Health economics
-
Financial incentives may increase performance on targeted activities and have unintended consequences for untargeted activities. An innovative pay-for-performance scheme was introduced for UK general practices in 2004. It incentivised particular quality indicators for targeted groups of patients. ⋯ We conclude that the incentives induced providers to improve targeted quality and make investments in quality that extended beyond the scheme. We estimate that the average provider was paid pound20 500 for recording 410 additional items of information on the risk factors targeted by the financial incentives. Allowance for the positive spillovers reduces the estimated average reward from pound50 to pound25 per additional record.
-
Priority setting research in health economics has traditionally employed quantitative methodologies and been informed by post-positivist philosophical assumptions about the world and the nature of knowledge. These approaches have been rewarded with well-developed and validated tools. However, it is now commonly noted that there has been limited uptake of economic analysis into actual priority setting and resource allocation decisions made by health-care systems. ⋯ These are illustrated with examples drawn from a real-world priority setting study. The examples demonstrate how such conceptually powerful qualitative traditions produce distinctive findings that offer unique insight into organizational contexts and decision-maker behavior. We argue that such investigations offer untapped benefits for the study of organizational priority setting and thus should be pursued more frequently by the health economics research community.
-
The current air quality limit values for airborne pollutants in the UK are low by historical standards and are at levels that are believed not to harm health. We assess whether this view is correct. We examine the relationship between common sources of airborne pollution and population mortality for England. ⋯ The panel nature of our data allows us to control for any unobserved time-invariant associations at local authority level between high levels of air pollution and poor population health and for common time trends. We estimate multi-pollutant models to allow for the fact that three of the pollutants are closely correlated. We find that higher levels of PM(10) and ozone are associated with higher mortality rates, and the effect sizes are considerably larger than previously estimated from the primarily time series studies for England.