Check out our latest papers!

• What can we learn about the impact of cancelled planned operations on waiting times? Maria Ana Matias and colleagues explain why it’s not as straightforward as you might think and why better data are essential.
• In COVID-19 and domiciliary care utilisation, Anastasia Arabadzhyan and colleagues find that “while aiming to protect the most vulnerable groups, pandemic containment policies negatively affected access to vital health and social care services, thereby increasing unmet care needs, and exacerbating existing inequalities.”

Read more on our publications page and sign up here to receive regular updates.

Please see a Waiting Times Summary which describes results emerging from a series of projects on waiting times undertaken at the University of York as part of the ESHCRU and EEPRU Policy Research Units.

The summary considers the health impact of waiting, as well as the impact on inequality and can be used to inform the development of waiting times policies.

Luigi Siciliani will be presenting ESHCRU research at the upcoming “Contracting for Health Outcomes” event on 3 October 2024.

This event is part of the newly launched SU Insights series by The Strategy Unit, exploring the potential and challenges of outcomes-based commissioning in healthcare.

Learn about the latest technical developments and practical pathways that could revive this approach to contracting for health outcomes.

Register here for the free online event.

Check out our poster summarising outputs from the 2019 to 2023 ESHCRU programme, and read more about a recent policy forum on Living with long waiting times.  For an indepth experience, see our recent publications on how to help the NHS deliver more patient health benefits and make care fairer, plus a close look at Community Diagnostic Centres.

• Contracting for health outcomes: from concept through theory to implementation • Wyatt S, Siciliani L, Revell M, Spilsbury P. • The Strategy Unit: Policy Briefing • Download Publication
• Elective surgery waiting time prioritisation to improve population health gains and reduce health inequalities • Gibbs NK, Griffin S, Gutacker N, Villasenor-Lopez A, Walker S • Policy Research Unit in Economic Evaluation of Health and Social Care Interventions. Universities of Sheffield and York. Report 071 • Download Publication
• Social Decision-Making Analysis: a general approach to inform decisions on resources in the public sector • Longo F, Claxton K, Griffin S, Mason A, Walker S, Weatherly H. • Value in Health • Download Publication
• The effect of Community Diagnostic Centres on volume and waiting time for diagnostic procedures in the UK • Sivey P, Wen J. • Health Policy • Download Publication

Two new ESHCRU publications are available:

Please see the publications page for details of our published work.

We are looking for public contributors with lived experience of health and social care to join our Advisory Groups.

We particularly encourage applications from groups that are underrepresented on our advisory groups including younger adults and people who identify as Black, Asian or from a Minority Ethnic background.

Please see the role description for Advisory Group members.

If you wish to apply, please complete the online application form.

Passionate about the economics of health and care?

ESHCRU is looking for two exceptional UK or international students to start in the academic year 2024/25.

We are offering three topic areas, with an application deadline of 25 March 2024.

Topic 1: The impact of care continuity and fragmentation in the UK NHS on patient outcomes. Empirical analyses using administrative data.

Supervisors: James Gaughan and Nigel Rice

Topic 2: The effect of demand and supply-side factors on hospital emergency department performance in the UK NHS: evidence using econometric and machine-learning methods. 

Supervisors: Peter Sivey, Rita Santos, Martin Chalkley

Topic 3: Quality-efficiency trade-offs: does reducing hospital length of stay reduce quality of care?

 Supervisor: Luigi Siciliani

For further details, including how to apply, see jobs.ac.uk

Please see the recently published policy briefing on the implications of reducing activity-based payments for emergency care:

The implications of reducing activity-based payments for emergency care • Chalkley M, Gravelle H, Jacob N, Santos R, Siciliani L • Policy Briefing • Download Publication

The paper summarises the findings of the ESHCRU project, Analysis of purchaser-provider contracts: modelling risk sharing and incentive implications.

Lay summaries have recently been produced in collaboration with members of the ESHCRU PPI Panel for the three research papers which focus on the implications of payment reform for emergency care:

Payment reform, purchaser and provider decisions and the performance of emergency healthcare systems: The case of blended payment in the English NHS • Chalkley M, Gravelle H, Jacob N, Santos R, Siciliani L • CHE Research Paper 187 • Download Lay Summary.

The Potential for Payment Reform to Influence Emergency Admissions: The Case of Blended Payment in the English NHS • Chalkley M, Gravelle H, Jacob N, Santos R, Siciliani L • CHE Research Paper 188 • Download Lay Summary.

The role of payment reform in influencing Accident and Emergency Department attendances: variation across Clinical Commissioning Groups • Chalkley M, Gravelle H, Jacob N, Santos R, Siciliani L • CHE Research Paper 191 • Download Lay Summary.

Many thanks to our PPI reviewers for their guidance.

Please see the recently published CHE Research Paper on payment reform:

The role of payment reform in influencing Accident and Emergency Department attendances: variation across Clinical Commissioning Groups • Chalkley M, Gravelle H, Jacob N, Santos R, Siciliani L • CHE Research Paper 191 • Download Publication • Download Lay Summary

For a full list of publications, please see the publications page.

The ESHCRU team has published a new paper:

The effect of hospital choice and competition on inequalities in waiting times • Moscelli G, Gravelle H, Siciliani L • Journal of Economic Behavior & Organization • Download Publication

For a full list of publications, please see the publications page.

A full list of ESHCRU publications are detailed on the publications page.

Please see recently published CHE Research Papers on Blended Payment in the English NHS:

Payment reform, purchaser and provider decisions and the performance of emergency healthcare systems: The case of blended payment in the English NHS • Chalkley M, Gravelle H, Jacob N, Santos R, Siciliani L • CHE Research Paper 187 • Download Publication

The Potential for Payment Reform to Influence Emergency Admissions: The Case of Blended Payment in the English NHS • Chalkley M, Gravelle H, Jacob N, Santos R, Siciliani L • CHE Research Paper 188 • Download Publication

Plus, this newly published analysis uses trajectory models to identify 4 end-of-life expenditure profiles: high cost late rise, medium-high cost late rise, medium-low cost, and low-cost late rise.
Heterogeneity in end of life health care expenditure trajectory profiles • Kasteridis P, Rice N, Santos R • Journal of Economic Behavior & Organization • Download Publication

The NIHR Policy Research Unit in Adult Social Care (ASCRU) hosted a showcase event in April 2022 to highlight research relevant to social care taking place within the National Institute of Health and Care Research’s Policy Research Units.

​Many thanks to Mike Shepherdson, ESHCRU II PPI Advisory Group member, for presenting at this event. The presentation on the role of public advisors in social care policy research is available to view on YouTube.

We have recently updated our PPI Payment Policy inline with new guidance from the University of York.

Publications are detailed on the publications page.

Please see the recently published CHE Research Paper, Approaches to Projecting Future Healthcare Demand.

Approaches to Projecting Future Healthcare Demand • Matias M.A, Santos R, Kasteridis P, Grasic K, Mason A, Rice N • CHE Research Paper 186 • Download Publication • Download Lay Summary

The ESHCRU research team are working on 9 new projects. Themes include tackling the electives backlog, displaced demand due to COVID-19, community health services, discharge to assess schemes and the wider impacts of adult social care spend. Plain English summaries for all our projects are available on the research page. Many thanks to members of our PPI panel for co-producing the summaries.

Recent presentations made by the ESHCRU team have included:

• The impact of social care on hospital discharges Fernandez, JL; Wistow, G • presentation to Department of Health and Social Care Integration Seminar Series, February 2022.
• Analysis of purchaser-provider contracts: modelling risk sharing and incentive implications Santos R, Chalkley M • presentation to NHS England Analytical Academy, February 2022.

In February, we held a training session for our PPI contributors which discussed a case study about the GPED study (GPs and emergency departments) and demonstrated the types of analytic approaches used by economists and health service researchers.

Publications are detailed on the publications page.

Recent publications include:

• Need, demand, supply in health care: working definitions, and their implications for defining access • Rodriguez Santana I, Mason A, Gutacker N, Kasteridis P, Santos R & Rice N. • Health Economics, Policy and Law 2021; 1–13. doi: 10.1017/S1744133121000293 • Download Publication.
• Incentives and Deterrents to the Supply of Long-term Care for the Elderly in England: Evidence and Experience in Two Local Authorities • Allan S & Darton R • Social Policy and Society 2021; 1-12. doi: 10.1017/S1474746421000403 • Download Publication.
• Extra Care Housing: The Current State of Research and Prospects for the Future • Darton R • Social Policy and Society 2021; 1-12. doi: 10.1017/S1474746421000683 • Download Publication.

Recent presentations made by the ESHCRU II team include:

• Paying for health gains Siciliani, L • Presentation to Faculti, November 2021.
• Drivers of excess mortality at home during the COVID-19 pandemic Arabadzhyan, A; Grasic, K; Sivey, P • Presentation to the Department of Health & Social Care, November 2021.

We have updated our PPI technical corner which considers some of the challenges and solutions of involving members of the public in data-heavy research. https://eshcru.com/ppi/

Using hip and knee replacements as examples, this new research report from ESHCRU II describes how a payment method based on contract theory can be used to reward providers for delivering health gains.  The work, led by Professor Luigi Siciliani, has already attracted interest from policy makers.      

Paying For Health Gains • Siciliani L, Gaughan J, Gutacker N, Gravelle H, Chalkley M • CHE Research Paper 183 • Download Publication

A full list of publications emerging from the old and new ESHCRU programmes is available on our website.  

Dr Rita Santos has been invited to deliver a keynote lecture on ‘Characterising end of life healthcare expenditure’ at the Health and Aging: the Sustainability and Equity Trade off

2nd Workshop APHEC, Genova, September 10-11, 2021.  The talk draws on research conducted under the Drivers of Demand project, led by Professor Nigel Rice. 

In July, Professor Karen Bloor gave an introductory session to Health Economics for our PPIE members. The session was in three parts: 

• The nature of economics and health economics, referencing the Williams’ ‘plumbing diagram. 
• How we can tell what works in health policy.
• Informing policy with economics research.

We hope to make the talk available on the university’s YouTube channel in due course.   

ESHCRU II’s Patient and Public Involvement and Engagement Strategy has been revised and is now available to view on our PPI page. The strategy was co-produced by the ESHCRU II Management Team and PPI members of ESHCRU II’s advisory groups. Many thanks to our PPI co-authors for all their invaluable contributions to the strategy.

Hospital competition and quality for non-emergency patients in the English NHS • Moscelli, G, Gravelle, H Siciliani, L • The RAND Journal of Economics. 2021; 1- 33. https://doi.org/10.1111 • Download Publication

Here are two recent presentations made by the ESHCRU II team:

• Publicly funded hospital care: expenditure growth and its determinants Rice, N & Aragon Aragon, MJM • Presentation to the Health Foundation, March 2021.
• Do small hospitals have lower quality: Evidence from the English NHS Gaughan J• Presentation to Faculti, April 2021.

Publications are detailed on the publications page.

Please see the recently published paper on unmet social care needs in England.

Unmet social care needs in England: a scoping study for evaluating support models for older people with low and moderate needs Fernandez JL, Malley J, Marczak J, Snell T, Wittenberg R, King D and Wistow G • CPEC Working Paper 6 • Download Publication

The ESHCRU team in York and at the LSE continue to work from home due to COVID19 and will do so for the foreseeable future.

Many are working flexibly to accommodate additional childcare responsibilities. We are fortunate that much of our work is desk-based and relies on remote access to secure datasets. We are therefore progressing our core work as much as possible but also responding to COVID19-related requests from the Department of Health and Social Care.

If you’d like to get in touch with us, please email Louise Campbell on che-eshcru@york.ac.uk and we’ll get back to you as soon as we can.

Publications are detailed on the publications page. Recently published papers from ESHCRU I include :

• Investigating the relationship between social care supply and healthcare utilisation by older people in England.
• Care home markets in England: changes over time and impact of local authority expenditure on supply.
• Cross-Cultural Comparison of the Impact of Housing Modification/Adaptation for Supporting Older People at Home: An Introduction.
• Reflections on Cross-Cultural Comparison of the Impact of Housing Modification/Adaptation for Supporting Older People at Home: A Discussion.
• Do small hospitals have lower quality? Evidence from the English NHS.
• Impact of primary care funding on patient satisfaction: a retrospective longitudinal study of English general practice, 2013–2016.
• Publicly funded hospital care: expenditure growth and its determinants.

Two ESHCRU papers were discussed at the winter HESG conference which was held at The London School of Hygiene and Tropical Medicine on 6-8 January 2021.

• Characterising end of life health care expenditure. Kasteridis P, Rice N, Santos R.
• Primary care mortality and the impact of funding: a national longitudinal study 2013 -2016. L’Esperance V, Ashworth M, Schofield P, Gravelle H.

Our website has been refreshed. Many thanks to our PPI reviewers for their invaluable suggestions and feedback which have greatly improved the layout and content of the site.

Why are there long waits at English emergency departments? • Gaughan J, Kasteridis P, Mason A, Street A • European Journal of Health Economics 21, 209–218 (2020) • Download Publication