Funding models in palliative care: Lessons from international experience.

Groeneveld, E Iris; Cassel, J Brian; Bausewein, Claudia; Csikós, Ágnes; Krajnik, Malgorzata; Ryan, Karen; Haugen, Dagny Faksvåg; Eychmüller, Steffen; Gudat Keller, Heike; Allan, Simon; Hasselaar, Jeroen; García-Baquero Merino, Teresa; Swetenham, Kate; Piper, Kym; Fürst, Carl Johan; Murtagh, Fliss Em (2017). Funding models in palliative care: Lessons from international experience. Palliative medicine, 31(4), pp. 296-305. Sage 10.1177/0269216316689015

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BACKGROUND Funding models influence provision and development of palliative care services. As palliative care integrates into mainstream health care provision, opportunities to develop funding mechanisms arise. However, little has been reported on what funding models exist or how we can learn from them. AIM To assess national models and methods for financing and reimbursing palliative care. DESIGN Initial literature scoping yielded limited evidence on the subject as national policy documents are difficult to identify, access and interpret. We undertook expert consultations to appraise national models of palliative care financing in England, Germany, Hungary, Republic of Ireland, New Zealand, The Netherlands, Norway, Poland, Spain, Sweden, Switzerland, the United States and Wales. These represent different levels of service development and a variety of funding mechanisms. RESULTS Funding mechanisms reflect country-specific context and local variations in care provision. Patterns emerging include the following: Provider payment is rarely linked to population need and often perpetuates existing inequitable patterns in service provision. Funding is frequently characterised as a mixed system of charitable, public and private payers. The basis on which providers are paid for services rarely reflects individual care input or patient needs. CONCLUSION Funding mechanisms need to be well understood and used with caution to ensure best practice and minimise perverse incentives. Before we can conduct cross-national comparisons of costs and impact of palliative care, we need to understand the funding and policy context for palliative care in each country of interest.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Clinic of Medical Oncology

UniBE Contributor:

Eychmüller, Steffen

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1477-030X

Publisher:

Sage

Language:

English

Submitter:

Nicole Corminboeuf

Date Deposited:

26 Mar 2018 16:30

Last Modified:

26 Mar 2018 16:30

Publisher DOI:

10.1177/0269216316689015

PubMed ID:

28156188

Uncontrolled Keywords:

Financing health care systems hospice palliative care reimbursement mechanisms

BORIS DOI:

10.7892/boris.111489

URI:

https://boris.unibe.ch/id/eprint/111489

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