What are the Benefits and Limits of Outcome-based Financing and Social. Impact Bonds in the Field of Health Promotion and Disease Prevention?

Absztrakt (kivonat)

The prevalence of non-communicable diseases, the ageing population, and the increasing need for robust healthcare governance after the pandemic all lead to the importance of health promotion and disease prevention. Fiscal space for OECD countries is shrinking, making even scarcer the resources available for health promotion and disease prevention, an area that receives insufficient policy attention regardless of countries' fiscal status. A novel financing model could mitigate the issue of lacking investments in the public health field. In this paper, the viability, feasibility, advantages, and disadvantages of outcome-based contracting and social impact bonds will be examined rigorously. The methodology of this thesis involved a quantitative research approach, combining a systematic literature search and expert interviews to comprehensively evaluate the effectiveness of social impact bonds in health prevention. The literature review aimed to collate and synthesize existing research findings, providing a broad understanding of the topic, while the interviews with social investing experts and investors offered in-depth insights into practical experiences and opinions on SIBs. This dual approach enabled a balanced examination of both the theoretical framework and real-world application of SIBs, ensuring a robust analysis of their potential advantages and limitations in the context of public health. Together with the thematic analysis of the interviews and the key findings from the white and grey literature this paper collects and organizes in which areas and cases outcome-based financing can work best and the never realized benefits of this financing model. The study suggests that outcome-based financing may not be the most optimal instrument to address the lack of resources for health prevention programmes.