Arguments are being made more frequently to incorporate economic evaluations and quality of life assessments into clinical trials. Using two randomised, multicentre trials of radiotherapy for cancer as an example, this paper outlines: (1) the importance of including such assessments; (2) the...

This paper analyses National Health Service R&D as a Samuelsonian public good. It also identifies other characteristics of NHS R&D: supplier-induced demand; information asymmetries; jointness in production of R&D, medical education and health care; multiplicity in research funding sources;...

Five years after the implementation of the UK health and social care reforms it is still difficult to evaluate objectively their success or failure. It is an opportune time to stand back and assess what were the real objectives of the reforms, and what have been their essential features. The...

An important consideration when establishing priorities in health care is the likely effects that alternative allocations of resources will have on health-related quality of life (HRQoL). This paper reports on the analysis of data from a study which elicited health state valuations (using the...

This paper presents the results of a study of the use by two general practices of the Reflotron dry chemistry analyser. The Reflotron is a desk top system which can perform diagnostic tests using a drop of blood, for components such as haemoglobin, glucose and cholesterol, and produces results...

There is an increasing awareness within the medical profession of the need to include quality of life as well as survival as an outcome measure. This paper reviews some of the evidence which assesses the quality of life of patients with cancer of the head and neck who have undergone surgery or...

Despite considerable progress and achievements in health care over the last century, we still cannot give every ill person as full a treatment as possible. With limited resources, decisions have to be made to determine priorities in the health care system. These decisions should be based on both...

The RAWP formula for the allocation of health care resources between Regional Health Authorities is being revised. It is being suggested that a socio-economic factor should be included as a measure of deprivation as well as the mortality rates. The favoured measure, the Jarman index, is...

This document describes the findings of a statistical analysis of the determinants of utilisation of National Health Service inpatient facilities by small areas in England. It forms part of a study by the University of York commissioned by the NHS Executive. The primary purpose of the study was...

Despite its potentially profound repercussions, the general practitioner fundholding scheme has received relatively little attention from researchers. We provide here a theoretical foundation for empirical studies of fundholding. We begin by reviewing the incentives of the fundholding scheme....