This article considers how the 'accidental logics' of political settlements for the English National Health Service (NHS) and the Medicare and Medicaid programmes in the United States have resulted in different institutional arrangements and different implicit social contracts for rationing,...

The aim of cost effectiveness analysis (CEA) is to inform the allocation of scarce resources. CEA is routinely used in assessing the cost-effectiveness of specific health technologies by agencies such as the National Institute for Health and Clinical Excellence (NICE) in England and Wales. But...

Objective:- To compare the performance of two new approaches to risk adjustment that are free of the influence of observational intensity with methods that depend on diagnoses listed in administrative databases. Setting:- Administrative data from the US Medicare program for services provided in...

Since devolution in 1998, it has become more difficult to collect comparable data across the four UK countries, particularly on NHS expenditure and waiting times. - NHS activity and health outcomes seem more dependent on how healthcare resources are deployed than higher levels of resources. -...

Purpose: Although information on variations in health service performance is now more widely available, relatively little is known about how healthcare payers use this information to improve resource allocation. We explore to what extent and how Primary Care Trusts (PCTs) in England have used...

Australian environments and natural resources have changed substantially since the Society was founded in 1957, partly as a result of changes to the economy, society, technology, and global conditions. This paper documents changes in the stock and condition of Australia’s environment and...