@article{fdi:010079912,
  title = {{E}ffect of a prospective payment method for health facilities on direct medical expenditures in a low-resource setting : a paired pre-post study},
  author = {{M}eda, {I}. {B}. and {K}ouanda, {S}. and {D}umont, {A}lexandre and {R}idde, {V}al{\'e}ry},
  editor = {},
  language = {{ENG}},
  abstract = {{A}lmost all sub-{S}aharan countries have adopted cost-reduction policies to facilitate access to health care. {H}owever, several studies underline the reimbursement delays experienced by health facilities, which lead to deficient implementation of these policies. {I}n {A}pril 2016, for its free care policy, {B}urkina {F}aso shifted from fee-for-service ({FFS}) paid retrospectively to {FFS} paid prospectively. {T}his study tested the hypothesis that this new method of payment would be associated with an increase in direct medical expenditures (expenses covered by the policies) associated with deliveries. {T}his paired pre-post study used data from two cross-sectional national surveys. {O}bservations were paired according to the health facility and the type of delivery. {W}e used a combined approach (state and household perspectives) to capture all direct medical expenses (delivery fees, drugs and supplies costs, paraclinical exam costs and hospitalization fees). {A} {W}ilcoxon signed-rank test was used to test the hypothesis that the 2016 distribution of direct medical expenditures was greater than that for 2014. {A} total of 279 pairs of normal deliveries, 66 dystocia deliveries and 48 caesareans were analysed. {T}he direct medical expenditure medians were {USD} 4.97 [interquartile range ({IQR}): 4.30-6.02], 22.10 [{IQR}: 15.59-29.32] and 103.58 [{IQR}: 85.13-113.88] in 2014 vs {USD} 5.55 [{IQR}: 4.55-6.88], 23.90 [{IQR}: 17.55-48.81] and 141.54 [{IQR}: 104.10-172.02] in 2016 for normal, dystocia and caesarean deliveries, respectively. {E}xcept for dystocia ({P}=0.128) and medical centres ({P}=0.240), the 2016 direct medical expenditures were higher than the 2014 expenses, regardless of the type of delivery and level of care. {T}he 2016 expenditures were higher than the 2014 expenditures, regardless of the components considered. {I}n the context of cost-reduction policies in sub-{S}aharan countries, greater attention must be paid to the provider payment method and cost-control measures because these elements may generate an increase in medical expenditures, which threatens the sustainability of these policies.},
  keywords = {{H}ealth financing ; health policy ; costs ; evaluation ; exemption ; mechanisms ; developing countries ; policy evaluation ; {BURKINA} {FASO} ; {AFRIQUE} {DE} {L}'{OUEST} ; {PAYS} {EN} {DEVELOPPEMENT}},
  booktitle = {},
  journal = {{H}ealth {P}olicy and {P}lanning},
  volume = {35},
  numero = {7},
  pages = {775--783},
  ISSN = {0268-1080},
  year = {2020},
  DOI = {10.1093/heapol/czaa039},
  URL = {https://www.documentation.ird.fr/hor/fdi:010079912},
}