IDEAS home Printed from https://ideas.repec.org/p/chy/respap/153chedp.html
   My bibliography  Save this paper

Risk and the GP budget holder

Author

Listed:
  • Stephen Martin
  • Nigel Rice

    (Centre for Health Economics, The University of York)

  • Peter Smith

    (Centre for Health Economics, The University of York)

Abstract

For most individuals, the use made of health care in a given year is determined principally by unpredictable random incidents. Of course, some individuals have a predictably higher predisposition to illness than others. However, the general consensus is that only a fraction of individual variability in health care costs can be predicted. The purpose of this paper is to explore the implications of this inherent randomness for budget setting for GP purchasers. The paper argues that variability in utilization in the NHS is very high; that no formula will ever completely capture that variability, even for large populations; that the problem of variability is likely to be very acute for a GP practice; and that health authorities and GP budget holders will therefore need to adopt a range of strategies to manage the variability.

Suggested Citation

  • Stephen Martin & Nigel Rice & Peter Smith, 1997. "Risk and the GP budget holder," Working Papers 153chedp, Centre for Health Economics, University of York.
  • Handle: RePEc:chy:respap:153chedp
    as

    Download full text from publisher

    File URL: http://www.york.ac.uk/media/che/documents/papers/discussionpapers/CHE%20Discussion%20Paper%20153.pdf
    File Function: First version, 1997
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Briers, Michael & Hirst, Mark, 1990. "The role of budgetary information in performance evaluation," Accounting, Organizations and Society, Elsevier, vol. 15(4), pages 373-398.
    2. Matsaganis, Manos & Glennerster, Howard, 1994. "The threat of 'cream skimming' in the post-reform NHS," Journal of Health Economics, Elsevier, vol. 13(1), pages 31-60, March.
    3. Glazer, Jacob & Shmueli, Amir, 1995. "The physician's behavior and equity under a fundholding contract," European Economic Review, Elsevier, vol. 39(3-4), pages 781-785, April.
    4. Govindarajan, V., 1984. "Appropriateness of accounting data in performance evaluation: An empirical examination of environmental uncertainty as an intervening variable," Accounting, Organizations and Society, Elsevier, vol. 9(2), pages 125-135, June.
    5. Harold Pollack & Richard Zeckhauser, 1996. "Budgets as Dynamic Gatekeepers," Management Science, INFORMS, vol. 42(5), pages 642-658, May.
    6. Hopwood, Ag, 1972. "Empirical Study Of Role Of Accounting Data In Performance Evaluation," Journal of Accounting Research, Wiley Blackwell, vol. 10, pages 156-182.
    7. Hopwood, Ag, 1972. "Empirical Study Of Role Of Accounting Data In Performance Evaluation - Reply," Journal of Accounting Research, Wiley Blackwell, vol. 10, pages 189-193.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Pettigrew, Luisa M. & Kumpunen, Stephanie & Rosen, Rebecca & Posaner, Rachel & Mays, Nicholas, 2019. "Lessons for ‘large-scale’ general practice provider organisations in England from other inter-organisational healthcare collaborations," Health Policy, Elsevier, vol. 123(1), pages 51-61.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Hartmann, Frank G. H. & Moers, Frank, 1999. "Testing contingency hypotheses in budgetary research: an evaluation of the use of moderated regression analysis," Accounting, Organizations and Society, Elsevier, vol. 24(4), pages 291-315, May.
    2. Henk Ter Bogt, 2001. "Politicians and output-oriented performance evaluation in municipalities," European Accounting Review, Taylor & Francis Journals, vol. 10(3), pages 621-643.
    3. Vagneur, K. & Peiperl, M., 2000. "Reconsidering performance evaluative style," Accounting, Organizations and Society, Elsevier, vol. 25(4-5), pages 511-525, May.
    4. Otley, David & Fakiolas, Alexander, 2000. "Reliance on accounting performance measures: dead end or new beginning?," Accounting, Organizations and Society, Elsevier, vol. 25(4-5), pages 497-510, May.
    5. Chenhall, Robert H., 2003. "Management control systems design within its organizational context: findings from contingency-based research and directions for the future," Accounting, Organizations and Society, Elsevier, vol. 28(2-3), pages 127-168.
    6. Barrett, T.F. & McDonagh, P. & Granleese, J., 1992. "The contagion effect in performance evaluation: Evidence from the evaluations of marketing managers: A research note," The British Accounting Review, Elsevier, vol. 24(4), pages 331-341.
    7. Klaus Derfuss, 2015. "Relating Context Variables to Participative Budgeting and Evaluative Use of Performance Measures: A Meta-analysis," Abacus, Accounting Foundation, University of Sydney, vol. 51(2), pages 238-278, June.
    8. Lau, Chong M. & Low, Liang C. & Eggleton, Ian R. C., 1995. "The impact of reliance on accounting performance measures on job-related tension and managerial performance: Additional evidence," Accounting, Organizations and Society, Elsevier, vol. 20(5), pages 359-381, July.
    9. Hartmann, Frank G. H., 2000. "The appropriateness of RAPM: toward the further development of theory," Accounting, Organizations and Society, Elsevier, vol. 25(4-5), pages 451-482, May.
    10. Chong Lau & Christen Buckland, 2000. "Budget emphasis, participation, task difficulty and performance: the effect of diversity within culture," Accounting and Business Research, Taylor & Francis Journals, vol. 31(1), pages 37-55.
    11. Dunk, Alan S., 2003. "Moderated regression, constructs and measurement in management accounting: a reflection," Accounting, Organizations and Society, Elsevier, vol. 28(7-8), pages 793-802.
    12. O'Connor, Neale G., 1995. "The influence of organizational culture on the usefulness of budget participation by Singaporean-Chinese managers," Accounting, Organizations and Society, Elsevier, vol. 20(5), pages 383-403, July.
    13. Löning, Hélène & Besson, M. & Mendoza, Carla, 2008. "Dual use of budgeting in uncertainty contexts: Explorative study of senior sales and marketing managers," HEC Research Papers Series 897, HEC Paris.
    14. David Emsley & Lai Hong Chung, 2010. "How Management Accountants' Cognitive Style and Role Involvement Combine to Affect the Effort Devoted to Initiating Change," Abacus, Accounting Foundation, University of Sydney, vol. 46(3), pages 232-257, September.
    15. Bogt, H.J. ter, 2000. "Politicians, output-budgets and performance evaluation : case research in three Dutch municipalities," Research Report 00A11, University of Groningen, Research Institute SOM (Systems, Organisations and Management).
    16. Bhimani, Alnoor & Sivabalan, Prabhu & Soonawalla, Kazbi, 2018. "A study of the linkages between rolling budget forms, uncertainty and strategy," The British Accounting Review, Elsevier, vol. 50(3), pages 306-323.
    17. Jean‐François Henri & Steeve Massicotte & Dominique Arbour, 2020. "Exploring the Consequences of Competing Uses of Budgets," Australian Accounting Review, CPA Australia, vol. 30(4), pages 257-268, December.
    18. Hartmann, Frank G. H. & Moers, Frank, 2003. "Testing contingency hypotheses in budgetary research using moderated regression analysis: a second look," Accounting, Organizations and Society, Elsevier, vol. 28(7-8), pages 803-809.
    19. Littkemann, Jörn, 1997. "Erfolgreiche Gestaltung unternehmensinterner Abrechnungssysteme," Manuskripte aus den Instituten für Betriebswirtschaftslehre der Universität Kiel 436, Christian-Albrechts-Universität zu Kiel, Institut für Betriebswirtschaftslehre.
    20. R. Murray Lindsay, 1994. "Publication System Biases Associated with the Statistical Testing Paradigm," Contemporary Accounting Research, John Wiley & Sons, vol. 11(1), pages 33-57, June.

    More about this item

    Keywords

    fundholding;

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:chy:respap:153chedp. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Gill Forder (email available below). General contact details of provider: https://edirc.repec.org/data/chyoruk.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.