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Economic Evaluation and the Shifting Balance Towards Primary Care: Definitions, Evidence and Methodological Issues

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  • Edward Godber
  • Ray Robinson
  • Andrea Steiner

Abstract

Current UK government policy places considerable emphasis on shifting the balance of health care provision from secondary towards primary care. Despite this emphasis, however, there has been very little economic evaluation of initiatives designed to achieve this shift. In view of this deficiency, our article has three main aims. First, it offers a working definition of shifts in the balance of care at the primary–secondary care interface. Second, it systematically reviews the existing literature on the cost‐effectiveness of initiatives designed to shift the balance of care. Third, it identifies a range of methodological issues that need to be addressed if future economic evaluations in this area are to be carried out satisfactorily. © 1997 by John Wiley & Sons, Ltd.

Suggested Citation

  • Edward Godber & Ray Robinson & Andrea Steiner, 1997. "Economic Evaluation and the Shifting Balance Towards Primary Care: Definitions, Evidence and Methodological Issues," Health Economics, John Wiley & Sons, Ltd., vol. 6(3), pages 275-294, May.
    • Handle: RePEc:wly:hlthec:v:6:y:1997:i:3:p:275-294
    DOI: 10.1002/(SICI)1099-1050(199705)6:3<275::AID-HEC255>3.0.CO;2-2
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    References listed on IDEAS

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    1. Jane Griffin, 1996. "The Future of Primary Care," Monograph 000418, Office of Health Economics.
    2. Ancona-Berk, V.A. & Chalmers, T.C., 1986. "An analysis of the costs of ambulatory and inpatient care," American Journal of Public Health, American Public Health Association, vol. 76(9), pages 1102-1104.
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    Cited by:

    1. K Taylor & B Dangerfield, 2005. "Modelling the feedback effects of reconfiguring health services," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 56(6), pages 659-675, June.
    2. Rob Anderson & Marion Haas, 2001. "Cost-effectiveness of shared care compared with usual hospital-based care for people with Hepatitis C, CHERE Project Report No 17," Research Reports 17, CHERE, University of Technology, Sydney.
    3. Bronwyn Lind & Don Weatherburn & Shuling Chen & Marian Shanahan & Emily Lancsar & Marion Haas, 2002. "New South Wales drug court evaluation: Cost-effectiveness, CHERE Project Report 17a," Research Reports 17a, CHERE, University of Technology, Sydney.
    4. Marian Shanahan & Emily Lancsar & Marion Haas & Bronwyn Lind & Don Weatherburn & Shuling Chen, 2004. "Cost-Effectiveness Analysis of the New South Wales Adult Drug Court Program," Evaluation Review, , vol. 28(1), pages 3-27, February.
    5. Robinson, Ray, 1999. "Limits to rationality: economics, economists and priority setting," Health Policy, Elsevier, vol. 49(1-2), pages 13-26, September.
    6. Rob Anderson, 2010. "Systematic reviews of economic evaluations: utility or futility?," Health Economics, John Wiley & Sons, Ltd., vol. 19(3), pages 350-364, March.

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