2022
DOI: 10.1186/s12961-022-00879-2
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Hospital funding reforms in Canada: a narrative review of Ontario and Quebec strategies

Abstract: Background In the early 2000s, Ontario and Quebec, two provinces of Canada, began to introduce hospital payment reforms to improve quality and access to care. This paper (1) critically reviews patient-based funding (PBF) implementation approaches used by Quebec and Ontario over 15 years, and (2) identifies factors that support or limit PBF implementation to inform future decisions regarding the use of PBF models in both provinces. Methods We adopte… Show more

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Cited by 5 publications
(4 citation statements)
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“…However, we also acknowledge the possibility of 'code creep' or 'upcoding', a phenomenon in which physicians bill for more expensive procedures over time, as this has previously been documented in outpatient clinics in Ontario [22]. However, code creep has not been documented in Ontario hospitals [23]. Indeed, the rates of hip replacements in our study remained constant over our study period.…”
Section: Discussionmentioning
confidence: 55%
“…However, we also acknowledge the possibility of 'code creep' or 'upcoding', a phenomenon in which physicians bill for more expensive procedures over time, as this has previously been documented in outpatient clinics in Ontario [22]. However, code creep has not been documented in Ontario hospitals [23]. Indeed, the rates of hip replacements in our study remained constant over our study period.…”
Section: Discussionmentioning
confidence: 55%
“…While we did not aim to examine differences in the prioritization of prevailing values across jurisdictions, nor unpack the decision-making process itself , such variation could be present and be in part responsible for variation in the timing of introduction and in the characteristics of integrated care funding policies implemented across jurisdictions. Further comparative studies are thus warranted to better understand the mechanisms behind the development of integrated care funding policy, as well as to explore barriers and enablers to their implementation (as already available for other funding approaches [ 48 ]).…”
Section: Discussionmentioning
confidence: 99%
“…With the pressure of demand-supply balance increasing on the healthcare system, hospital activity-based funding, or 'pay-per-performance', is growing in popularity among governing administrations. [1][2][3][4] Under activitybased funding, hospitals are paid a predefined amount of money for each patient. 5,6 This is based on patients' specific conditions and factors that may add complexity or cost to their care.…”
Section: Introductionmentioning
confidence: 99%