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Related Experiment Videos

What do we known about fundholding in general practice?

J Dixon1, H Glennerster

  • 1Health Services Research Unit, London School of Hygiene and Tropical Medicine.

BMJ (Clinical Research Ed.)
|September 16, 1995
PubMed
Summary

General practice fundholding curbed costs and improved hospital services, but may have inequitable funding. Its full impact on care quality and costs remains unevaluated.

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Area of Science:

  • Health policy research
  • Primary care management
  • Healthcare economics

Background:

  • The general practice fundholding scheme was implemented four years prior to this review.
  • A formal national evaluation of the scheme's impact has not yet been conducted.
  • Existing research indicates emerging trends in its effects.

Purpose of the Study:

  • To review published research on the impact of general practice fundholding.
  • To identify trends in prescribing costs and hospital service improvements.
  • To highlight unknown impacts on equity, transaction costs, and quality of care.

Main Methods:

  • Systematic review of published research on general practice fundholding.
  • Analysis of trends in prescribing costs and hospital service delivery.
  • Identification of areas lacking formal evaluation.

Main Results:

  • Fundholding practices have demonstrated a reduction in prescribing costs.
  • General practitioners in fundholding schemes have gained influence over hospital service improvements, such as reduced waiting times.
  • Fundholding practices may have received disproportionately higher funding compared to non-fundholding practices.

Conclusions:

  • While fundholding shows potential benefits in cost control and service influence, its overall impact remains incompletely understood.
  • The effects of fundholding on transaction costs, equity, and quality of care, especially for patients of non-fundholding general practitioners, require further investigation.
  • Coordinated research is essential to fully evaluate the implications of significant healthcare reforms like fundholding.

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