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This book provides a comparative analysis of performance budgeting and financing implementation, and examines failures and successes across both developed and developing countries. Beginning with a review of theoretical research on performance budgeting and financing, the book synthesises the numerous studies on the subject. The book describes the situation in the US, Australia, New Zealand, Germany, Austria and Switzerland, Netherlands and Italy, as well as in seven developing countries - Bulgaria, Czech Republic, Slovakia, Slovenia, Ukraine, Russia and South Africa, at the national, and at the local level. Each chapter provides historical and descriptive details of successful or failed experiments in performance budgeting and performance financing.
Given dramatic changes in Central and Eastern Europe since the fall of the Berlin Wall 1989 and the dissolution of the Soviet Union in 1991, local area experts were challenged to examine their national systems of health care, as well as proposals to reform them. Each chapter of this book provides contextual data and information on the empirical realities of a specific country at five-year intervals since 1990, as well as the organizational framework of its health care system. The book explores the historical thread of the reforms attempted and their current state of implementation by addressing criteria for reforming national health systems such as costs, effectiveness, efficiency, equity, and feasibility. The book stresses selected policy elements, such as the roles of major actors, the shadow economy, cost containment, access, centralization, and decentralization. While no blueprint is offered, intriguing patterns emerge across the cases, plus observations about 'next steps' in the unfolding process of health reforms in the region.
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