Does better disease management in primary care reduce hospital costs? Evidence from English primary care

TY - JOUR

T1 - Does better disease management in primary care reduce hospital costs?

T2 - Evidence from English primary care

AU - Dusheiko, Mark Alan

AU - Gravelle, Hugh Stanley Emrys

AU - Rice, Nigel

AU - Martin, Stephen

AU - Smith, P.C.

PY - 2011/9

Y1 - 2011/9

N2 - We apply cross-sectional and panel data methods to a database of 5 million patients in 8000 English general practices to examine whether better primary care management of 10 chronic diseases is associated with reduced hospital costs. We find that only primary care performance in stroke care is associated with lower hospital costs. Our results suggest that the 10% improvement in the general practice quality of stroke care between 2004/5 and 2007/8 reduced 2007/8 hospital expenditure by about £130 million in England. The cost savings are due mainly to reductions in emergency admissions and outpatient visits, rather than to lower costs for patients treated in hospital or to reductions in elective admissions.Keywords: Disease management; Primary care; Hospital costs; Ambulatory care; sensitive conditions; Preventative careJEL categories: I12, I18

AB - We apply cross-sectional and panel data methods to a database of 5 million patients in 8000 English general practices to examine whether better primary care management of 10 chronic diseases is associated with reduced hospital costs. We find that only primary care performance in stroke care is associated with lower hospital costs. Our results suggest that the 10% improvement in the general practice quality of stroke care between 2004/5 and 2007/8 reduced 2007/8 hospital expenditure by about £130 million in England. The cost savings are due mainly to reductions in emergency admissions and outpatient visits, rather than to lower costs for patients treated in hospital or to reductions in elective admissions.Keywords: Disease management; Primary care; Hospital costs; Ambulatory care; sensitive conditions; Preventative careJEL categories: I12, I18

UR - http://www.scopus.com/inward/record.url?scp=80052846662&partnerID=8YFLogxK

U2 - 10.1016/j.jhealeco.2011.08.001

DO - 10.1016/j.jhealeco.2011.08.001

M3 - Article

SN - 0167-6296

VL - 30

SP - 919

EP - 932

JO - Journal of health economics

JF - Journal of health economics

IS - 5

ER -