Publications
311 results found
Smith P, 2002, Measuring up - Improving health system performance in OECD counries - Editor's preface, Conference on Measuring Up - Improving Health System Performance in OECD Countries, Publisher: ORGANIZATION ECONOMIC COOPERATION & DEVELOPMENT, Pages: 7-9
Smith PC, Chesher A, Foreman-Peck J, et al., 2002, How not to measure the efficiency of public services (and how one might) -: Discussion on the paper by Stone, JOURNAL OF THE ROYAL STATISTICAL SOCIETY SERIES A-STATISTICS IN SOCIETY, Vol: 165, Pages: 422-434, ISSN: 0964-1998
Smith PC, 2002, Measuring health system performance., Eur J Health Econ, Vol: 3, Pages: 145-148, ISSN: 1618-7598
The improvement of health system performance has become a key policy issue in most developed nations. To that end, many initiatives to measure system performance are being put in place. This paper examines the performance measurement movement from a principal/agent viewpoint. It argues that the effectiveness of performance measurement systems depends on four key factors: the extent to which the chosen performance measures reflect faithfully the objectives of the system, the nature and quality of the data, the incentives for clinicians to scrutinize and act upon the data, and the culture of the organization within which the data are deployed. Although the optimal design of performance measurement systems depends heavily on local factors, they are likely to offer a highly cost-effective instrument for securing major improvements in system performance if properly deployed.
Hauck K, Shaw R, Smith PC, 2002, Reducing avoidable inequalities in health: a new criterion for setting health care capitation payments, Health Economics, Vol: 11, Pages: 667-677, ISSN: 1099-1050
Traditionally, most health care systems which pretend to any sort of rationality and cost control have sought to allocate their limited funds in order to secure equal opportunity of access for equal need. The UK government is implementing a fundamental change of resource allocation philosophy towards ‘contributing to the reduction of avoidable health inequalities’. The purpose of this essay is to explore some of the economic issues that arise when seeking to allocate health care resources according to the new criterion. It indicates that health inequalities might arise because of variations in the quality of health services, variations in access to those services, or variations in the way people produce health, and that the resource allocation consequences differ depending on which source is being addressed. The paper shows that an objective of reducing health inequalities is not necessarily compatible with an objective of equity of access, nor with the objective of maximising health gain. The results have profound consequences for approaches towards economic evaluation, the role of clinical guidelines and performance management, as well as for resource allocation methods.Copyright © 2002 John Wiley & Sons, Ltd.
Goddard M, Smith P, 2001, Equity of access to health care services:, Social Science & Medicine, Vol: 53, Pages: 1149-1162, ISSN: 0277-9536
Rice N, 2001, Ethics and geographical equity in health care, Journal of Medical Ethics, Vol: 27, Pages: 256-261, ISSN: 0306-6800
Smith PC, Rice N, Carr-Hill R, 2001, Capitation funding in the public sector, Journal of the Royal Statistical Society: Series A (Statistics in Society), Vol: 164, Pages: 217-257, ISSN: 0964-1998
Rice N, Smith PC, 2001, Capitation and Risk Adjustment in Health Care Financing: An International Progress Report, The Milbank Quarterly, Vol: 79, Pages: 81-113, ISSN: 0887-378X
Smith PC, Street A, 2001, The changing hospital industry: comparing not-for-profit and for-profit institutions. Edited by David M. Cutler. Chicago University Press, Chicago (2000). 384 pages, US$53.00. ISBN 0 226 13219 6., Health Economics, Vol: 10, Pages: 85-86
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Shaw R, Dolan P, Tsuchiya A, et al., 2001, Development of a questionnaire to elicit public preferences regarding health inequalities
A review of relevant literature within health economics, psychology and moral philosophy suggests that people want resource allocation decisions in health to be informed by considerations of equity as well as efficiency. A number of empirical studies demonstrate that people are willing to sacrifice overall health benefits for a more equal distribution of health (Dolan and Shaw, 2001a). However, it is not clear from the available evidence exactly which distributional considerations people want to take into account when allocating resources. Further, on the whole, discussions about equity are rarely cast in quantitative terms (but see Olsen, 1994) and so it is not clear to what extent people want various equity notions to be taken into account.In this study funded by the ESRC Health Variations Programme, we have elicited the views of the general public in order to quantify people’s preferences regarding equity in health. The two-year study first explored whether people wish to give differential priority to groups with different characteristics (such as age, family responsibilities and the extent to which people are ‘responsible’ for their illness). The study then derived a way of asking questions on various inequality issues which enable people to indicate their strength of preference for different sorts of reduction in health inequalities.This paper reports upon these attempts to present to members of the general public meaningful trade-offs between efficiency and equity. The purpose of this paper is to report on the development of the questions and to indicate how they might be used by other researchers. Part A shows how the questions were developed from a series of pilot interviews and made suitable for use in either an interview setting or postal survey. Part B provides some guidance on administration and reproduces the questions in order to make them available to interested researchers and policy makers. Those readers whose main aim is
Sheldon TA, Smith PC, 2000, Equity in the allocation of health care resources, HEALTH ECONOMICS, Vol: 9, Pages: 571-574, ISSN: 1057-9230
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- Citations: 27
Palmer S, Smith PC, 2000, Incorporating option values into the economic evaluation of health care technologies, Journal of Health Economics, Vol: 19, Pages: 755-766
Palmer S, Smith PC, 2000, Incorporating option values into the economic evaluation of health care technologies
Davies H, Nutley S, Smith P, 2000, Introducing evidence-based policy and practice in public services, What works?Evidence-based policy and practice in public services, Publisher: Policy Press, Pages: 1-11, ISBN: 9781861341914
Goddard M, Mannion R, Smith P, 2000, Enhancing performance in health care: A theoretical perspective on agency and the role of information, HEALTH ECONOMICS, Vol: 9, Pages: 95-107, ISSN: 1057-9230
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- Citations: 77
Rice N, Smith P, 2000, Editorial: Capitation and risk adjustment in health care, Health Care Management Science, Vol: 3, Pages: 73-75
Capitation and risk adjustment have become the chosen policy instruments to seek cost containment and equity of access for many developed health care systems. Increasingly, this entails the prospective setting of global budgets for the health care expenditures incurred by health care plans on behalf of their members. Methods of deriving such budgets are diverse and tailored to the specific circumstances of the health care system they seek to serve. This special issue presents a collection of papers devoted to issues surrounding the rationale, derivation, and implementation of capitation and risk adjustment methods of financing health care. These are discussed within the context of health care systems in eight countries, illustrating the range of interest in the topic. Undoubtedly, capitation and risk adjustment will become increasingly significant elements of virtually all systems of health care and we hope the collection of papers will help to stimulate further debate and research in this important and interesting area of health care financing. Copyright Kluwer Academic Publishers 2000
Rice N, Smith PC, 2000, Capitation and risk adjustment in health care., Health Care Manag Sci, Vol: 3, Pages: 73-75, ISSN: 1386-9620
Capitation and risk adjustment have become the chosen policy instruments to seek cost containment and equity of access for many developed health care systems. Increasingly, this entails the prospective setting of global budgets for the health care expenditures incurred by health care plans on behalf of their members. Methods of deriving such budgets are diverse and tailored to the specific circumstances of the health care system they seek to serve. This special issue presents a collection of papers devoted to issues surrounding the rationale, derivation, and implementation of capitation and risk adjustment methods of financing health care. These are discussed within the context of health care systems in eight countries, illustrating the range of interest in the topic. Undoubtedly, capitation and risk adjustment will become increasingly significant elements of virtually all systems of health care and we hope the collection of papers will help to stimulate further debate and research in this important and interesting area of health care financing.
Nutley SM, Davies HTO, Smith PC, 2000, What Works? Evidence-based Policy and Practice in Public Services, Cambridge, Publisher: MIT Press, ISBN: 9781861341914
With its relevance to both cutting-edge practice and research, this book is important reading for a wide range of managers and professionals in different sectors, as well as students and academics studying public policy, public ...
Dawson D, Goddard M, Smith P, 2000, The NHS plan: an economic perspective
The NHS Plan, published in July 2000, presented an ambitious blueprint for the transformation of the way the NHS delivers health care. The backdrop to the Plan is the substantial increase in resources for the NHS promised for the next 5 years. At the heart of the Plan is the aim of ensuring these resources are used effectively to provide a health service “designed around the patient”.After reviewing the perceived flaws in the current system and dismissing the notion of alternative systems of health care funding, the main part of the Plan outlines the strategy for tackling the shortcomings. The discussion is wide-ranging and includes not only those areas we would expect to see covered, such as the interface between health and social care and the performance management system, but also issues such as investment in infrastructure, the relationships between the NHS and the private sector and key personnel issues such as the supply of health care professionals and their contractual arrangements.This discussion paper summarises the main elements of the Plan before focusing more closely on seven key themes on which economic analysis has a distinctive insight to offer – investment, information, labour markets, the independent sector, waiting times, performance management, and patient and carer responses. Some of the preconditions for success of the Plan are outlined and gaps in the available evidence to support various aspects of the Plan are highlighted. Our conclusions suggest that there is reason to be optimistic that the Plan will deliver many of its lofty aspirations if two key conditions are met. First, that front-line staff are on board and have the resources and the will to help implement the Plan; and second, that political expediency and the desire to achieve short-term goals does not drive out the commitment to the long-term aims for the NHS.
van Ackere A, Smith PC, 1999, Towards a macro model of National Health Service waiting lists, System Dynamics Review, Vol: 15, Pages: 225-252, ISSN: 0883-7066
Carr-Hill RA, Rice N, Smith PC, 1999, The determinants of expenditure on children's personal social services, BRITISH JOURNAL OF SOCIAL WORK, Vol: 29, Pages: 679-706, ISSN: 0045-3102
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- Citations: 13
Goddard M, Mannion R, Smith PC, 1999, Assessing the performance of NHS Hospital Trusts: the role of ‘hard’ and ‘soft’ information, Health Policy, Vol: 48, Pages: 119-134, ISSN: 0168-8510
Pedraja-Chaparro F, Salinas-Jiménez J, Smith P, 1999, On the quality of the data envelopment analysis model, Journal of the Operational Research Society, Vol: 50, Pages: 636-644, ISSN: 0160-5682
Smith PC, 1999, Setting budgets for general practice in the new NHS, BMJ, Vol: 318, Pages: 776-779, ISSN: 0959-8138
Buck D, Eastwood A, Smith PC, 1999, Can we measure the social importance of health care?, INTERNATIONAL JOURNAL OF TECHNOLOGY ASSESSMENT IN HEALTH CARE, Vol: 15, Pages: 89-107, ISSN: 0266-4623
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- Citations: 2
Martin S, Smith PC, 1999, Rationing by waiting lists: an empirical investigation, Journal of Public Economics, Vol: 71, Pages: 141-164, ISSN: 0047-2727
Davies HTO, Nutley SM, Smith PC, 1999, Editorial: What Works? The Role of Evidence in Public Sector Policy and Practice, Public Money and Management, Vol: 19, Pages: 3-5, ISSN: 0954-0962
Rice N, Smith P, 1999, Approaches to capitation and risk adjustment in health care: an international survey
This report is a survey of current capitation methods in health care finance in developed countries. It was commissioned as part of the fundamental review by UK Ministers of the formula used to allocate health care finance to local areas in England, being carried out under the auspices of the Advisory Committee on Resource Allocation (ACRA). The study was commissioned in February 1999 and completed in May 1999. It was informed by a review of published literature and an extensive network of contacts in government departments and academic institutions.A capitation can be defined as the amount of health service funds to be assigned to a person for the service in question, for the time period in question, subject to any national budget constraints. In effect, a capitation system puts a “price” on the head of every citizen. Capitations are usually varied according to an individual’s personal and social characteristics, using a process known as risk adjustment. In most nations, the intention is that the risk-adjusted capitation should represent an unbiased estimate of the expected costs of the citizen to the health care plan over the chosen time period (typically one year). There is an element of capitation funding in the health care systems of almost all developed countries. Capitation is seen as an important mechanism for securing both equity and efficiency objectives.The review examined capitation schemes in 19 countries and concentrated on major strategic risk adjustment schemes implemented at the national or regional level. It identified two broad approaches to setting capitations, which we term matrix methods and index methods. The fundamental difficulties affecting both approaches are a lack of suitable data and the problem of disentangling needs effects from supply effects on health care utilization. Almost all schemes rely on analysis of empirical data, and various analytic methods have been used for setting capitations. Numerous need and cost f
Martin S, Rice N, Smith PC, 1998, Risk and the general practitioner budget holder, Social Science & Medicine, Vol: 47, Pages: 1547-1554, ISSN: 0277-9536
Ozcan YA, Smith P, 1998, Towards a science of the management of health care., Health Care Manag Sci, Vol: 1, Pages: 1-4, ISSN: 1386-9620
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