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      Defining the “Health Benefit Basket” in nine European countries : Evidence from the European Union Health BASKET Project

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          Abstract

          This article identifies and analyses a framework for “health baskets,” the taxonomy of benefit catalogues for curative services, and the criteria for the in- or exclusion of benefits in nine EU member states (Denmark, England, France, Germany, Hungary, Italy, The Netherlands, Poland and Spain). Focusing on services of curative care, it is found that the explicitness of benefit catalogues varies largely between the countries. In the absence of explicitly defined benefit catalogues, in- and outpatient remuneration schemes have the character of benefit catalogues. The criteria for the in- or exclusion into benefit catalogues are often not transparent and (cost-)effectiveness is applied only for certain sectors. An EU-wide harmonization of benefit baskets does not seem realistic in the short or medium term as the variation in criteria and the taxonomies of benefit catalogues are large but not insurmountable. There may be scope for a European core basket.

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          Most cited references13

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          Best practice in undertaking and reporting health technology assessments. Working group 4 report.

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            How comprehensive are the basic packages of health services? An international comparison of six health insurance systems.

            Interest in the composition of the health care menu has grown. Its outwardly comprehensive nature is as rhetorical as the slogans of universal access and affordability. This paper summarizes the international part of a report to the Swiss government, in which we explored the basic package of services covered by social health insurance in France, Germany, Israel, Luxembourg, The Netherlands and Switzerland. The aim of the initial report was to check the appropriateness of the Swiss catalogue, with special attention to the risk of unequal access to health care by rationing of effective services. In this paper, we highlight the major differences in service coverage between the countries and address the possible factors explaining those differences. The contents of the basic packages of the six countries were compared using data from government ministries and sickness funds. Coverage is most comprehensive in Germany and Switzerland; these are also the countries with the greatest total health expenditure. Three countries separated nursing care from other types of health care by creating an independent insurance scheme. Some health care benefits are also covered under the heading of social care. High out-of-pocket payments are increasingly used as hidden rationing instruments. The present comparison highlights the multi-factorial character of the choices made in six countries in order to keep their health care menu within the possibilities offered by available resources. Copyright The Royal Society of Medicine Press Ltd 2002.
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              Geographically-decentralized planning and management in health care: some informational issues and their implications for efficiency.

              Geographically decentralized planning and management is an emerging theme within the health sector in many OECD countries. Advocates of decentralization argue that providing greater authority to local decision-making bodies can improve both the technical and allocative efficiency with which health care systems operate. Using concepts drawn from organizational theory and the economics of organizations, we examine the potential of centralized and decentralized planning and management structures to be efficient in light of the informational problems that must be overcome to allocate resources efficiently. We focus in particular on the need to integrate information regarding: (1) the effectiveness and efficiency of alternative clinical interventions and of alternative ways organize the delivery of health care; (2) the needs, values, and preferences in the population; and (3) local circumstances that affect delivery of care across regions. Informational concerns suggest that decentralized structures have greater potential to be efficient. We then briefly discuss some principles for the design of decentralized structures to aid in realizing these potential efficiency gains.
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                Author and article information

                Contributors
                jonas.schreyoegg@tu-berlin.de
                Journal
                Eur J Health Econ
                The European Journal of Health Economics
                Springer-Verlag (Berlin/Heidelberg )
                1618-7598
                1618-7601
                24 November 2005
                November 2005
                : 6
                : Suppl 1
                : 2-10
                Affiliations
                [1 ]Berlin University of Technology, Berlin, Germany
                [2 ]Department of Health Care Management, Berlin University of Technology, Strasse des 17. Juni 145, 10623 Berlin, Germany
                Article
                312
                10.1007/s10198-005-0312-3
                1388078
                16270212
                eeeddad7-fdef-431a-a6b3-096c364da179
                © Springer Medizin Verlag 2005
                History
                Categories
                Original Papers
                Custom metadata
                © Springer Medizin Verlag 2005

                Economics of health & social care
                health priorities,health services,national health programs,health benefit plans,insurance benefits

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