The impact of market oriented reforms on choice and information : a case study of cataract surgery in outer London and Stockholm.
In the early 1990s, a set of market-oriented reforms was introduced into health care systems of the UK and Sweden, two exemplary cases of reliance on planned budgeting and integrated provision of services.
In the pursuit of increased efficiency, several County Councils in Sweden have followed the public competition model, while in the UK internal market reforms were introduced.
It was expected that the separation of functions of planners and purchasers from those of providers, which were to be freely chosen by the former, would achieve higher allocative efficiency but also enhance users'satisfaction with care.
This paper uses cataract surgery as a case study to trace the impact of competition among providers on choice and information.
Qualitative research methods were employed to record the perception of changes in their type and amount as it was given to both purchasers and patients.
A set of open ended and standardised questionnaires was designed to elicit the views of all actors involved and to measure the likely transformations.
Four study sites from Outer London were selected representing the diversity of responses, and the only existing large provider of eye services to Stockholm County Council was used.
The analysis of the data showed that the quasi-market reforms have resulted in a change of attitude of providers. (...)
Mots-clés Pascal : Cataracte, Chirurgie, Compétition, Attitude, Choix, Information, Homme, Malade, Suède, Europe, Royaume Uni, Système santé, Oeil pathologie, Cristallin pathologie, Segment antérieur pathologie
Mots-clés Pascal anglais : Cataract, Surgery, Competition, Attitude, Choice, Information, Human, Patient, Sweden, Europe, United Kingdom, Health system, Eye disease, Lens disease, Anterior segment disease
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0253691
Code Inist : 002B09E. Création : 16/11/1999.