IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v137y2023ics0168851023001896.html
   My bibliography  Save this article

Analysing changes to the flow of public funding within local health and care systems: An adaptation of the System of Health Accounts framework to a local health system in England

Author

Listed:
  • Moss, Charlie
  • Anselmi, Laura
  • Morciano, Marcello
  • Munford, Luke
  • Stokes, Jonathan
  • Sutton, Matt

Abstract

Financial flows relating to health care are routinely analysed at national and international level. They have rarely been systematically analysed at local level, despite sub-national variation due to population needs and decisions enacted by local organisations. We illustrate an adaptation of the System of Health Accounts framework to map the flow of public health and care funding within local systems, with an application for Greater Manchester (GM), an area in England which agreed a health and social care devolution deal with the central government in 2016. We analyse how financial flows changed in GM during the four years post-devolution, and whether spending was aligned with local ambitions to move towards prevention of ill-health and integration of health and social care. We find that GM decreased spending on public health by 15%, and increased spending on general practice by 0.1% in real terms. The share of total local expenditure paid to NHS Trusts for general and acute services increased from 70.3% to 71.6%, while that for community services decreased from 11.7% to 10.3%. Results suggest that GM may have experienced challenges in redirecting resources towards their goals. Mapping financial flows at a local level is a useful exercise to examine whether spending is aligned with system goals and highlight areas for further investigation.

Suggested Citation

  • Moss, Charlie & Anselmi, Laura & Morciano, Marcello & Munford, Luke & Stokes, Jonathan & Sutton, Matt, 2023. "Analysing changes to the flow of public funding within local health and care systems: An adaptation of the System of Health Accounts framework to a local health system in England," Health Policy, Elsevier, vol. 137(C).
    • Handle: RePEc:eee:hepoli:v:137:y:2023:i:c:s0168851023001896
    DOI: 10.1016/j.healthpol.2023.104904
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851023001896
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.healthpol.2023.104904?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Looman, Willemijn & Struckmann, Verena & Köppen, Julia & Baltaxe, Erik & Czypionka, Thomas & Huic, Mirjana & Pitter, Janos & Ruths, Sabine & Stokes, Jonathan & Bal, Roland & Rutten-van Mölken, Maureen, 2021. "Drivers of successful implementation of integrated care for multi-morbidity: Mechanisms identified in 17 case studies from 8 European countries," Social Science & Medicine, Elsevier, vol. 277(C).
    2. Polin, Katherine & Hjortland, Maximilien & Maresso, Anna & van Ginneken, Ewout & Busse, Reinhard & Quentin, Wilm, 2021. "“Top-Three” health reforms in 31 high-income countries in 2018 and 2019: an expert informed overview," Health Policy, Elsevier, vol. 125(7), pages 815-832.
    3. Humphries, Richard, 2015. "Integrated health and social care in England – Progress and prospects," Health Policy, Elsevier, vol. 119(7), pages 856-859.
    4. Pankaj Bahuguna & Indranil Mukhopadhyay & Akashdeep Singh Chauhan & Saroj Kumar Rana & Sakthivel Selvaraj & Shankar Prinja, 2018. "Sub-national health accounts: Experience from Punjab State in India," PLOS ONE, Public Library of Science, vol. 13(12), pages 1-17, December.
    5. Guglielmin, Maria & Muntaner, Carles & O’Campo, Patricia & Shankardass, Ketan, 2018. "A scoping review of the implementation of health in all policies at the local level," Health Policy, Elsevier, vol. 122(3), pages 284-292.
    6. Mueller, Michael & Morgan, David, 2017. "New insights into health financing: First results of the international data collection under the System of Health Accounts 2011 framework," Health Policy, Elsevier, vol. 121(7), pages 764-769.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Maite Morteruel & Amaia Bacigalupe & Elena Aldasoro & Isabel Larrañaga & Elena Serrano, 2020. "Health Impact Assessments in Spain: Have They Been Effective?," IJERPH, MDPI, vol. 17(8), pages 1-18, April.
    2. Alonso, José M. & Andrews, Rhys, 2022. "Does vertical integration of health and social care organizations work? Evidence from Scotland," Social Science & Medicine, Elsevier, vol. 307(C).
    3. Rice, Thomas & Barnes, Andrew J. & Rosenau, Pauline & Unruh, Lynn Y. & van Ginneken, Ewout, 2021. "Health reforms in the United States: The outlook after Biden's first 100 days," Health Policy, Elsevier, vol. 125(10), pages 1277-1284.
    4. Nishita Dsouza & Anitha Devadason & Araliya M. Senerat & Patrin Watanatada & David Rojas-Rueda & Giselle Sebag, 2023. "Sustainability and Equity in Urban Development (S&EUD): A Content Analysis of “Bright Spots” from the Accelerating City Equity (ACE) Project," Sustainability, MDPI, vol. 15(9), pages 1-16, April.
    5. Djoeke van Dale & Lidwien Lemmens & Marieke Hendriksen & Nella Savolainen & Péter Nagy & Edit Marosi & Michela Eigenmann & Ingrid Stegemann & Heather L. Rogers, 2020. "Recommendations for Effective Intersectoral Collaboration in Health Promotion Interventions: Results from Joint Action CHRODIS-PLUS Work Package 5 Activities," IJERPH, MDPI, vol. 17(18), pages 1-20, September.
    6. Gutin, Iliya, 2022. "Not ‘putting a name to it’: Managing uncertainty in the diagnosis of childhood obesity," Social Science & Medicine, Elsevier, vol. 294(C).
    7. Amri, Michelle & Chatur, Ali & O'Campo, Patricia, 2022. "An umbrella review of intersectoral and multisectoral approaches to health policy," Social Science & Medicine, Elsevier, vol. 315(C).
    8. Wren, Maev-Ann & FitzPatrick, Aoife, 2020. "How does Irish healthcare expenditure compare internationally?," Research Series, Economic and Social Research Institute (ESRI), number RS114, August.
    9. Exworthy, Mark & Powell, Martin & Glasby, Jon, 2017. "The governance of integrated health and social care in England since 2010: great expectations not met once again?," Health Policy, Elsevier, vol. 121(11), pages 1124-1130.
    10. Achilleas Anastasiou & Peter Hatzopoulos & Alex Karagrigoriou & George Mavridoglou, 2021. "Causality Distance Measures for Multivariate Time Series with Applications," Mathematics, MDPI, vol. 9(21), pages 1-15, October.
    11. Singh, Nidhi & Misra, Richa & Singh, Sonali & Rana, Nripendra P. & Khorana, Sangeeta, 2022. "Assessing the factors that influence the adoption of healthcare wearables by the older population using an extended PMT model," Technology in Society, Elsevier, vol. 71(C).
    12. Daniel Rippon & Andrew McDonnell & Michael Smith & Michael McCreadie & Mark Wetherell, 2020. "A grounded theory study on work related stress in professionals who provide health & social care for people who exhibit behaviours that challenge," PLOS ONE, Public Library of Science, vol. 15(2), pages 1-23, February.
    13. Sharon Ron & Noelle Dimitri & Shir Lerman Ginzburg & Ellin Reisner & Pilar Botana Martinez & Wig Zamore & Ben Echevarria & Doug Brugge & Linda S. Sprague Martinez, 2021. "Health Lens Analysis: A Strategy to Engage Community in Environmental Health Research in Action," Sustainability, MDPI, vol. 13(4), pages 1-13, February.
    14. Owusu-Addo, Ebenezer & Renzaho, Andre M.N. & Smith, Ben J., 2020. "Developing a middle-range theory to explain how cash transfers work to tackle the social determinants of health: A realist case study," World Development, Elsevier, vol. 130(C).
    15. Kendrick, Hannah & Mackenzie, Ewan, 2023. "Austerity and the shaping of the ‘waste watching’ health professional: A governmentality perspective on integrated care policy," LSE Research Online Documents on Economics 120265, London School of Economics and Political Science, LSE Library.
    16. Eriksen, Astrid & Berger, Elke & Reichebner, Christoph & Wiedicke, Annemarie & Busse, Reinhard, 2023. "The media's coverage and framing of hospital reforms: The case of Denmark," Health Policy, Elsevier, vol. 133(C).
    17. Antoine Noël Racine & Jean-Marie Garbarino & Bernard Massiera & Anne Vuillemin, 2020. "Analysis of the Local Health-Enhancing Physical Activity Policies on the French Riviera," IJERPH, MDPI, vol. 18(1), pages 1-10, December.
    18. Ellen Strøm Synnevåg, 2022. "Evaluating ‘Health in All Policies’ in Norwegian Municipalities," Societies, MDPI, vol. 12(3), pages 1-8, June.
    19. Duminy, Lize & Ress, Vanessa & Wild, Eva-Maria, 2022. "Complex community health and social care interventions – Which features lead to reductions in hospitalizations for ambulatory care sensitive conditions? A systematic literature review," Health Policy, Elsevier, vol. 126(12), pages 1206-1225.
    20. Boswell, John & Cairney, Paul & St Denny, Emily, 2019. "The politics of institutionalizing preventive health," Social Science & Medicine, Elsevier, vol. 228(C), pages 202-210.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:137:y:2023:i:c:s0168851023001896. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.