Choice of contracts in the British National Health Service: an empirical study.
Following major reforms of the British National Health Service (NHS) in 1990, the roles of purchasing and providing health services were separated, with the relationship between purchasers and providers governed by contracts. Using a mixed multinomial logit analysis, we show how this policy shift led to a selection of contracts that is consistent with the predictions of a simple model, based on contract theory, in which the characteristics of the health services being purchased and of the contracting parties influence the choice of contract form. The paper thus provides evidence in support of the practical relevance of theory in understanding health care market reform.
Chalkley
Martin
M
Department of Economic Studies, University of Dundee, Scotland, UK.
McVicar
Duncan
D
D002755:Choice Behavior; D003153:Community Health Services / Q000191:economics; D003284:Contract Services / Q000145:classification* / Q000191:economics*; D032982:Contracts / Q000145:classification* / Q000191:economics*; D003659:Decision Making, Organizational; D036262:Empirical Research; D017048:Health Care Costs; D018166:Health Care Reform / Q000458:organization & administration*; D006302:Health Services Research; D006779:Hospitals, Public / Q000145:classification / Q000191:economics; D006801:Humans; D016015:Logistic Models; D008605:Mental Health Services / Q000191:economics; D017059:Models, Econometric; D017008:Negotiating; D011320:Primary Health Care / Q000191:economics; D011682:Purchasing, Hospital; D013222:State Medicine / Q000191:economics / Q000458:organization & administration*; D009626:Terminology as Topic; D006113:United Kingdom