Objective

To review the concepts, developments and effects of the payment mechanisms used in different countries to propose a payment methodology applicable to hospitals in Bogotá.

Method

Literature review in which essential concepts, developments and effects derived from payment mechanisms used in different countries were analyzed. The authors and various groups and teams of the Bogotá Health Department participated, hospitals, academia and national health authorities held work sessions with the intention of creating a methodological design for a payment scheme that could be applied to the hospitals attached to the health network in Bogotá.

Results

The literature review allowed establishing work axes for a prospective payment scheme per network that included performance bonuses based on the optimization of technical efficiency (provision of health services at lower cost, locative efficiency (optimization of the mix of health services), and on better care outcomes.

Discussion

The proposed payment scheme should be an integrating factor in the patient care process, and should also result in a better operation, service delivery and health care governance, while optimizing the flow of resources and local sustainability.