Evaluation of total purchasing pilots in England and Scotland and implications for primary care groups in England : personal interviews and analysis of routine data.
To evaluate the reported achievements of the 52 first wave total purchasing pilot schemes in 1996-7 and the factors associated with these ; and to consider the implications of these findings for the development of the proposed primary care groups.
Face to face interviews with lead general practitioners, project managers, and health authority representatives responsible for each pilot ; and analysis of hospital episode statistics.
England and Scotland for evaluation of pilots ; England only for consideration of implications for primary care groups.
Main outcome measures
The ability of total purchasers to achieve their own objectives and their ability specifically to achieve objectives in the service areas beyond fundholding included in total purchasing.
The level of achievement between pilots varied widely.
Achievement was more likely to be reported in primary than in secondary care.
Reported achievements in reducing length of stay and emergency admissions were corroborated by analysis of hospital episode statistics.
Single practice and small multipractice pilots were more likely than large multipractice projects to report achieving their objectives.
Achievements were also associated with higher direct management costs per head and the ability to undertake independent contracting.
Large multipractice pilots required considerable organisational development before progress could be made. (...)
Mots-clés Pascal : Soin santé primaire, Homme, Angleterre, Grande Bretagne, Royaume Uni, Europe, Ecosse, Programme scientifique, Réussite, Gestion hospitalière, Budget, Développement
Mots-clés Pascal anglais : Primary health care, Human, England, Great Britain, United Kingdom, Europe, Scotland, Scientific program, Achievement, Hospital management, Budget, Development
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0376192
Code Inist : 002B30A04B. Création : 25/01/1999.