Reflections on the Management of the National Health Service: An American Looks at Incentives to Efficiency in Health Services Management in the UKThe nhs is caught in a 'gridlock' of forces that make change ex- ceedingly difficult to bring about. Public policy should seek to cre- ate an environment for the nhs that is hospitable to quality- impro- ving and efficiency-improving change. Opportunities for constructive change should be nurtured, not politicized or otherwise abused. The nhs runs on the ability and dedication of the many people who work in it. But its structure contains no serious incentives to guide the nhs in the direction of better quality care and service at reduced cost. In fact, the strucutre of the nhs contains perverse incentives. The nhs could benefit from making much greater use of demonstration pro- jects. |
Contents
Introduction and disclaimers | 5 |
Incentives and economic efficiency 13 39 | 13 |
Griffiths | 19 |
Copyright | |
3 other sections not shown
Common terms and phrases
ANGE ANGELES THE LIBRARY ANGELES THE UNIVERSITY ANGELEST benefit British BUPA buy services CALIFORN LOS ANGELES CALIFORN THE UNIVERSITY CALIFORNIA capita spending cent clinical budgeting competing HMO model Competitive tendering computed tomography consultants contracts cost cost-conscious create develop DHSS District Management doctors economic effective efficiency efficiency-improving changes experience fee-for-service gridlock group practice HE-LIBRARY Health Authorities Health Care Financing health care services health insurance Health Maintenance Organization health services management hip replacement idea improve increase innovation inpatient interest internal market model leadership Medicare medicine National Health Service NHS Management Inquiry Nuffield Provincial Hospitals OF-CALIFORN perverse incentives pilot Districts political population Preferred Provider Insurance pressure primary care physician private sector problem Provincial Hospitals Trust randomized controlled trial RAWP formula recommend reduced referrals Regional responsible reward scheme specialty subscribers suppliers surgery UNIVERS UNIVERSIT UNIVERSITY LOS ANGELES waiting lists டி