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Hospital cost differences and payment by results

Published online by Cambridge University Press:  01 October 2007

JAMES M. MALCOMSON*
Affiliation:
University of Oxford, Oxford, UK
*
*Correspondence to: Professor James M. Malcomson, Department of Economics, University of Oxford, Manor Road Building, Manor Road, Oxford OX1 3UQ, UK. Email: [email protected]

Extract

Street and Maynard (2007) argue the case for refining the system of payment by results currently being introduced for English hospitals. On the basis of international experience, they recommend, among other things, moving away from setting prices equal to average cost towards setting them equal to best practice costs, adjusting them for quality and using them to signal what activities are desirable. They also discuss how to control total expenditure for primary care trusts (PCTs) under payment by results and question the merits of extending payment by results to mental health services, ambulances, community services, and long-term conditions, ‘where it is difficult to describe patient care requirements and cost variations may be high’ (p. 9).

Type
Response
Copyright
Copyright © Cambridge University Press 2007

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References

Chalkley, M. and Malcomson, J. M. (1998a), ‘Contracting for health services when patient demand does not reflect quality’, Journal of Health Economics, 17(1):119.CrossRefGoogle Scholar
Chalkley, M. and Malcomson, J. M. (1998b), ‘Contracting for health services with unmonitored quality’, Economic Journal, 108(449):10931110.CrossRefGoogle Scholar
Chalkley, M. and Malcomson, J. M. (2000), ‘Government purchasing of health services’, in Culyer, A. J. and Newhouse, J. P. (eds), Handbook of Health Economics, Vol. 1A, Amsterdam: Elsevier Science, chapter 15, pp. 847–890.Google Scholar
Chalkley, M. and Malcomson, J. M. (2002), ‘Cost sharing in health service provision: an empirical assessment of cost savings’, Journal of Public Economics, 84(2):219249.CrossRefGoogle Scholar
Dusheiko, M., Gravelle, H., Yu, N., and Campbell, S. (2007), ‘The impact of budgets for gatekeeping physicians on patient satisfaction: evidence from fundholding’, Journal of Health Economics, 26(4): 742762.CrossRefGoogle ScholarPubMed
Ellis, R. P. and McGuire, T. G. (1993), ‘Supply-side and demand-side cost sharing in health care’, Journal of Economic Perspectives,7(4):135151.CrossRefGoogle ScholarPubMed
Fuchs, V. R. (1986), The Health Economy, Cambridge, MA: Harvard University Press.Google Scholar
Laffont, J.-J. and Tirole, J. (1993), A Theory of Incentives in Procurement and Regulation, Cambridge, MA: MIT Press.Google Scholar
Malcomson, J. M. (2004), ‘Health service gatekeepers’, RAND Journal of Economics, 35(2):401421.CrossRefGoogle Scholar
Malcomson, J. M. (2005), ‘Supplier discretion over provision: theory and an application to medical care’, RAND Journal of Economics, 36(2):412432.Google Scholar
McClellan, M. (1997), ‘Hospital reimbursement incentives: an empirical analysis’, Journal of Economics and Management Strategy, 6(1):91128.Google Scholar
Newhouse, J.P. (2002), Pricing the Priceless: A Health Care Conundrum, Cambridge, MA: MIT Press.CrossRefGoogle Scholar
Shleifer, A. (1985), ‘A theory of yardstick competition’, RAND Journal of Economics, 16(3): 319327.CrossRefGoogle Scholar
Siciliani, L. (2006), ‘Selection of treatment under prospective payment systems in the hospital sector’, Journal of Health Economics, 25(3):479499.CrossRefGoogle ScholarPubMed
Street, A. and Maynard, A. (2007), ‘Activity based financing in England: the need for continual refinement of payment by results’, Health Economics, Policy and Law, this issue.CrossRefGoogle ScholarPubMed