Purchaser-provider: the international dimension
| Autor: | Alastair M. S. Mason, Kieran Morgan |
|---|---|
| Rok vydání: | 1995 |
| Předmět: |
Project commissioning
Population macromolecular substances Group Purchasing Public administration State Medicine Health care Humans Medicine education Finland General Environmental Science Social Responsibility education.field_of_study Economic Competition business.industry Australia General Engineering General Medicine Contract Services United Kingdom Purchasing Accountability Costs and Cost Analysis General Earth and Planetary Sciences Managed care Family Practice business Delivery of Health Care Social responsibility Research Article New Zealand |
| Zdroj: | BMJ. 310:231-235 |
| ISSN: | 1468-5833 0959-8138 |
| DOI: | 10.1136/bmj.310.6974.231 |
| Popis: | Purchaser-provider systems in health care are being implemented in several countries and are under consideration in many more. These new arrangements are described for the United Kingdom, Finland, New Zealand, and Australia, and in each case responsibility for funding, purchasing, providing, and ownership is identified. The four systems, along with managed care organisations in the United States, are also compared with regard to several important features. There is a fundamental similarity between these purchaser-provider arrangements but several key differences are well worth systematic study. This is a major challenge for academic bodies in Britain and other countries, and the opportunity to learn from each other should not be missed. The United Kingdom is not the only country in which purchaser-provider arrangements are being introduced into taxation funded health services. Finland and Sweden have pilot projects under way, and New Zealand and Western and South Australia are implementing major changes. These arrangements undoubtedly have their origins in the commercial sector but they cannot be thought of merely as the introduction of financial transactions between health authorities and so either good or bad for that reason alone. The purchaser-provider separation brings into the open many issues about health care that have previously been obscured. With the identification of purchasers charged with commissioning health care on behalf of a population comes the question of accountability. With the advent of the general practitioner purchaser comes the ethical question of clinical decision making within a fixed budget. Despite similarities in the purchaser-provider arrangements between different countries there are important variations in approach. Study of these variations could, in time, shed light on these questions. For about two years senior executives from agencies responsible for purchasing in Helsinki, Auckland, Perth, Adelaide, and Bristol have been comparing experiences and sharing expertise. This paper was written after a … |
| Databáze: | OpenAIRE |
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