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Biomedical subjects

C Ham

Publications and source records attributed to C Ham.

At least 37 records · Page 2Linked to original sources
PubMed1997

Priority setting in health care: learning from international experience.

Priority setting in health care is not new but it is an issue of growing importance. In publicly financed health care systems, the combination of constrained resources and increasing demands has led policy makers to address this issue more directly than in the past. This is exemplified by experience in Oregon, the Netherlands, New Zealand, Sweden and the UK. In each of these systems, policy makers have taken the initiative to set priorities on a more explicit basis. This paper compares and contrasts experience in these systems and identifies a number of emerging themes. The work done so far can be likened to an exercise in policy learning in which policy makers have tried out a range of approaches and have adjusted course several times in the process. Priority setting is not amenable to once and for all solutions and the issues involved must be kept under continuous review.

Advisory Committees↗
PubMed1996

Managed markets in health care: the UK experiment.

The reforms to the United Kingdom national health service initiated in 1989 have unlocked established relationships. Health care providers have come under challenge from an alliance of purchasers and general practitioners. This is resulting in a major rationalisation of acute hospital services in cities such as London. The general practitioner fundholding scheme appears to have produced benefits for patients, although its impact in the longer term remains uncertain. The combination of population based and patient focused models of purchasing within the reforms has created competition between purchasers as well as providers. This has served as a stimulus to purchasers to act as effective agents for patients but it also creates a risk of fragmentation. This paper analyses these developments and draws out their implications for the future of the National Health Service.

Contract Services↗
PubMed1996

Population-centered and patient-focused purchasing: the U.K. experience.

A critical feature of the reforms to the National Health Service (NHS) in the United Kingdom is the separation of responsibility for purchasing and providing health care. In the new structure, health authorities purchase care from a population perspective, and general practitioner fundholders undertake patient-focused purchasing. The evidence suggests that each approach has distinctive advantages. There is, however, a risk of fragmentation if the decisions of the different types of purchaser are not coordinated. This risk is compounded by the emergence of hybrid models combining aspects of population-centered and patient-focused purchasing. The separation of purchasing from providing has changed the balance of power within the NHS, although whether the benefits of the new system outweigh the costs is a matter of continuing debate.

Contract Services↗