In April 2003 a new payment system for hospitals called Payment by Results (PbR) was introduced in England. The new system is a fixed tariff case-mix based prospective payment system which reimburses hospitals for the type and amount of care they provide. By linking provider income more closely...

Expenditure on medicines is a readily identifiable element of health service costs. As such, it is the focus of much attention by payers, not least in the UK despite the fact that the ex-manufacturer cost of medicines represents less than 10% of total UK National Health Service (NHS)...

Objectives: The objectives of this research were to identify the cost-effectiveness of health care services at the margin in the Scottish NHS; consider the extent to which the thresholds observed in Scottish NHS decision making are consistent with the threshold being used to make judgements...

Expenditure on medicines is a readily identifiable element of health service costs. As such, it is the focus of much attention by payers, not least in the UK despite the fact that the ex-manufacturer cost of medicines represents less than 10% of total UK National Health Service (NHS)...

Most health care systems could improve their efficiency in using physical capital - buildings and equipment. Health care systems in which assets are provided by governments or donated by aid organizations generally have only weak incentives for those assets to be used efficiently. Wrongly...

The objective of this briefing is to summarise concisely the evidence on incentives that encourage providers of health care to follow guidance on best practice, particularly where that guidance requires the use of specific medicines or other health technologies. We define incentives broadly, to...

Competition is firmly established as a tool of public policy in England and is being accorded a growing role within health care. Since 2002 competition has become an actively promoted tool of government health care policy in England, particularly for the provision of hospital care to publicly...

There has been long-standing interest in the use of incentives to encourage delivery of high-quality health care services at the lowest feasible cost. Although it is clear that health care professionals have intrinsic incentives to deliver high-quality care to patients, there are significant...

Background: It is often assumed that the objective of health care is to maximise health using available resources. This is the principle underpinning NICE's use of cost effectiveness analysis based on incremental cost per QALY gained. Yet research on local NHS decision making shows that cost per...