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- W2022936739 abstract "<h3>Abstract</h3> <b>Objective</b>: To describe the extracontractual referrals of residents of a health authority during a six month period in 1994, identifying the number and cost of emergency and non-emergency referrals, including the number of cases costing more than pounds sterling20000 and those cases when payment was refused. <b>Design</b>: Descriptive analysis of all extracontractual referrals submitted to the health authority between 1 April and 30 September 1994. <b>Setting</b>: A health authority covering a poulation of 614000. <b>Results</b>: Payment of pounds sterling2 583 693 was made to 263 different providers for 2400 episodes of care, of which 1469 were emergencies and 931 were elective or tertiary referrals. Authorisation was granted for an additional 1376 referrals for future treatment but was refused in 713 instances, mostly for technical reasons. Sixteen extracontractual referrals together accounted for over a fifth of total expenditure during the study period. <b>Conclusions</b>: Handling large numbers of episodes of care on an individual cost per case basis imposes an enormous administrative burden on both purchasers and providers, diverting money away from patient care. Extracontractual referrals also expose health authorities to considerable financial risk and may undermine commissioning strategies. Measures are proposed to limit the number of episodes handled in this way. <h3>Key messages</h3> Key messages Sixteen non-elective referrals, each costing over pounds sterling20 000, accounted for 21% of total expenditure Mandatory payment for non-elective referrals can undermine a health authority9s commissioning strategy and expose it to considerable financial risk The high administrative costs of extra contractual referrals arise because a large number of episodes of care are handled individually Measures should be introduced to limit the administrative burden of extracontractual referrals and other cost per case contracts to prevent further diversion of funds away from patient care" @default.
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- W2022936739 date "1995-06-17" @default.
- W2022936739 modified "2023-09-24" @default.
- W2022936739 title "Extracontractual referrals: safety valve or administrative paperchase?" @default.
- W2022936739 cites W1995743314 @default.
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- W2022936739 doi "https://doi.org/10.1136/bmj.310.6994.1573" @default.
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