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Taking care of the budget? Practice-level outcomesduring commissioning reforms in England

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  • Pinchbeck, Ted

Abstract

I investigate whether vesting budgets with doctors impacts treatment decisions and patients outcomes by exploiting the transitional phase of major recent health care reforms in England that passed budgets to consortia of General Practitioners (GPs). Applying difference-indifference techniques to balanced treatment and control groups, I find that practices becoming actively responsible for consortia budgets engaged in cost-saving prescribing and referral behaviour but that patients in these practices experienced a relative deterioration in the quality of their care. I discuss a number of explanations for these results, including that the reforms incentivised doctors to reduce quality in order to save cash or that they simply distracted those doctors most closely involved.

Suggested Citation

  • Pinchbeck, Ted, 2016. "Taking care of the budget? Practice-level outcomesduring commissioning reforms in England," LSE Research Online Documents on Economics 66532, London School of Economics and Political Science, LSE Library.
    • Handle: RePEc:ehl:lserod:66532
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    More about this item

    Keywords

    NHS reforms; commissioning; primary care; health care budgets;
    All these keywords.

    JEL classification:

    • J61 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Geographic Labor Mobility; Immigrant Workers
    • J62 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Job, Occupational and Intergenerational Mobility; Promotion

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