Reports of rationing from the neglected realm of capital investment
Responses to resource constraint in the English National Health Service
Datos Bibliográficos
| ID | 7217652 |
|---|---|
| Autores | Iestyn Williams (0000-0002-9462-9488, University of Birmingham, autor de correspondencia), Kerry Allen (0000-0002-7661-2340, University of Birmingham), Gunveer Plahe (University of Birmingham) |
| Año | 2019 |
| Volumen | 225 |
| Páginas | 1-8 |
| Fecha de publicación | 2019-02-13 |
| Peer Reviewed | Sí |
| Open Access | Sí |
| Tipo | ARTICLE |
| Revista | Social Science & Medicine (JOURNAL) |
| Identificadores de la revista | ISSN: 0277-9536 • E-ISSN: 1873-5347 |
| Editorial | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/j.socscimed.2019.02.015 |
| PMID | 30776723 |
| OpenAlex | W2912923424 |
| Idioma | EN |
| Citas recibidas | 2 |
| Referencias citadas | 49 |
Health systems around the world face financial pressures that can affect sustainability and patient outcomes, and there is a vast literature devoted to the allocation of scarce health care resources. Capital spending - for example on estates, equipment and information technology - is an important but often neglected area of this literature. This study explores the constraints on the allocation of capital budgets in health care, before addressing the question: what is the role of priority setting and rationing in responses to these constraints? The paper presents findings from interviews conducted with senior finance professionals in 30 National Health Service local provider organisations across England. Findings suggest a pervasive sense of impending crisis, with capital restrictions limiting investment in buildings, infrastructure and equipment. The paper applies a conceptual classification scheme from the classic rationing literature (the forms of rationing framework) and identifies widespread practices of 'selection', 'dilution' and 'delay', with 'denial' and 'termination' comparatively rare. Practices of 'deflection' and 'deterrence' are ascribed to national actors as a means of restricting the flow of capital resources to the system. The study suggests that there is little by way of tailored support for priority setting in capital spending, and a perception that decisions are often reactive and short term. It also suggests that wider system features and dynamics can preclude or constrain priority setting at the organisational level. The authors use these findings to suggest future conceptual development of the forms of rationing framework and make recommendations for research and practice in this area
Actuarial science · Business · Economic growth · Economics · Health care · Public economics · Rationing · Global Health Care Issues · Health Systems, Economic Evaluations, Quality of Life · Healthcare Policy and Management
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| Obras citantes distintas | 2 |
|---|---|
| Citas por año | 0,33 |
| Intervalo de citas | 2020 - 2021 (2) |
| Velocidad de citación | historical |
| Altamente citado | No |
| Tipos de cita | Neutras: 2 |