Page 112 - Hospital Authority Convention 2017

Parallel Sessions Parallel Sessions
HOSPITAL AUTHORITY CONVENTION 2017

PS2.1 Healthcare Financing 14:30 Theatre 1

Strategic Purchasing for Health System Goals in Pluralistic Financing and Providers Systems
Yeoh EK
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong
Universal challenges in health systems are centred on escalating costs of healthcare, demand generated by the chronic
disease burden and rising expectations of populations for better and safer healthcare. This has created an environment
where government’s role in raising and allocation resources for healthcare has moved beyond one of a passive funder to an
active and strategic role of purchasing for health system goals.

Strategic purchasing can improve the health system performance through effective allocation of financial resources to
providers. Strategic purchasing involves five sets of decisions:
(1) Who should be purchasing and what are the roles of the individual, and complementary agents including the government,
third-party payers, and employers in the context of pluralistic financing and provider health systems
(2) For whom to purchase in the context of different financing and provider health systems
(3) What interventions or services should be purchased, taking into consideration population needs, national health goals
and priorities, and cost-effectiveness
(4) From whom to purchase, whether to produce or to select and contract service providers, giving consideration to
Tuesday, 16 May Strategic purchasing should lead to a maximisation of overall health gain from available resources (i.e., increased allocative
capacity and supply, service quality, efficiency and equity
(5) How services will be purchased and at what price, including contractual arrangements and how providers will be paid
taking into account the inherent incentives in different provider payment mechanisms

efficiency), however it imposes considerable demands on purchasers, requiring capacity, data and intelligence.

PS2.2 Healthcare Financing 14:30 Theatre 1

Population-based Resource Allocation
Yeoh EK
The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong

Resource allocation is a mechanism for distributing resources between competing claims to meet certain pre-specified
goals. There are various approaches for resource allocation including political patronage, historical, bid-based, expenditure-
based, and formula-based using either case/activity or capitation. The capitation approach based on population has the
potential to address equity in healthcare provision and provides incentives for efficiency. To be effective, the population-
based model needs to be able to estimate resource needs according to the healthcare needs of the population served
and ensure all key parameters, including factors affecting healthcare needs and health seeking behaviour which represent
demonstrably material influences on the need to consume the service are included (Smith, Rice and Carr-Hill, 2001). In
the Hospital Authority ’s context, population based resource allocation is to foster equity between clusters as well to drive
changes in the healthcare system without causing unintentional and undesirable impact on existing baseline services. Cross-
Cluster movement of patients also needs to be addressed. A refined population-based resource allocation model alone
is necessary but not sufficient to direct resources to where they are most needed. Population-based resource allocation
needs to be an integral part of a holistic approach of strategic service and resource planning and management. The model
will generate business intelligence and facilitate better understanding of healthcare needs and the optimal mix of services
required and it is crucial to examine how this can be applied in the resource and service planning and provision to enable the
cluster population, access to a comprehensive range of healthcare services. A conceptual framework linking the three key
dimensions, i.e., population healthcare needs, service planning and resource planning will be discussed at the presentation
which will enable the development of a comprehensive analytical framework to achieve the goals of equity and efficiency in
cluster healthcare provision and utilisation.

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