Rationality and reality: attitudes of health economists working at local level in the UK National Health Service
The number of health economists in the UK has grown rapidly over the last 25 years. Little is known about the impact of health economics on local resource allocation decisions although academic health economists assert the superiority of 'rational' and systematic approaches to priority setting. However, recently, there have been suggestions that health economics has 'lost its way' by failing to provide practical advice to guide decision makers. If this failing is due in part to the 'ivory tower' perspective of health economics, it may be that health service organizations should employ health economists directly. Relatively few health service purchasers and providers have chosen to adopt this course of action and the lack of published evidence relating to the success or otherwise of such a strategy makes it difficult to draw conclusions. To shed light on this subject we interviewed health economists working at local level in the NHS. This paper presents the findings from these interviews and discusses the implications for health economics and the NHS.
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