Title: Competition, contracting and cost-sharing in the NHS internal market

Authors: Keith E. Gray, Deb Ghosh

Addresses: Coventry University, UK. ' Coventry University, UK

Abstract: The NHS Internal Market provided a testing ground for some hypotheses on relationship building between purchasers and providers of secondary health care. An empirical analysis is presented based upon a major survey of NHS Trusts. LOGIT models were used to tackle the qualitative nature of a series of different hypotheses relating to competing MIS Trusts and their risk avoidance strategies. Furthermore, the analysis has been extended to estimate the prevalence of risk avoidance strategies for any specific local health market scenario. The results also enabled some predictions regarding the impact of recent NHS reforms on the relationship building phenomenon.

Keywords: NHS internal market; UK National Health Service; purchasers; providers; secondary healthcare; NHS Trusts; risk avoidance; relationship building.

DOI: 10.1504/GBER.2000.006153

Global Business and Economics Review, 2000 Vol.2 No.1, pp.85 - 103

Published online: 07 Feb 2005 *

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