Publications
310 results found
Smith P, Häkkinen U, 2007, Information strategies for decentralization, Decentralization in health care: strategies and outcomes, Editors: Saltman, Bankauskaite, Vrangbæk, Publisher: Open Univ Pr, ISBN: 9780335219254
..This text explores the capacity and impact of decentralization within European health care systems.
Smith P, 2007, Public packages of health care alongside voluntary insurance, Private voluntary health insurance in development: friend or foe?, Editors: Preker, Scheffler, Bassett, Publisher: World Bank Publications, ISBN: 9780821366196
This volume is the third in a series of in-depth reviews of the role of health care financing in providing access for low-income populations to needed health ...
Smith PC, Street A, 2007, The measurement of non-market output in education and health, Economic and Labour Market Review, Vol: 1, Pages: 46-52, ISSN: 1751-8326
Smith PC, 2006, Formula funding of public services, Publisher: Taylor & Francis, ISBN: 9780415362894
The purpose of this book is to fill that gap.
Jacobs R, Martin S, Goddard M, et al., 2006, Exploring the determinants of NHS performance ratings: lessons for performance assessment systems., J Health Serv Res Policy, Vol: 11, Pages: 211-217, ISSN: 1355-8196
OBJECTIVES: A basic tenet of effective performance management is that decision makers should be held responsible only for aspects of performance over which they have control. We examine the degree to which variations in the performance of health care organizations are explained by a range of factors that are subject to differing degrees of managerial control. METHODS: We use multiple regression methods and data on 304 National Health Service (NHS) Primary Care Trusts (PCTs) in England for 2002/03 to analyse the relationship between their performance, as measured by 'star ratings' and nine key performance targets, and a large number of explanatory variables. We classify the explanatory variables into five groups along a spectrum from 'no managerial control' to 'total managerial control'. We also analyse the relationship between PCTs that are service purchasers and their main providers to assess the degree to which their performance is linked. RESULTS: For all of the key performance targets, most of the variation in performance is unexplained, although variables in groups 1, 2 and 3 (less managerial control) explain the largest proportion of variation. We find some evidence that socioeconomic and geographic factors have an impact on performance. We also find a positive relationship between the performances of purchaser and provider organizations. CONCLUSIONS: The star ratings did not allow for the different environmental circumstances within which PCTs operate and which affect their performance. Policy-makers should exercise caution in using such performance indicators to regulate health care organizations.
Busse R, Schreyögg J, Smith PC, 2006, Hospital case payment systems in Europe., Health Care Manag Sci, Vol: 9, Pages: 211-213, ISSN: 1386-9620
Since the introduction of the system of diagnosis related groups (DRGs) for USA Medicare patients in 1983, case payment mechanisms have gradually become the principal means of reimbursing hospitals in most developed countries. The use of case payments nevertheless poses severe technical and policy challenges, and there remain many unresolved issues in their implementation. This paper introduces a special issue of the journal that describes and compares experience with the use of case payments for reimbursing hospitals in nine European countries. The editorial sets the policy scene, and argues that DRG systems must be seen both as a technical reimbursement method and as a fundamental incentive mechanism within the health system.
Dawson D, Jacobs R, Martin S, et al., 2006, The impact of patient choice and waiting time on the demand for health care: results from the London Patient Choice project, APPLIED ECONOMICS, Vol: 38, Pages: 1363-1370, ISSN: 0003-6846
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- Citations: 5
Jacobs R, Goddard M, Smith P, 2006, Public services: are composite measures a robust reflection of performance in the public sector?
A composite indicator is an aggregated index comprising individual performance indicators.Composite indicators integrate a large amount of information in a format that is easilyunderstood and are therefore a valuable tool for conveying a summary assessment ofperformance in priority areas.This research investigates the degree to which composite measures are an appropriatemetric for evaluating performance in the public sector. Do they reflect accurately theperformance of organisations? To what degree are they influenced by the uncertaintysurrounding underlying indicators on which they are based? Are they robust and stable overtime? The construction of composite measures creates specific methodological challengesthat make such questions especially pertinent. We address these through a series ofquantitative analyses of panel data relating to healthcare (Star ratings of NHS acute Trusts)and local government (Comprehensive Performance Assessment (CPA) ratings of authorities)in England where composites have been widely used.The creation of a composite comprises a number of important steps, each of which requirescareful judgement. These include the specification of the choice of indicators, thetransformation of measured performance on individual indicators, the specification of a set ofweights on individual indicators, and combining the indicators using aggregation methods ordecision rules. We use Monte Carlo simulations to examine the robustness of performancejudgements to these different technical choices. We show the extent to which compositesprovide stable performance rankings of organisations over time and assess whethervariations are due to genuine performance improvement or merely the result of randomstatistical variation.The analysis suggests that the judgements that have to be made in the construction of thecomposite can have a significant impact on the resulting score. Technical and analyticalissues in the design of composite indicators have important policy impli
Mason A, Smith PC, 2006, Le système de santé anglais : régulation et rapports entre les différents acteurs, Revue française des affaires sociales, Pages: 265-284, ISSN: 0035-2985
<jats:p>Résumé Cet article porte sur la régulation financière du système de santé en Angleterre. Après un rapide historique, il présente la structure institutionnelle actuelle avant de s’intéresser aux instruments de régulation et à l’organisation financière du système. Pour conclure, il propose une analyse critique de certaines des réformes en cours, en soulignant que l’Angleterre peut être une source d’inspiration pour d’autres pays cherchant à réformer leur système de santé. Toutefois, le système de santé anglais traverse actuellement une période de fortes turbulences, de nombreux éléments de son mode de financement étant en cours de redéfinition. Ces transformations rendant l’évaluation de l’impact des réformes difficile, nombre des conclusions présentées ont inévitablement un caractère hypothétique.</jats:p>
Dusheiko M, Gravelle H, Jacobs R, et al., 2006, The effect of financial incentives on gatekeeping doctors: Evidence from a natural experiment, JOURNAL OF HEALTH ECONOMICS, Vol: 25, Pages: 449-478, ISSN: 0167-6296
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- Citations: 70
English M, Lanata CF, Ngugi I, et al., 2006, The district hospital, Disease control priorities in developing countries, Editors: Jamison, Publisher: Oxford University Press, USA, ISBN: 9780821361795
A decade after publication of the first edition, the World Bank, the World HealthOrganization, and the Fogarty International Center of the U.S. National ...
Jacobs R, Smith PC, Street A, 2006, Measuring efficiency in health care: Analytic techniques and health policy, ISBN: 9780521851442
With the healthcare sector accounting for a sizeable proportion of national expenditures, the pursuit of efficiency has become a central objective of policymakers within most health systems. However, the analysis and measurement of efficiency is a complex undertaking, not least due to the multiple objectives of health care organizations and the many gaps in information systems. In response to this complexity, research in organizational efficiency analysis has flourished. This 2006 book examines some of the most important techniques currently available to measure the efficiency of systems and organizations, including data envelopment analysis and stochastic frontier analysis, and also presents some promising new methodological approaches. Such techniques offer the prospect of many new and fruitful insights into health care performance. Nevertheless, they also pose many practical and methodological challenges. This is an important critical assessment of the strengths and limitations of efficiency analysis applied to health and health care.
Goddard M, Hauck K, Smith PC, 2006, Priority setting in health - a political economy perspective., Health economics, policy, and law, Vol: 1, Pages: 79-90
Most countries face high demands on their health care systems and have limited resources with which to meet them. Priority setting seeks to address these problems by proposing rules to decide which groups of patients or disease areas should secure favoured access to limited health care resources. The economic approach towards priority setting, particularly in the form of cost-effectiveness analysis, is commonly advocated. However, despite many decades of refinement of the technical and methodological issues arising from the use of economic evaluation in priority setting, decision makers continue to diverge frequently from the principles of economic evaluation. Our approach in this paper is to highlight the potential contribution of models of political economy to understanding what constitutes rational behaviour when agents operate within political and institutional constraints. We argue that there may be potentially greater benefits to be gained from exploration and analysis of priority setting using models based on concepts such as median voter and competing interest groups, than from further efforts to refine the techniques of economic evaluation.
Smith P, Street A, 2006, Measurement of Non-Market Output in Education and Health
In recent years considerable progress has been made in developing improved methodologies tomeasure non-market output in the National Accounts. Most EU Member States have supported theintroduction of a legal framework to implement these methodologies and have introduced current bestpractice methods to measure output of health and education services. This report summarisescontributions at a Workshop held in October 2006 that focussed on building on this foundation andfurther improving the measurement of non-market output in the National Accounts. The Workshopsupports a project intended to provide detailed international guidelines for the further development ofvolume measures of non-market outputs, in particular for education and health.
Jacobs R, Smith PC, Street A, 2006, A comparison of SFA and DEA, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 151-166
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- Citations: 3
Smith PC, Street A, 2006, Concepts and challenges in measuring the performance of health care organizations, ELGAR COMPANION TO HEALTH ECONOMICS, Editors: Jones, Publisher: EDWARD ELGAR PUBLISHING LTD, Pages: 317-325
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- Citations: 9
Jacobs R, Smith PC, Street A, 2006, Efficiency in health care, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 1-15
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- Citations: 3
Jacobs R, Smith PC, Street A, 2006, The components of an efficiency model, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 17-39
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- Citations: 1
Jacobs R, Smith PC, Street A, 2006, Measuring Efficiency in Health Care Analytic Techniques and Health Policy <i>Conclusions</i>, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 207-214
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- Citations: 1
Jacobs R, Smith PC, Street A, 2006, Data description, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 215-218
Jacobs R, Smith PC, Street A, 2006, Some alternative approaches to measuring performance, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 179-205
Jacobs R, Smith PC, Street A, 2006, Measuring Efficiency in Health Care Analytic Techniques and Health Policy <i>Preface</i>, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: XIII-+
Jacobs R, Smith PC, Street A, 2006, Stochastic frontier analysis of panel data, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 69-90
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- Citations: 1
Jacobs R, Smith PC, Street A, 2006, Stochastic frontier analysis of cross-sectional data, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 41-68
Jacobs R, Smith PC, Street A, 2006, Data envelopment analysis, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 91-128
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- Citations: 5
Jacobs R, Smith PC, Street A, 2006, Unresolved issues and challenges in efficiency measurement, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 167-178
Jacobs R, Smith PC, Street A, 2006, The Malmquist index, MEASURING EFFICIENCY IN HEALTH CARE: ANALYTIC TECHNIQUES AND HEALTH POLICY, Publisher: CAMBRIDGE UNIV PRESS, Pages: 129-150
Goddard M, Hauck K, Smith PC, 2006, Priority setting in health-a political economy perspective, Health Economics, Policy and Law, Vol: 1, Pages: 79-90, ISSN: 1744-1331
Most countries face high demands on their health care systems and have limited resources with which to meet them. Priority setting seeks to address these problems by proposing rules to decide which groups of patients or disease areas should secure favoured access to limited health care resources. The economic approach towards priority setting, particularly in the form of cost-effectiveness analysis, is commonly advocated. However, despite many decades of refinement of the technical and methodological issues arising from the use of economic evaluation in priority setting, decision makers continue to diverge frequently from the principles of economic evaluation. Our approach in this paper is to highlight the potential contribution of models of political economy to understanding what constitutes rational behaviour when agents operate within political and institutional constraints. We argue that there may be potentially greater benefits to be gained from exploration and analysis of priority setting using models based on concepts such as median voter and competing interest groups, than from further efforts to refine the techniques of economic evaluation.(Published Online December 2 2005)
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