A review of worldwide experience with an alternative model of hospital funding suggests that it increases the number of patients needing post-acute care. Activity-based funding (ABF) is a system whereby hospitals are paid a set rate for each episode of care, intended to fund the bundle of services provided to patients with particular diagnoses, as opposed to a lump sum at the beginning of each year to cover all patients in a jurisdiction.
A systematic review of the evidence produced over the last 30 years from other countries where ABF has been tried found that the relative number of patients discharged to post-acute care – for example, a skilled nursing facility, home care, convalescent care, etc. – increases by 24% with ABF. The authors warn that jurisdictions experimenting with ABF (including Ontario, Quebec and BC) must be prepared for this and other possible consequences.
Original research paper published in PLOS ONE on October 27, 2014.
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