PUBLIC HOSPITALS IN DEVELOPING COUNTRIESINTRODUCTIONThis book
examines economic and financial issues of hospital resource
allocation with the objective of contributing to policies that will
improve the use of public sector funds by hospitals.this book
concerns the allocation of health sector resources between
hospitals and nonhospital alternatives, the internal efficiency of
hospital operationseffective and equitable cost-recovery policies
for hospitals
PATTERNS OF HOSPITAL RESOURCE USEhospital services have a role
in providing referral services to support and complement
nonhospital health programs, but in resource-poor countries the
magnitude and diversity of hospital services to be provided should
be limited.In most countries the resources going to hospitals
appear to exceed the amount required for allocational
efficiency.PATTERNS OF HOSPITAL RESOURCE USE Thus, to reduce the
use by hospitals of public sector resources and to make additional
resources available for nonhospital programs, it is important to
find ways of increasing internal efficiency in hospitals, to find
mechanisms to reduce the dependence of hospitals on public finance,
and to develop low-cost alternatives to hospitals.HOSPITAL COSTS
AND EFFICIENCYThe findings in this chapter complement the policy
discussion in the subsequent three chapters on pricing and hospital
service alternatives.Pricing should be intimately related to costs,
which constitute half of the information required for determining
optimum pricing levels.HOSPITAL COSTS AND EFFICIENCYWith regard to
hospital alternatives, the discussion of cost and efficiency in
this chapter has suggested that improving referral patterns by
directing patients to lower-level hospitals and nonhospital
alternatives might provide savings without sacrificing health
status.HOSPITAL FINANCING ALTERNATIVESthe alternatives have
potential effects on the use and provision of services that are
both beneficial and detrimental to welfare. The planner's dilemma
is to weigh the benefits and costs associated with the
alternativesHOSPITAL FINANCING ALTERNATIVESThe principalFees should
be consistent with ability to payFees should provide signals that
promote economic efficiencyFees and the quality of service should
be linked
