Funding within the Health Care Sectors

Sector Funding, 1990.

Mixed Economy of Care 1997, 1999 and 2000 framework

PPT 4 -

Q&A – what does this mean?

A fundamental requirement of government at all levels—national and local—is to distribute the limited funds that it wishes to spend on particular public services between geographical areas or institutions, which are effectively competitors for such funds.

Increasing use is now being made of capitation methods for such purposes, in which a standard estimate of expected expenditure is attached to a citizen with given characteristics.

The issues – samples of demographics data and the health issues associated with them are often to small or distorted

Statistical methods are playing an important role in determining such capitation/budgets, but they give rise to profound methodological problems.

Severe limitations of government data mean that small area data are used as the unit of observation, giving rise to considerable complexity in the model to be estimated.

As a result, a range of methodologies including two-stage least squares and multilevel modelling methods are deployed.

suggestions for an approach which would represent an improvement on current capitation methods, but which would require data on individuals rather than on small areas could solve these issues, what do you think?

Meaning of - two-stage least squares and multilevel modelling methods are deployed

Two stage least squares is an instrumental variables estimation technique. This has been used to estimate the correlation between the health needs of people in a given geographical area of the UK and anticipated expected health expenditure.

Q&A

What do they mean by limitation in this method of mixed economy of care?

How do you think that central government can judge how budgets should be distributed on such small scale case studies?

What do they mean by given characteristics?

What is meant by the term ‘mixed economy of care’?

Mixed economy of care is the provision of care by a range of service providers.

Instead of services being solely provided by the NHS and social services (the public sector), some services are commissioned from the independent and voluntary sectors.

Funding of Social Care Central government provides the money to

the local councils through the Standards Spending Assessment (SSA) formula, based on the population profile of the area, including such factors as:› The number of older people› Types of housing› Single parents› Ethic groupings› Population densityLocal councils also raise money from › local council tax› Fees & charges for their services

Standard Spending Assessment (SSA) formula

In Britain, the amount of money that the government calculates a local council needs to spend on providing a particular service, and which they give to the council for this purpose.

Task 1

1. What are the origins of the statutory care sector?

2. List what the four different care sectors are and give examples.

AfL

1. The four different care sectors are private, statutory, voluntary and informal care.

2. The welfare state of the 1940’s. this was the beginning of an organisation, accessible and wide-ranging heath and welfare system for all citizens.

Task 2 1. Explain the advantages of

developing greater partnership between agencies within health care. Reference ‘mixed economy of care’.

2. Indentify the effects of the introduction of an internal market on the care system.

AfL1. Maximise resources effectively2. Minimise overlapping and duplication of services3. Services are needs led, instead of budget led4. Improved quality of provision5. Effective communication between agencies6. Financial resources are used effectively7. Creates a range and variety of resources8. Creates good sound networking between agencies 9. Multidisciplinary approach (Patients with colorectal,

gastric, and pancreatic malignancies often have a complex array of medical issues and require a combination of surgery, chemotherapy, radiation therapy, therapeutic endoscopy and other treatments. Recognising that a team approach is the most beneficial way to manage cancer, many organisation have developed a multidisciplinary program for treating patients).

Tasks 1 – showing understanding of the UK care system – AfL written answers

1. Using your notes – explain the difference between primary, secondary and tertiary health care

2. What is the main example of the statutory health care sector?

3. Give a definition of social care4. What is SSA and explain why you think

central government carries out this process?

After SSA

Once government has assessed the standard of spending to be directed at specific health care facilities in your Local authority (LA), the LA will also raise funds from local council tax.

Local councils are monitored on performance and spending by government and by the Commission for Social Care Inspection (CSCI)

Some services relating to education and children eg. child minding, nursery school provision are monitored by the Office for Standards in education (OFSTED)

University of York

Journal of the Royal Statistical Society: Series A (Statistics in Society)

Volume 164, Issue 2, 2001, Pages: 217–257, Peter C. Smith, Nigel Rice and Roy Carr-Hill

Article first published online : 6 JAN 2002, DOI: 10.1111/1467-985X.00200