Kizza, Diana;
Mushumbamwiza, Hyacinth;
Ndwandwe, Siyabonga;
Butholenkosi, Moyo;
Hitimana, Regis;
Kirchoffer, Damien;
Houdek, Jason;
... Muvunyi, Zuberi; + view all
(2022)
Financial Implications of Tariffs for Medical Oxygen on Rwandan Public Hospitals' Finance Management During the Coronavirus Epidemic.
Global Health: Science and Practice
, 10
(5)
, Article e2200058. 10.9745/GHSP-D-22-00058.
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Abstract
In Rwanda, provider reimbursements for oxygen are based on the duration of patient consumption at a fixed hourly tariff rate. This study sought to assess whether the current insurance tariff in Rwanda was adequate to cover the costs of oxygen used in oxygen therapy and to explore alternative tariff models.The assessment found that hospitals make a marginal surplus from low volume flow rate patients and incur losses from patients who require high volume flow rates. In high volume nonspecialized hospitals with a large pool of patients consuming medical oxygen, low flow rate usage patients (e.g., neonates) tend to subsidize high flow usage patients (surgery), if the number of patients consuming low flow oxygen is higher than the latter. The study found that the current tariff was sufficient before the exponential surge in demand for high flow usage during the peak of the COVID-19 pandemic. A variable tariff that factors both the duration (hours) and the volume (liters) used during the therapy may require more work but better reflects the cost of consumption in each ward. A case-based payment model provides a standard pricing framework based on the patient's diagnosis, intervention, and intensity of treatment.This study highlights the need for a transition from the time-based tariff structure to a case-based or volume-based tariff to incentivize sustainable production and provision (supply) of medical oxygen services at health facilities in Rwanda. Social health insurance reimbursement tariffs for medical oxygen need to reflect both duration and volume of consumption because oxygen therapy varies based on intervention, disease severity, patient age, length of stay, and responsiveness to treatment.
| Type: | Article |
|---|---|
| Title: | Financial Implications of Tariffs for Medical Oxygen on Rwandan Public Hospitals' Finance Management During the Coronavirus Epidemic |
| Location: | United States |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.9745/GHSP-D-22-00058 |
| Publisher version: | https://doi.org/10.9745/GHSP-D-22-00058 |
| Language: | English |
| Additional information: | © Kizza et al. This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly cited. To view a copy of the license, visit https://creativecommons.org/licenses/by/4.0/. When linking to this article, please use the following permanent link: https:// doi.org/10.9745/GHSP-D-22-00058 |
| Keywords: | Infant, Newborn, Humans, Rwanda, Oxygen, Pandemics, COVID-19, Hospitals, Public |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Primary Care and Population Health |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10158857 |
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