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Introduction of User Fees

A Viable Means of Health Care Financing?

M. Kamrul Ahsan is Senior Lecturer, Department of Management, AUT School of Business, Auckland University of Technology, Private Bag 92006, New Zealand, E-mail: kamrul.ahsan{at}aut.ac.nz

Jan Bartlema

Jan Bartlema is Honorary Senior Lecturer, Centre for Population Studies, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK. E-mail: bartlema{at}xs4all.nl

One of the priorities of the Bangladesh Health and Family Planning Programme is to focus on a cost recovery policy by the introduction of user fees to improve quality and financial sustainability. To assist the policy we propose an operations research-based cost recovery model to find the best ‘service mix’ from outdoor, indoor, emergency and diagnostic services for sub-district-level health facilities. The model considers budget, patient flow patterns, resource availability, service demand and equity principal constraints. The study offers proposals to assist the decision-making process for the introduction of a user fee and considers how much to charge, which services to start with, and which to include later.

Journal of Health Management, Vol. 10, No. 1, 87-100 (2008)
DOI: 10.1177/097206340701000105


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