Health policy
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In 1990 the UK Government announced the introduction of general practitioner (GP) fundholding whereby GPs were given a budget from which to purchase some health care services. The UK Government is at present piloting total fundholding which extends the partial model by allowing GPs in some practices to purchase all their health care services. If other countries intend to adopt schemes similar to the fundholding model then it is important that the success or otherwise of the UK experience informs their health care policy. ⋯ This review showed that there is a dearth of high quality research evidence evaluating fundholding referral behaviour whereas data on differences in prescribing costs is relatively abundant. The studies reviewed did not evaluate the effect of fundholding on patient health status, quality, patient choice or equity criteria. The difficulties involved in evaluating fundholding model presents a considerable challenge to the evaluation of total fundholding.