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The impact of budgets for gatekeeping physicians on patient satisfaction: Evidence from fundholding

Dusheiko, M., Gravelle, H., Yu, N. and Campbell, S. (2007) The impact of budgets for gatekeeping physicians on patient satisfaction: Evidence from fundholding. Journal of Health Economics, 26 (4). pp. 742-762. ISSN 0167-6296

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Between 1991 and 1998 English general practices had the option of holding budgets for prescribing and elective secondary care. Fundholding was reintroduced in 2005. We examine the effect of fundholding on patients’ satisfaction with their practice, using a cross section of 4441 patients from 60 practices in the last year of fundholding (1998). We employ instrumental variables to allow for the endogeneity of fundholding. Patients of fundholders were less satisfied with the opening hours of their practice, their GP's knowledge of their medical history, with their GP's ability to arrange tests and willingness to refer to a specialist, and were more likely to agree that their doctor was more concerned about keeping costs down. Fundholder practices performed better on a number of process measures of care, and fundholding patients were more satisfied with additional non-medical services provided by the practice. The probability that patients were overall at least very satisfied with their GP practice was 0.073 (95% CI, 0.009–0.138) smaller in fundholding practices.

Item Type: Article
Institution: The University of York
Academic Units: The University of York > Centre for Health Economics (York)
Depositing User: York RAE Import
Date Deposited: 22 Apr 2009 13:45
Last Modified: 22 Apr 2009 13:45
Published Version: http://dx.doi.org/10.1016/j.jhealeco.2006.12.003
Status: Published
Publisher: Elsevier Science B.V., Amsterdam.
Identification Number: 10.1016/j.jhealeco.2006.12.003
URI: http://eprints.whiterose.ac.uk/id/eprint/6710

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