التفاصيل البيبلوغرافية
| العنوان: |
Opportunity costs and local health service spending decisions: a qualitative study from Wales. |
| المؤلفون: |
Schaffer, Sarah Karlsberg, Sussex, Jon, Hughes, Dyfrig, Devlin, Nancy, Karlsberg Schaffer, Sarah |
| المصدر: |
BMC Health Services Research; 3/25/2016, Vol. 16, p1-13, 13p, 1 Diagram, 2 Charts |
| مصطلحات موضوعية: |
MEDICAL technology, MEDICAL care costs, MEDICAL care, HEALTH outcome assessment, MEDICAL economics, ECONOMICS, NATIONAL health services, ASSOCIATIONS, institutions, etc., COST effectiveness, GROUP decision making, INTERVIEWING, QUALITY assurance, QUALITATIVE research |
| مصطلحات جغرافية: |
UNITED Kingdom, WALES |
| الشركة/الكيان: |
GREAT Britain. National Health Service |
| مستخلص: |
Background: All health care systems face the need to find the resources to meet new demands such as a new, cost-increasing health technology. In England and Wales, when a health technology is recommended by the National Institute for Health and Care Excellence (NICE), the National Health Service (NHS) is mandated to provide the funding to accommodate it within three months of publication of the recommendation. Identifying what, in practice, is foregone when new cost-increasing technologies are introduced is important for understanding the effects of health technology assessment (HTA) decisions on the NHS or any other health care system. Our objective was to investigate how in practice local NHS commissioners in Wales accommodated financial "shocks" arising from technology appraisals (TAs) issued by NICE and from other cost pressures.Methods: Semi-structured interviews were conducted with Finance Directors and Medical Directors from all seven Local Health Boards (LHBs) in NHS Wales. These interviews covered prioritisation processes, as well as methods of financing NICE TAs and other financial shocks at each LHB. We then undertook a systematic identification of themes and topics from the information recorded. The study relates to the period October 2010 to March 2013.Results: The financial impact of NICE TAs is generally anticipated and planned for in advance and the majority of LHBs have contingency funds available to cope with these and other financial shocks within-period. Efficiency savings (defined as reductions in costs with no assumed reductions in quality) were a source of funds for cost pressures of all kinds. Service displacements were not linkable to particular NICE TAs and there appears to be a general lack of explicit prioritisation activities. The Welsh Government has, on occasion, explicitly or implicitly acted as the funder of last resort.Conclusions: Services may be displaced as part of a response to the cumulative impact of all types of cost pressures, including cost-increasing health technologies recommended by NICE, but such displacements were not direct responses to the publication of individual NICE TAs. The additional cost pressure represented by a new NICE TA is likely to be accommodated at least partly by greater efficiency and increased expenditure rather than displacement of services. [ABSTRACT FROM AUTHOR] |
|
Copyright of BMC Health Services Research is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.) |
| قاعدة البيانات: |
Complementary Index |
Full Text Finder