000			01781naa a2200181uu 4500
001			11718
003			OSt
005			20190211155616.0
008			030311s2006 xx ||||gr |0|| 0 eng d
100	1		_aLOCOCK, Louise _96218
245	1	0	_aThe changing nature of rationing in the UK national health service
260			_bR.A.W. Rhodes, _c2000
520	3		_aThis paper presents findings from empirical research exploring recent developments in healthcare rationing in the UK , and how far these were influenced by the National Health Service (NHS) internal market. Results suggest explicit rationing has continued to spread, but the focus has shifted from exclusions of whole treatments from NHS provision towards a reconciliation of implicit and explicit approaches. There is growing interest in explicit criteria to guide decision making, within clinicians exercise discretion in individual cases. The market contributed to the growth in explicit rationing, notably by decoupling healthcare purchasers (health authorities and GP fundholders) and providers (hospital and comunity health services) from their previously shared responsibility to manage resources. However, other factors have been influential , especially concern to control rising expenditure. Having originally prompted more explicit decisions (especially exclusions), resource pressures are now rekindling interest in fixed provider budgets and implicit clinicl decision making. The paper concludes by considering the implications for rationing of proposals to abolish the NHS internal market
773	0	8	_tPublic Administration: an international quarterly _g78, 1, p. 91-109 _dR.A.W. Rhodes, 2000 _w
942			_cS
998			_a20030311 _bCassio _cCassio
998			_a20060330 _b1620^b _cQuiteria
999			_aConvertido do Formato PHL _bPHL2MARC21 1.1 _c11841 _d11841
041			_aeng