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Accounting for cross boundary flows.

J Brazier1

  • 1Department of Community Medicine, United Medical School, Guy's Hospital, London.

British Medical Journal (Clinical Research Ed.)
|October 10, 1987
PubMed
Summary
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The Resource Allocation Working Party (RAWP) method for cross-boundary patient flows has issues for individual health authorities and the National Health Service. Cross-charging is a proposed alternative, but faces challenges beyond just cost estimation.

Area of Science:

  • Health economics
  • Healthcare management
  • Public health policy

Background:

  • The Resource Allocation Working Party (RAWP) method adjusts health authority targets for cross-boundary patient flows.
  • Previous research highlighted issues for inner-city District Health Authorities (DHAs) with RAWP adjustments.
  • This paper extends the analysis to the National Health Service (NHS) as a whole.

Purpose of the Study:

  • To examine the broader implications of RAWP cross-boundary flow adjustments for the entire NHS.
  • To evaluate cross-charging as an alternative funding mechanism for patient flows.
  • To identify neglected issues associated with cross-charging beyond cost estimation.

Main Methods:

  • Analysis of the Resource Allocation Working Party (RAWP) methodology.

Related Experiment Videos

  • Examination of the proposed cross-charging model for inter-authority patient transfers.
  • Discussion of practical and systemic challenges in healthcare funding models.

    • Main Results:

    • RAWP adjustments present significant challenges not only for individual DHAs but for the NHS overall.
    • Cross-charging, while proposed as a solution, introduces complexities and neglected issues.
    • Cost estimation is a known difficulty, but other substantial barriers to cross-charging exist.

    Conclusions:

    • The RAWP system's impact on national health resource allocation requires careful consideration.
    • Cross-charging presents a viable alternative but necessitates addressing a wider range of implementation challenges.
    • Further research is needed to fully understand and mitigate the complexities of inter-authority healthcare funding.