title: Commissioning regional specialist services-HIV and AIDS. Experiences of a consortium arrangement in the North East of England.
abstract: The introduction of effective double combination therapy for HIV disease in 1996 and triple therapy in 1997 had cost implications for both purchasers and providers of regional specialist services. There is evidence that more patients presented for treatment. A consortium purchasing approach was undertaken in the North East of England to manage the introduction of combination therapy, to ensure that therapy was available for those who could benefit and to minimise the financial risk for individual health districts. The strengths and weaknesses of such an approach are discussed as well as the potential application to commissioning other specialist services.
authors.affiliation: Department of Public Health Medicine, Sunderland Health Authority, Durham Road, Sunderland, SR3 4AF.
authors.forename: D
authors.initials: D
authors.lastname: Tregoning
mesh_terms: D019380:Anti-HIV Agents / Q000191:economics / Q000627:therapeutic use; D023241:Antiretroviral Therapy, Highly Active / Q000191:economics / Q000706:statistics & numerical data; D001509:Bed Occupancy / Q000706:statistics & numerical data; D003284:Contract Services / Q000458:organization & administration*; D003659:Decision Making, Organizational; D016527:Drug Costs / Q000706:statistics & numerical data; D004739:England / Q000453:epidemiology; D019983:Guideline Adherence; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006302:Health Services Research; D006742:Hospital Bed Capacity / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D020380:Needs Assessment; D009937:Organizational Objectives; D017410:Practice Guidelines as Topic; D015397:Program Evaluation; D012041:Regional Medical Programs / Q000458:organization & administration*; D013222:State Medicine / Q000458:organization & administration
chemical_list: D019380:Anti-HIV Agents