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Personal Budgets, Choice and Health – a review of international evidence from 11 OECD countries: A Review of International Evidence from 11 OECD Countries

Gadsby, Erica W., Segar, Julia, Allen, Pauline, Checkland, Kath, Coleman, Anna, Mcdermott, Imelda, Peckham, Stephen (2013) Personal Budgets, Choice and Health – a review of international evidence from 11 OECD countries: A Review of International Evidence from 11 OECD Countries. International Journal of Public and Private Health care Management and Economics, 3 (3). pp. 15-28. ISSN 2155-6423. E-ISSN 2155-6431. (doi:10.4018/ijpphme.2013070102) (KAR id:41307)


Personal or individual budgets for purchasing health and social care are intended to offer more choice,

control and flexibility to service users when compared with agency-directed care. They are becoming an

increasingly common feature in high-income countries for purchasing personal care that often lies on the

border line between health and social care. In England, they have recently been introduced explicitly for the

purchasing of health care. There are some key motivations behind their introduction: they are expected to

give individuals more choice about care they receive; to expand options for care; to improve outcomes; and

to reduce expenditure. This paper draws from a review of the international evidence on personal budgets

which identified: descriptive detail on personal budget schemes in 11 OECD countries to examine their key

features and implementation processes; empirical evidence on the experiences of, and outcomes for, people

using these schemes, and; empirical evidence regarding the impact of the schemes on the healthcare system,

particularly with regards to resources. The paper examines the motivating factors behind personal budget

schemes in light of this evidence. It concludes that there is little in the evidence to suggest that international

governments’ expectations for personal budget programmes are well-founded. The assumptions that they

improve choice, and that more choice will in turn lead to greater autonomy and then improved outcomes at

lower cost, are actually far more complex and generally unsupported by evidence.

Item Type: Article
DOI/Identification number: 10.4018/ijpphme.2013070102
Uncontrolled keywords: Cash-For-Care, Health Policy, Patient Choice, Personal Budgets, Personalisation
Subjects: H Social Sciences > HB Economic Theory
H Social Sciences > HG Finance
R Medicine > RA Public aspects of medicine
Divisions: Divisions > Division for the Study of Law, Society and Social Justice > School of Social Policy, Sociology and Social Research > Centre for Health Services Studies
Depositing User: Tony Rees
Date Deposited: 06 Jun 2014 12:50 UTC
Last Modified: 16 Nov 2021 10:16 UTC
Resource URI: (The current URI for this page, for reference purposes)

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