Abstract

This paper aims to examine empirically the development and usage of cost information in the UK National Health Services (NHS) in order to provide information on how it is currently used and how it might be used in the future. The issues of costing healthcare service have been discussed internationally, in the light of the Diagnostic Related Groups (DRGs). The findings suggests that, in the UK, despite the introduction of Health Resource Groups (HRGs), there is no indication that the Department of Health has any direct interest in pursuing the consideration of HRGs as a control device. Therefore, the micro effect is a decoupling from cost control at the organisational level. The paper adds to our understanding of the nature of the interaction between the macro steering process and the micro effects. The analysis of the data follows Habermas’ (1984) discursive process, which involves marshalling evidence, informed by a ‘middle range’ methodology (Laughlin, 1995, 2004) to develop a convincing argument concerning a particular situation.

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