Controlling costs : strategic issues in health care management

Controlling costs in health care is rarely something that can be tackled in isolation. Cost control invariably interacts with issues of quality and health care access. Thus, this diverse collection of papers is concerned not just with costs but more importantly with value. Both macro and micro concerns are covered. At the macro level, health care reforms (and especially the 'marketisation' of health care systems) receive some attention. Papers explore how policy prescriptions get translated and modified during implementation, and assess how these prescriptions impact on both the incentive context and subsequent patterns of service delivery. Resource allocation within bureaucratic health systems continues to pose problems and these too are analysed with new solutions being proposed. At the micro level, a number of contributors wrestle with the difficulties of carrying out the economic evaluation of new drugs and technologies. In each case, the wider theoretical and practical implications of balancing costs and benefits are explored. This collection should prove helpful to health care policy specialists, managers and researchers interested in gaining a feel for the real-world application of cost-focused health services research.