Skip to main content Accessibility help
×
Home
Hostname: page-component-77ffc5d9c7-kttml Total loading time: 1.119 Render date: 2021-04-23T04:58:43.092Z Has data issue: true Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false, "newCitedByModal": true }

Activity based financing in England: the need for continual refinement of payment by results

Published online by Cambridge University Press:  01 October 2007

ANDREW STREET
Affiliation:
Centre for Health Economics, University of York, York, UK
ALAN MAYNARD
Affiliation:
Department of Health Sciences, University of York, York, UK
Corresponding
E-mail address:

Abstract

The English National Health Service is introducing activity based tariff systems or Payment by Results (PbR) as the basis for hospital funding. The funding arrangements provide incentives for increasing activity, particularly day surgery, and, uniquely, are based on costing data from all hospitals. But prices should not be based on average costs and the potential of PbR to improve the quality of care is yet to be exploited. Without refinement, PbR threatens to undermine expenditure control, to divert resources away from primary care, and to distort needs based funding.

Type
Debate
Copyright
Copyright © Cambridge University Press 2007

Access options

Get access to the full version of this content by using one of the access options below.

References

Appleby, J and Devlin, N. (2005), Measuring NHS Success: Can Patients' Views on Health Outcomes Help to Manage Performance? London: King's Fund.Google Scholar
Carter, G. MNewhouse, J. P. and Relles, D. A. (1990), ‘How much change in the case mix index is DRG creep?’, Journal of Health Economics, 9:499504.CrossRefGoogle Scholar
Centers for Medicare and Medicaid Services (2004), ‘CMS announces guidelines for reporting hospital quality data’, Press Release, 202-690-6145.Google Scholar
CHKS Ltd(2005), ‘The Countess of Chester NHS trust signs up to CHKS' Patient Reported Outcomes Programme’, Press Release 12/11/05, CHKS Ltd, London.Google Scholar
Clews, G. (2006), ‘Destination unknown – which way now for GP referrals?’, Health Service Journal, 25: May, 14–15.Google Scholar
Department of Health (2002), Reforming NHS Financial Flows: Introducing Payment by Results, London: Department of Health.Google Scholar
Department of Health (2004), Sharing the Learning: Demand Management and Controlling Risk, London: Department of Health.Google Scholar
Department of Health (2005a), Health Reform in England: Update and Next Steps, London: Department of Health.Google Scholar
Department of Health (2005b), Measurement of Healthcare Output and Productivity, technical paper 1, London: Department of Health.Google Scholar
Department of Health (2006a), Delivering Quality and Value: Focus on Productivity and Efficiency, London: NHS Institute for Innovation and Improvement.Google Scholar
Department of Health (2006b), Payment by Results Guidance 2007/08, London: Department of Health.Google Scholar
Department of Health (2007a), Choose and Book: GMS Contract Directed Enhanced Service for Choice and Booking FAQs, London: Department of Health.Google Scholar
Department of Health (2007b), Options for the Future of Payment by Results: 2008/09 to 2010/11, London: Department of Health.Google Scholar
Department of Health and Social Security (1976), Priorities in Health and Personal Social Services in England, London: HMSO.Google Scholar
Dredge, B. (2003), ‘Spell it out’, Health Service Journal, 113: 35.Google Scholar
Duckett, S. (1994), ‘Reform of public hospital funding in Victoria’, SydneySchool of Health Services Management, University of New South Wales.Google Scholar
Duckett, S. (2000), ‘Casemix funding for acute hospital inpatient services in Australia’, Medical Journal of Australia, 169: S17S21.Google Scholar
Dusheiko, M., Gravelle, H., Jacobs, R., and Smith, P. (2006), ‘The effect of financial incentives on gatekeeping doctors: evidence from a natural experiment’, Journal of Health Economics,25:449478.CrossRefGoogle Scholar
Ellis, R. P. and McGuire, T. G. (1986), ‘Provider behaviour under prospective reimbursement: cost sharing and supply’, Journal of Health Economics, 5: 129151.CrossRefGoogle Scholar
Fisher, E. S. (2003), ‘Medical care – is more always better?’, New England Journal of Medicine,349:16651667.CrossRefGoogle Scholar
Fisher, E. S., Wennberg, D. E., Stukel, T. E., Gottlieb, D. J., Lucas, F. L., and Pinder, E. L. (2003), ‘The implications of regional variations in medicare spending. Part 2: health outcomes and satisfaction with care’, Annals of Internal Medicine,138:288298.CrossRefGoogle Scholar
Health and Community Services (1994), Casemix Funding for Public Hospitals 1994–95, Victoria, Australia: H&CS Productions Unit.Google Scholar
Healthcare Commission (2007), ‘Annual health check: NHS performance ratings 2005/2006 results’, http://annualhealthcheckratings.healthcarecommission.org.uk/annualhealthcheckratings.cfm accessed 24 April 2007, Healthcare Commission, London.Google Scholar
Hsia, D. C., Ahern, C. A., Ritchie, B. P., Moscoe, L. M., and Krushat, W. M. (1992), ‘Medicare reimbursement accuracy under the prospective payment system, 1985 to 1988’, Journal of the American Medical Association, 268:896899.CrossRefGoogle Scholar
Jackson, T. (2001), ‘Using computerised patient-level costing data for setting DRG weights: the Victorian (Australia) cost weights studies’, Health Policy, 56:149163.CrossRefGoogle Scholar
Kjerstad, E. M. (2003), ‘Prospective funding of general hospitals in Norway – incentives for higher production?’, International Journal of Health Care Finance and Economics, 3:231251.CrossRefGoogle Scholar
Llewellyn, S. and Northcott, D. (2005), ‘The average hospital’, Accounting, Organizations and Society, 30:555583.CrossRefGoogle Scholar
Mannion, R., Marini, G., and Street, A. (2006), ‘Demand management and administrative costs under payment by results’, Health Policy Matters, 12: 18.Google Scholar
National Audit Office (2006), The Provision of Out-Of-Hours Care in England, London: National Audit Office.Google Scholar
Schreyögg, J., Stargardt, T., Tiemann, O., and Busse, R. (2006a), ‘Methods to determine reimbursement rates for diagnosis related groups (DRG): a comparison of nine European countries’, Health Care Management Science, 9:215223.CrossRefGoogle Scholar
Schreyögg, J., Tiemann, O., and Busse, R. (2006b), ‘Cost accounting to determine prices: how well do prices reflect costs in the German DRG-system?’, Health Care Management Science,9:269279.CrossRefGoogle Scholar
Street, A. and Duckett, S. (1996), ‘Are waiting lists inevitable?’, Health Policy, 36:115.CrossRefGoogle Scholar
Vaida, M. L. (1984), ‘The financial impact of prospective payment on hospitals’, Health Affairs,3:112119.CrossRefGoogle Scholar
Wiley, M. (2004), In Activity Based Funding for Hospitals: English Policy, International Experience, Sussex, J. and Street, A. (eds), London: Office of Health Economics.Google Scholar

Altmetric attention score

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 14
Total number of PDF views: 209 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 23rd April 2021. This data will be updated every 24 hours.

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Activity based financing in England: the need for continual refinement of payment by results
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Activity based financing in England: the need for continual refinement of payment by results
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Activity based financing in England: the need for continual refinement of payment by results
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *