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Related Experiment Videos

Which "internal market"?

O O Oni1

  • 1Glenfield Hospital, Leicester.

Journal of Management in Medicine
|December 9, 1993
PubMed
Summary

The study differentiates two internal market types in healthcare. Type I restricts patient choice to contracted providers, contrasting with Type II

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Area of Science:

  • Healthcare management
  • Health services research

Background:

  • The concept of internal markets in healthcare aims to improve efficiency and patient choice.
  • Two distinct models, Type I and Type II, are proposed for internal market operation.

Purpose of the Study:

  • To analyze the characteristics and implications of Type I and Type II internal markets.
  • To evaluate the alignment of the "Working for Patients" policy with these market types.
  • To determine the most suitable internal market model for the National Health Service (NHS).

Main Methods:

  • Conceptual analysis of internal market structures.
  • Comparison of policy rhetoric versus practical implementation.
  • Evaluation of historical healthcare management models.

Main Results:

  • "Working for Patients" policy rhetoric supports Type II (free choice), but practice reflects Type I (contracted providers).
  • Type I internal markets, with their emphasis on contracting, represent a detrimental evolution of previous hierarchical structures.
  • The ethos of the NHS is more compatible with a Type II market structure.

Conclusions:

  • The current implementation of internal markets in healthcare, particularly Type I, may not align with stated goals of patient choice.
  • The National Health Service (NHS) may benefit from adopting a Type II internal market model, fostering greater provider choice.
  • Lessons from other public services, like higher education, can inform healthcare market design.

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