Critical leg ischaemia can be treated by amputation of the affected leg or by reconstruction of the arteries. Arterial reconstruction is perceived to be an expensive procedure, often requiring more than one operation, which does not always prevent amputation. However, amputation is associated...

The objective of this paper is to examine the impact of economic evaluation on the reimbursement process for pharmaceuticals. Before the introduction of economic evaluation, a range of arrangements existed across different jurisdictions, varying from reimbursement based on clinical criteria...

The English NHS has introduced a system of budgets for general practices covering hospital expenditure for the patients on their lists. We model individual expenditure using diagnostic information from previous hospital spells, plus a large set of attributed variables measuring population,...

We examine whether a hospitals quality is affected by the quality provided by other hospitals in the same market. We first set out a theoretical model with regulated prices which specifies conditions on demand and cost functions which determine whether a hospital will have higher quality when...

Patient-reported outcome measures (PROMs) are now routinely collected in the English National Health Service (NHS) and used to compare and reward hospital performance within a high-powered pay-for-performance scheme. However, PROMs are prone to missing data. For example, hospitals often fail to...

A study by health economists at the University of York has, for the first time, produced an estimate of the impact on other NHS patients of new and more costly drugs and other treatments. This research suggests a refinement of the way the National Institute for Health and Clinical Excellence...

Healthcare systems in low- and middle-income countries face considerable population healthcare needs with markedly fewer resources than those in higher income countries. The way in which available resources are allocated across competing priorities has a profound effect on how much health is...

Objectives: Network meta-analysis (NMA) methods extend the standard pair-wise framework to allow simultaneous comparison of multiple interventions in a single statistical model. Despite published work on NMA mainly focussing on the synthesis of aggregate data (AD), methods have been developed...

We examine how public sector third-party purchasers and hospitals negotiate quality targets when a fixed proportion of hospital revenue is required to be linked to quality. We develop a bargaining model linking the number of quality targets to purchaser and hospital characteristics. Using data...

Hospital bed blocking occurs when hospital patients are ready to be discharged to a nursing home but no place is available, so that hospital care acts as a more costly substitute for long-term care. We investigate the extent to which higher supply of nursing home beds or lower prices can reduce...