Jacobs, Rowena orcid.org/0000-0001-5225-6321, Gutacker, Nils orcid.org/0000-0002-2833-0621, Ride, Jemimah Ruth orcid.org/0000-0002-1820-5499 et al. (6 more authors) (2022) Impact of prevention in primary care on costs in primary and secondary care for people with serious mental illness. Health Economics. pp. 343-355. ISSN 1057-9230
Abstract
A largely unexplored part of the financial incentive for physicians to participate in preventive care is the degree to which they are the residual claimant from any resulting cost savings. We examine the impact of two preventive activities for people with serious mental illness (care plans and annual reviews of physical health) by English primary care practices on costs in these practices and in secondary care. Using panel two-part models to analyze patient-level data linked across primary and secondary care, we find that these preventive activities in the previous year are associated with cost reductions in the current quarter both in primary and secondary care. We estimate that there are large beneficial externalities for which the primary care physician is not the residual claimant: the cost savings in secondary care are 4.7 times larger than the cost savings in primary care. These activities are incentivized in the English National Health Service but the total financial incentives for primary care physicians to participate were considerably smaller than the total cost savings produced. This suggests that changes to the design of incentives to increase the marginal reward for conducting these preventive activities among patients with serious mental illness could have further increased welfare.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Dates: |
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Institution: | The University of York |
Academic Units: | The University of York > Faculty of Social Sciences (York) > Centre for Health Economics (York) The University of York > Faculty of Social Sciences (York) > Economics and Related Studies (York) |
Funding Information: | Funder Grant number NETSCC 13/54/40 |
Depositing User: | Pure (York) |
Date Deposited: | 23 Dec 2022 13:30 |
Last Modified: | 21 Jan 2025 18:06 |
Published Version: | https://doi.org/10.1002/hec.4623 |
Status: | Published |
Refereed: | Yes |
Identification Number: | 10.1002/hec.4623 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:194708 |
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Description: Health Economics - 2022 - Ride - Impact of prevention in primary care on costs in primary and secondary care for people
Licence: CC-BY 2.5