IDEAS home Printed from
MyIDEAS: Log in (now much improved!) to save this article

La régulation économique des dépenses de santé : réflexions sur la réforme britannique

Listed author(s):
  • Dominique Bureau
  • Jacques Esposito
Registered author(s):

    [fre] Tout en offrant une couverture universelle, le N.H.S. est le système de santé qui enregistre une des meilleures performances dans le contrôle des dépenses de santé. Avant sa réforme, il représentait l'archétype du système public fiscalisé, dont la maîtrise des coûts n'était réalisée qu'au prix de contraintes réglementaires progressivement contestées. La réforme entreprise en 1991 y a rétabli certains mécanismes de marché, notamment une véritable fonction d'acheteur, les prestataires de soins de premier recours achetant des soins aux prestataires de second recours. Il s'agit là d'une réforme d'ensemble dont l'examen permet de dégager une grille d'analyse de portée générale sur la régulation des dépenses de santé. [eng] Despite universal coverage, the N.H.S. is the health system which obtains the best outcome for spending control. Prior to 1991, this result was associated with little consumer choice over health care, queues, and a general lack of flexibility. The 1991 reform has reintroduced market-type mechanisms in the N.H.S. One of its central ideas is the systematic identification of a purchaser function: the "GP fundholder", who is responsible for purchasing secondary services for his patients, is an agent of particular interest in this new context. The study of this wide-ranging reform provides an useful benchmark to discuss the various policy options available to improve the performances of health care systems.

    If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

    File URL:
    Download Restriction: no

    File URL:
    Download Restriction: no

    Article provided by Programme National Persée in its journal Revue française d'économie.

    Volume (Year): 11 (1996)
    Issue (Month): 1 ()
    Pages: 147-181

    in new window

    Handle: RePEc:prs:rfreco:rfeco_0769-0479_1996_num_11_1_999
    Note: DOI:10.3406/rfeco.1996.999
    Contact details of provider: Web page:

    No references listed on IDEAS
    You can help add them by filling out this form.

    This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

    When requesting a correction, please mention this item's handle: RePEc:prs:rfreco:rfeco_0769-0479_1996_num_11_1_999. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Equipe PERSEE)

    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 references are entirely missing, you can add them using this form.

    If the full references list an item that is present in RePEc, but the system did not link 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 profile, as there may be some citations waiting for confirmation.

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

    This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.