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Total purchasing in primary care: three case studies

Stephen Abbott (Senior Research Fellow, Health and Community Care Research Unit, University of Liverpool, Liverpool, UK)
Stephen Harrison (Professor of Health Policy and Politics, Nuffield Institute for Health, University of Leeds, Leeds, UK, and)
Nicola Walsh (Fellow, Health Services Management Centre, University of Birmingham, Birmingham, UK)

Journal of Management in Medicine

ISSN: 0268-9235

Article publication date: 1 December 1999

295

Abstract

Total purchasing in primary care (TPPC) was piloted in the mid‐1990s, first by four “pioneer sites”, and later by over 80 first and second waves of “pilot sites”. Separate evaluations of three of the pioneers show that they faced challenges similar to those experienced by the pilot sites, namely: the need to develop organisations which were effective both internally and, in their relationships with other health‐care agencies, externally; and the difficulties encountered when attempting to change the behaviour of local acute care providers. Although GP fund holding and/or TPPC have had some successes in influencing the pattern of delivery for some elective and community services, the challenge of reducing hospital admissions and lengths of stay remains formidable.

Keywords

Citation

Abbott, S., Harrison, S. and Walsh, N. (1999), "Total purchasing in primary care: three case studies", Journal of Management in Medicine, Vol. 13 No. 6, pp. 365-372. https://doi.org/10.1108/02689239910299812

Publisher

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MCB UP Ltd

Copyright © 1999, MCB UP Limited

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