Jagiellonian University Medical College, Krakow, Poland.
Riga Stradiņš University, Riga, Latvia.
Inquiry. 2024 Jan-Dec;61:469580241287626. doi: 10.1177/00469580241287626.
Central and Eastern European (CEE) countries have recently implemented reforms to health care provider payment systems, which include changing payment methods and related systems such as contracting, management information systems, and accountability mechanisms. This study examines factors influencing provider payment reforms implemented since 2010 in Bulgaria, Croatia, Czechia, Estonia, Latvia, Lithuania, Hungary, Poland, and Romania. A four-stage mixed methods approach was used: developing a theoretical framework and data collection form using existing literature, mapping payment reforms, consulting with national health policy experts, and conducting a comparative analysis. Qualitative analysis included inductive thematic analysis and deductive approaches based on an existing health policy model, distinguishing context, content, process, and actors. We analyzed 27 payment reforms that focus mainly on hospitals and primary health care. We identified 14 major factor themes influencing those reforms. These factors primarily related to the policy process (pilot study, coordination of implementation systems, availability of funds, IT systems, training for providers, reform management) and content (availability of performance indicators, use of clinical guidelines, favorability of the payment system for providers, tariff valuation). Two factors concerned the reform context (political willingness or support, regulatory framework, and bureaucracy) and two were in the actors' dimension (engagement of stakeholders, capacity of stakeholders). This study highlights that the content and manner of implementation (process) of a reform are crucial. Stakeholder involvement and their capacities could influence every dimension of the reform cycle. The nine countries analyzed share similarities in barriers and facilitators, suggesting the potential for cross-country learning.
中东欧(CEE)国家最近对医疗服务提供者的支付系统进行了改革,包括改变支付方式以及相关的系统,如合同、管理信息系统和问责机制。本研究考察了自 2010 年以来保加利亚、克罗地亚、捷克、爱沙尼亚、拉脱维亚、立陶宛、匈牙利、波兰和罗马尼亚实施的影响提供者支付改革的因素。采用了四阶段混合方法:使用现有文献制定理论框架和数据收集表、绘制支付改革图、与国家卫生政策专家协商以及进行比较分析。定性分析包括基于现有卫生政策模型的归纳主题分析和演绎方法,区分背景、内容、过程和行为者。我们分析了 27 项主要针对医院和初级卫生保健的支付改革。我们确定了影响这些改革的 14 个主要因素主题。这些因素主要与政策过程(试点研究、实施系统的协调、资金的可用性、信息技术系统、提供者培训、改革管理)和内容(绩效指标的可用性、临床指南的使用、提供者支付系统的有利性、关税估值)有关。两个因素涉及改革背景(政治意愿或支持、监管框架和官僚主义),两个因素涉及行为者维度(利益相关者的参与、利益相关者的能力)。本研究强调,改革的内容和实施方式(过程)至关重要。利益相关者的参与及其能力可能会影响改革周期的各个方面。分析的九个国家在障碍和促进因素方面存在相似之处,这表明了国家间学习的潜力。