Health care technology in the United Kingdom

Spiby, Jackie

doi:10.1016/0168-8510(94)00690-g

Cited by 7 publications

(4 citation statements)

References 17 publications

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“…Much of the increased activity in the acute sector was achieved through reductions in lengths of day and the expansion of day surgery. Such trends were, themselves, greatly facilitated by changes in medical technology and pharmacology (Marks, 1994;Spiby, 1994;Vetter, 1995), which are expected to continue influencing the scale and provision of in-patient services in three main ways. First, outpatient care, day surgery and shorter lengths of stay are being facilitated by the utilisation of CT and MRI scanning, endoscopy, laporoscopy, developments in anaesthetics and the use of drugs as alternatives to surgery.…”

Section: Reshaping Acute Hospitalsmentioning

confidence: 99%

“…Thus, Edwards and Werneke (1994, p. 32) suggest that the assumption that``community intervention is more cost effective than hospitalisation is largely untested''. The introduction of new technologies has been subject to limited control or evaluation of their effectiveness (Spiby, 1994) and some of the central features of the changes in acute service have been only partially evaluated, including minimal access surgery (MAS), day surgery and hospital at home schemes (Banta, 1993;Spiby, 1994;POST, 1995;Marks, 1994;Warner and Riley, 1994;Fulop et al, 1997).…”

Section: Reshaping Acute Hospitalsmentioning

confidence: 99%

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Home care and the reshaping of acute hospitals in England – An overview of problems and possibilities

Wistow

2000

Jnl of Management in Medicine

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A changing boundary between hospital and home-care services over two decades has taken place enabling people to live in their own homes wherever possible, enabling "choice of independence". Against this background, five principal issues are raised regarding how hospital services have been reshaped over that time and how the pattern of service developments outside the hospital has altered over the same period.

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Section: Reshaping Acute Hospitalsmentioning

confidence: 99%

Section: Reshaping Acute Hospitalsmentioning

confidence: 99%

Home care and the reshaping of acute hospitals in England – An overview of problems and possibilities

Wistow

2000

Jnl of Management in Medicine

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“…This section highlights the features of the National Health Service reforms implemented in 1991. More comprehensive discussions are found in Smee and Parsonage (1990), Spiby (1994), and Maynard (1994a, b), while Chalkley and Malcomson (1996) provide a detailed analysis of incentives under the new system. The reforms concentrated on the supply side of the market by introducing stronger incentives for ef®ciency.…”

Section: A Brief Outline Of the Nhs Reformsmentioning

confidence: 99%

The Impact of the NHS Reforms on Queues and Surgical Outcomes in England: Evidence From Hip Fracture Patients

Hamilton

Bramley-Harker

1999

The Economic Journal

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National Health Service (NHS) reform introduced incentives for ef®ciency and cost effectiveness, yet little is known about their effectiveness in reducing waiting times for surgery or improving post-surgical outcomes. This paper ®nds that waiting times for hip fracture surgery declined after the NHS reforms, and patients were more likely to be discharged to another provider. However, hospitals have not simply shifted the burden of care to other providers, since lengths of stay ending in a discharge to home fell. The effect of wait time on surgical outcomes is small in magnitude and cannot explain the post-reform improvements in outcomes.

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“…Drug prices are regulated by the Pharmaceutical Price Regulation Scheme, a voluntary agreement between the government and the U.K. pharmaceutical industry. The scheme seeks to limit the overall profits of U.K. companies (to about 17-21%), rather than to control directly the price for and/or access to specific products (61). Aggregate expenditures on sales promotion, as a percentage of total sales revenue, are also controlled.…”

Section: Controls On Health Technologymentioning

confidence: 99%

Health Technology Assessment in the United Kingdom

Woolf

Henshall²

2000

Int J Technol Assess Health Care

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The National Health Service (NHS) provides universal health coverage for all British citizens. Most services are free of charge, although modest copayments are sometimes applied. About 11% of the population also has private insurance. General practitioners, generally the first point of contact for accessing the system, are independent contractors who serve as gatekeepers for specialist and hospital services and enjoy substantial clinical autonomy. Hospitals are public and are regionalized, but the 1990 reforms made them self-governing trusts that contract with local purchasers (health authorities and general practitioner fundholders). Reforms beginning in 1990 moved the NHS away from a centralized administrative structure to more pluralistic arrangements in which competition, as well as management, influences how services develop. Health technology and health technology assessment (HTA) have gained increasing attention in the NHS during this period, as part of a wider NHS Research and Development (R&D) Strategy. The strategy promotes a knowledge-based health service with a strong research infrastructure and the capacity to critically review its own needs. HTA is the largest and most developed of the programs within the strategy. It has a formal system for setting assessment priorities involving widespread consultation within the NHS, and a National Co-ordinating Centre for Health Technology Assessment. The strategy supports related centers such as the U.K. Cochrane Centre and the NHS Centre for Reviews and Dissemination. A hallmark of the HTA program is strong public participation. The United Kingdom has made a major commitment to HTA and to seeking effective means of reviewing and disseminating evidence.

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Health care technology in the United Kingdom

Cited by 7 publications

References 17 publications

Home care and the reshaping of acute hospitals in England – An overview of problems and possibilities

Home care and the reshaping of acute hospitals in England – An overview of problems and possibilities

The Impact of the NHS Reforms on Queues and Surgical Outcomes in England: Evidence From Hip Fracture Patients

Health Technology Assessment in the United Kingdom

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