The Effect of Additional Payment for Health Workers on Case Mix Index in Thailand: Panel Data Analysis

The maldistribution of health resources is a challenging problem for Thailand’s health system. Thus, the application of financial incentives is a choice to get through the situation. This article presents efficiency measuring of financial incentives for health workforce efficiency through the Case Mix Index as a proxy for hospital efficiency. The panel data used in this article included the Case Mix Index and financial incentives paid to health workers at a hospitals during 2009-2014. A fixed effect analysis was adopted in order to control the different hospital service plans’ effects and time variation. Moreover, we separated the study results into two parts. The first focused on allowance paid in fixed monthly amounts by workload criteria. The second part explored the individual effect of each financial incentive program on the Case Mix Index. The result found that the Top-up program, with a fixed monthly amount, could increase the Case Mix Index significantly. The individual program analysis found the non-private practice allowance program and P4P program conducted a critical improvement of the Case Mix Index of the hospital. Keywords: Fixed-Effect Analysis, Additional Health Payment, Health Workforce, Case Mix Index (CMI)