Conference
Activity Based Hospital Funding in a Cash-Limited System – Qualitative Analysis of ‘Payment by Results’ in England
- Date:
- 06 Jul 06 - 09 Jul 06
- Venue:
- Budapest, Hungary, 6-9 July 2006
- Host:
- The European Conference on Health Economics
- Speakers:
- Jon Sussex
- Outline
- Jon Sussex gave the above presentation, co-authored with Shelley Farrar of Aberdeen University, and produced as part of the National Evaluation of ‘Payment by Results’. The audience was international, primarily health economists. (This is a high prestige, once-every-2-years academic conference).....
- Full Description
- Aims:
‘Payment by Results’ (PbR) is a major change in the system of funding hospitals in the National Health Service in England, whereby hospitals are remunerated according to the type and volume of activity they undertake. The aim of the research reported here, which is part of the national evaluation funded by the Department of Health, is to examine the process of implementing PbR and analyse its effects on local health economies. PbR is intended to incentivise the system to meet specific policy objectives and is likely to have perverse as well as intended effects.
Methods and Data:
Interview-based, qualitative analysis. A purposive sample of senior local NHS managers was contacted and interviewed confidentially. Interviewees were from Foundation and non-Foundation NHS Hospital Trusts, Primary Care Trusts and Strategic Health Authorities. Semi-structured interviews sought managers’ knowledge and expectations about the impact of PbR.
Results and Conclusions:
The interviews raised many interesting issues – some confirming, but others contrasting with, theoretical hypotheses as to the incentive effects of PbR and its impacts on hospital activity, efficiency and competition. The quantitative element of the evaluation will be used to test the robustness of these initial findings, some of which will be returned to in future rounds of qualitative analysis.