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...

We assess the impact of the English version of prospective payment, termed Payment by Results (PbR), on hospital quality, as measured by in-hospital mortality and 28-day emergency readmission. To do this, we exploit the phased introduction of PbR across hospitals and across three treatments (hip...

Productivity is one of the key measures against which NHS achievements can be judged and is the focus of this report. We update our previous analyses of NHS productivity growth since 2004/05, focussing on the change in NHS productivity between 2011/12 and 2012/13, the latter financial year being...

The use of casemix-based funding mechanisms is increasing internationally. This funding approach potentially offers incentives for a range of diverse objectives, including improvements in efficiency, quality of care and patient choice. However, to date, the application of this approach to mental...

The aim of this 6-month project was to undertake a scoping study to provide recommendations for identifying NICE’s methodological research priorities and to establish an initial set of such priorities. Specifically the project had three main objectives: (i) To describe current processes by...

The Medical Manpower Standing Advisory Committee made its first report, “Planning the Medical Workforce”, to the Secretary of State in December 1992; recommending that research should be undertaken to quantify the manpower effects of skill mix initiatives. These issues are being raised against a...

Skill mix emerged as a prominent issue in nursing at a time when a new environment, imbued with management values, was forged within the NHS. The issues surrounding skill mix are often highly contentious and, not surprisingly, various interest groups either welcome or reject attempts to examine...

The demand for private health insurance in the UK has risen rapidly in the last decade. The paper discusses the nature of the demand for private health insurance in a health care market dominated by a public supplier, in which the consumer may neither opt out of his contribution to the National...

Is the value of being healthy the same across all ages? The standard practice of economic evaluation assumes so, and does not discriminate between a QALY (Quality Adjusted Life Year) to an elderly person and one to a child. But on the other hand, it is possible to assume that the value of a...