Resources - classification
Health Resources - statistics & numerical data
Health Services Research
Hospitals
Hospitals, Public - economics
Hospitals, Public - organization & administration
Hospitals, Public - statistics & numerical data
Humans
Morbidity
Patients
Personnel Staffing and Scheduling - statistics & numerical data
Public Health
Public Sector
Resource Allocation
Severity of Illness Index
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Summary:National hospitals in developing countries command a disproportionate share of medical care budgets, justified on the grounds that they have a more difficult patient case mix and higher occupancy rates than decentralized district hospitals or clinics. This paper empirically tests the hypothesis by developing direct measures of the severity of patient illness, hospital case-mix and a resource intensity index for each of El Salvador's public hospitals. Based on an analysis of inpatient care staffing requirements, national hospitals are found to receive funding far in excess of what case-mix and case-load considerations would warrant. The findings suggest that significant system-wide efficiency gains can be realized by allocating hospital budgets on the bases of performance-related criteria which incorporate the case-mix approach developed here.
ISSN:0268-1080
1460-2237
1460-2237
DOI:10.1093/heapol/13.3.296