Effect of fundholding on waiting times: database study.
OBJECTIVE
To determine whether fundholding patients have shorter waiting times for surgery than non-fundholding patients and to establish if any such differences resulted from practices attaining fundholding status.


METHODS
Comparison of waiting times of fundholding and non-fundholding patients for elective surgery covered by the fundholding scheme at four providers over four years. Comparison of the waiting times for patients of practices in their last year outside and first year inside the fundholding scheme with those for patients of practices remaining non-fundholding.


METHODS
West Sussex.


METHODS
Over 57,000 patients on the elective waiting list who had operations purchased by a health authority or fundholding practice during 1992-6. Patients with booked or planned elective admissions were excluded.


METHODS
Waiting times for patients of fundholding and non-fundholding patients.


RESULTS
Patients of fundholding practices had significantly shorter waiting times than those of non-fundholders for all four providers and over all four years. Waiting times for patients did not fall until the year that the practices joined the fundholding scheme.


CONCLUSIONS
Fundholding shortens waiting times. This may be because purchasing of elective surgery is best done at a practice level or because fundholding practices are funded overgenerously.
Dowling
B
B
Department of Social Policy and Administration, London School of Economics and Political Science.
D017558:Elective Surgical Procedures / Q000191:economics* / Q000706:statistics & numerical data; D004739:England; D005194:Family Practice / Q000191:economics*; D005376:Financial Management; D005381:Financing, Organized; D006801:Humans; D012017:Referral and Consultation; D013997:Time Factors; D014850:Waiting Lists