Journal of health services research & policy
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J Health Serv Res Policy · Jul 2002
'Inappropriate' attendance at an accident and emergency department by adults registered in local general practices: how is it related to their use of primary care?
To identify the relationship between 'inappropriate' attendance at an accident and emergency department (AED) by adults registered with local general practices and their use of primary care. ⋯ GP-registered, 'inappropriate' attendees at AEDs utilise primary care services more than matched controls; this pattern of service utilisation appears to be unrelated to chronic physical illness. Thus, simply providing new, directly accessible primary health care services may not significantly reduce AED use.
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J Health Serv Res Policy · Jan 2002
Comparative StudySalaried contracts in UK general practice: a study of job satisfaction and stress.
To compare job satisfaction and stress levels of general practitioners (GPs) employed on salaried contracts with GPs on a 'standard' performance-related contract paid by fee-for-service and capitation. ⋯ Overall job satisfaction levels among salaried doctors were similar to those of doctors on contracts paid by mixed fee-for-service and capitation. Future studies of job satisfaction levels under different doctor payment systems need to take account of the extent to which doctors have preferences for different types of contract if they are to derive unbiased results.
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J Health Serv Res Policy · Jul 2001
ReviewAssessing the value of hospital-in-the-home: lessons from Australia.
To identify factors that influence the cost-effectiveness of hospital-in-the-home (HITH) and to discuss the impact of funding arrangements in creating incentives or disincentives for the establishment of HITH services. ⋯ Evaluations are essential to inform decisions about whether HITH is likely to be a viable and cost-effective alternative to inpatient care. However, the relative costs of HITH and conventional care will depend on local factors. From the point of view of the decision-maker, these will be affected by funding and organisational arrangements. Funders must be aware that complex financial incentives may mask the true costs of HITH services relative to hospital services. They need to ensure that the incentives created by funding arrangements are transparent.
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J Health Serv Res Policy · Jan 2001
ReviewImpact of payment method on behaviour of primary care physicians: a systematic review.
To review the impact of payment systems on the behaviour of primary care physicians. ⋯ There is some evidence to suggest that how a primary care physician is paid does affect his/her behaviour but the generalisability of these studies is unknown. Most policy changes in the area of payment systems are inadequately informed by research. Future changes to doctor payment systems need to be rigorously evaluated.
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J Health Serv Res Policy · Jan 2001
Comparative StudyCost analysis of a hospital-at-home initiative using discrete event simulation.
To examine whether, from a National Health Service (NHS) and local authority social services' viewpoint, a hospital-at-home service was cost saving compared with conventional inpatient care. ⋯ For elderly patients assessed as needing no more than 14 days of hospital care, hospital-at-home care is cost saving to health and social care agencies when compared with conventional inpatient care.