Health System Funding

This Hot Topic is Health System Funding.

This topic is a compliment to the upcoming Centre for Health Care Management (CHCM) seminar on Health Care Funding Policy in Canada. The seminar will be led by Dr. Jason Sutherland of the UBC Centre for Health Services and Policy Research (CHSPR). To learn more or register for the seminar, visit .

The READ Portal has a number of valuable articles relating to Health System Funding. In order to learn more, visit the economics tag or the heath care costs tag.

Additionally, the following list of resources chosen by Dr. Sutherland and the READ librarian will provide excellent background reading on the topic. While most articles are freely available online, some require a subscription for access. Please contact your institution’s librarian for full-text versions.

  • Canadian Institute of Health Information. (2001). Acute care in Canada. Ottawa, ON: McKillop, I., Pink, G.H., & Johnson, L.M. Available at
    This study provides a comprehensive inventory of practices related to the management of the financial resources dedicated primarily to hospital- delivered acute care in Canada for the fiscal year April 1, 2000 through March 31, 2001.
  • Busse, R., Schreyogg, J., & Smith, P.C. Editorial: Hospital case payment systems in Europe. Health Care Management Science, 9: 211-213. Available at
    This article examines the issues associated with case payment mechanisms in a hospital setting.
  • Canadian Health Services Research Foundation. (2011). Hospital payment mechanisms: An overview and options for Canada. Ottawa, ON: Sutherland, J.M. Available at
    This report looks at the changing nature of costs to Canada’s health system and presents an alternative hospital funding model.
  • Street, A., & Maynard, A. (2007). Activity based financing in England: the need for continual refinement of payment by results. Health Economics, Policy and Law, 2:419-427. Available at
    This paper reviews the English National Health Services introduction of activity based tariff systems or Payment by Results (PbR) as the basis for hospital funding.
  • Farrar, S., Yi, D., Sutton, M., Chalkley, M., Sussex, J. & Scott, A. (2009). Has payment by results affected the way that English hospitals provide care? Difference-in-differences analysis. British Medical Journal, 339. Available at
    This article examines whether the introduction of payment by results (a fixed tariff case mix based payment system) was associated with changes in key outcome variables measuring volume, cost, and quality of care between 2003/4 and 2005/6.
  • Buntin, M., Colla, C. & Escarce, J. (2009). Effects of payment changes on trends in post-acute care. Health Services Research, 44(4):1188-1210. Available at
    This report focuses specifically on how the implementation of new Medicare post-acute payment systems has affected the use of inpatient rehabilitation facilities, skilled nursing facilities, and home health care.
  • Mor, V., Intrator, O., Feng, Z. & Grabowski, D.C. (2010). The revolving door of rehospitalization from skilled nursing facilities. Health Affairs, 29(1):57-64. Available at
    This article advises revising incentives to Medicare in order to achieve major savings for providers and improve quality of life for beneficiaries.
  • Canadian Health Services Research Foundation (CHSRF). (2011). Exploring alternate level of care (ALC) and the role of funding policies: An evolving evidence based for Canada. CHSRF Series of Reports on Cost Drivers and Health System Efficiency, Paper 8. Ottawa, ON: Sutherland, Jason M. and Crump, R.T.
  • Canadian Health Services Research Foundation (CHSRF). (2011). CHSRF Series of Reports on Financing Models: Paper 3. Deber, R.B.
    This synthesis is the third of a series of papers being produced by the Canadian Health Services Research Foundation on the topic of healthcare financing models.
  • Tuohy, C.H. (2009). Single payers, multiple systems: the scope and limits of subnational variation under a Federal health policy framework. Journal of Health Politics, Policy and Law, 34(4):453-96.
    This article provides a definitive overview of single-payer healthcare systems, with a specific focus on experiences within a Canadian context.
  • Flood, C.M., & Thomas, B. (2010). Blurring of the public/private divide: the Canadian chapter. European Journal of Health Law, 17(3):257-78.
    This article presents an overview of the changing boundaries between public and private health systems in Canada, and how these changes can impact Canadians.

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