Hospital funding reforms require transparency and collaboration: study

February 26, 2018

Changing the way hospitals are funded may be one way to improve health care system sustainability.

Some Canadian hospitals are moving towards “patient based” hospital funding to replace annual global budgets. Linking funding to quality of patient care in a bid to improve care and achieve better patient outcomes may encourage smarter use of limited resources.

But a recent study by Karen Palmer, an SFU health sciences adjunct professor, finds that achieving major changes in complex health care systems can be fraught with challenges. 

Palmer and her colleagues at the Women's College Hospital's Institute for Health System Solutions and Virtual Care (WIHV) in Toronto evaluated the implementation of Quality-Based Procedures (QBPs), a new “patient-based” funding mechanism to replace existing global hospital budgets in Ontario. Whereas global budgets provide hospitals with fixed funding per year, QBPs pay them a set price to cover each episode of care for patients with particular diagnoses or for specific procedures.

QBPs were launched with evidence-based care guidelines, aimed at helping clinicians provide the best care for the set price.

The study revealed that health system leaders in Ontario didn't have a shared understanding of the goals for reforming hospital funding, and are still uncertain about those goals four years after implementation. A prolonged implementation period, key staff turnover, and inconsistent messaging resulted in the policy drifting over time, which exacerbated implementation of the reforms.

“Ongoing differences in understanding the QBP goals and funding mechanism have made implementation challenging, and have created difficulties in measuring success,” says Palmer.

As a result, she suggests that Canadian hospitals could improve the implementation of funding and quality reforms through processes that are more transparent, collaborative, and intentional.

Latest News

  • March 21, 2018
    Applications closing for once in a degree opportunity
    Health Change Lab Fall 2018 applications close on April 1st! This once-in-a-degree experiential learning program will push you outside of the classroom and outside of your comfort zone to investigate a real social, economic, or environmental challenge that impacts community health. In interdisciplinary teams, you will build a sustainable business model to creatively respond to it and pitch your ideas to community influencers – all in just 13 weeks.
  • March 14, 2018
    Future of HIV treatment found in the sea?
    Worldwide 36.7 million people globally are living with HIV, and of these 20.9 million people are accessing antiretroviral therapy according to recent estimates. Discovering new classes of antiretroviral medications is essential in the fight against HIV.
  • March 14, 2018
    SFU project looks to patients to help shape future primary care research in BC
    Simon Fraser University (SFU) researchers are working with a group of 10 patients from across British Columbia to help shape future primary health care research in the province. The team, part of the B.C. Primary Health Care Research Network, has worked together to develop a survey