No-show fees for non-attending patients

• Abstract
• Purpose of health policy or idea
• Characteristics of this policy
• Political and economic background
• Purpose and process analysis
• Expected outcome
• References

Abstract

The central government is in the process of introducing a new policy which enables the hospitals to allocate fines to those patients who did not show for their appointments. The purpose of this policy is to reduce patients? non-attendance rate for ambulatory appointments and appointments for operation. The policy proposal allows hospitals to charge non-attending patients a fine which should influence the patients? financial incentive to miss an appointment.

Purpose of health policy or idea

The central government is in the process of introducing a new policy which enables the hospitals to allocate fines to those patients who did not show for their appointments. The purpose of this policy is to reduce patients' non-attendance rate for ambulatory appointments and appointments for operation. The policy proposal allows hospitals to charge non-attending patients a fine which should influence the patients' financial incentive to miss an appointment.

Groups affected

Hospitals, Patients

Innovationsgrad	traditionell		innovativ
Kontroversität	unumstritten		kontrovers
Strukturelle Wirkung	marginal		fundamental
Medienpräsenz	sehr gering		sehr hoch
Übertragbarkeit	sehr systemabhängig		systemneutral

Political and economic background

The central government has introduced a series of policy suggestions. The suggestion to enable hospitals to fine non-attending patients is part  of a broader policy which enables public service produces to fine user for misuse (parents picking their children to late etc.).

Change based on an overall national health policy statement

Purpose and process analysis

Current Process Stages

	Idee	Pilotprojekt	Strategiepapier	Gesetzgebung	Umsetzung	Evaluation	Veränderung/Richtungswechsel
Implemented in this survey?

Origins of health policy idea

The idea to fine non-attending patients has been discussed for some time. The possibility to fine misuse has been piloted in kindergarten but has not been used in hospitals. The policy proposal is the culmination of an ongoing debate about the size of waiting lists, efficiency of hospital services and patients' non-attendance. The policy proposal is innovative in the Danish context.

Stakeholder positions

The proposal to fine non-attending patients is suggested by the central government. The counties who own, manage and finance the hospitals do not support the policy suggestion mainly because of potential bureaucratic problems. Hospitals do not have an administrative apparatus to handle fines and this will in it self increase the administrative burden. Secondly, the counties foresee a number of unsolved issues about the patients' rights and about the practical management of a fine system. Thirdly, the Association of Counties does not believe that fines only have marginal influence on the non-attendance rate.

Influences in policy making and legislation

The policy suggestion is planned to be presented late spring 2004 as legislation proposal.

Legislative outcome

n/a

Adoption and implementation

The counties' negative commentary to the policy may not influence the legislation process but will undoubtedly influence the implementation of the policy because they own and manage the hospitals.

Monitoring and evaluation

No evaluation is available and no system to monitor non-attendance rates is implemented systematically at this stage.

Expected outcome

Impact of this policy

Qualität	kaum Einfluss		starker Einfluss
Gerechtigkeit	System weniger gerecht		System gerechter
Kosteneffizienz	sehr gering		sehr hoch

References

Author/s and/or contributors to this survey

Mickael Bech

Empfohlene Zitierweise für diesen Online-Artikel:

Mickael Bech. "No-show fees for non-attending patients". Health Policy Monitor, 01/04/04. Available at http://www.hpm.org/survey/dk/a3/6