The thesis consists of seven published papers linked by three themes. First, they investigate the effects of health care policy in primary care on a variety of patient outcomes. Five papers look at the impact of budget holding by gatekeeping general practitioners on hospital admissions, waiting times, patient satisfaction and commissioning patterns for secondary care. Two papers evaluate a case management intervention for patients considered to be at high risk of emergency hospital readmission. Second, the papers confront similar methodological issues arising from the use of non-randomised data and illustrate the methods for tackling the resulting problems of selection bias and potential confounding. Third, the papers illustrate the gains from the ability to link data sets, in particular from linking administrative data on individual patients and practices with small area socio-economic data.
|12 Sept 2010
|Published - 2010