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Examining variations in hospital productivity in the English NHS

Author

Listed:
  • Adriana Castelli
  • Andrew Street
  • Rossella Verzulli
  • Padraic Ward

Abstract

We have set out a means of assessing hospital productivity that captures their multiple outputs and inputs. We find substantial variation in productivity among English hospitals, suggesting scope for productivity improvement. Copyright The Author(s) 2015

Suggested Citation

  • Adriana Castelli & Andrew Street & Rossella Verzulli & Padraic Ward, 2015. "Examining variations in hospital productivity in the English NHS," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(3), pages 243-254, April.
    • Handle: RePEc:spr:eujhec:v:16:y:2015:i:3:p:243-254
    DOI: 10.1007/s10198-014-0569-5
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    References listed on IDEAS

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    1. Rossella Verzulli & Rowena Jacobs & Maria Goddard, 2011. "Do hospitals respond to greater autonomy? Evidence from the English NHS," Working Papers 064cherp, Centre for Health Economics, University of York.
    2. Castelli, Adriana & Laudicella, Mauro & Street, Andrew & Ward, Padraic, 2011. "Getting out what we put in: productivity of the English National Health Service," Health Economics, Policy and Law, Cambridge University Press, vol. 6(3), pages 313-335, July.
    3. Adriana Castelli & Diane Dawson & Hugh Gravelle & Rowena Jacobs & Paul Kind & Pete Loveridge & Stephen Martin & Mary O'Mahony & Philip Stevens & Lucy Stokes & Andrew Street & Martin Weale, 2007. "A New Approach To Measuring Health System Output and Productivity," National Institute Economic Review, National Institute of Economic and Social Research, vol. 200(1), pages 105-116, April.
    4. Paul Rouse & Robert Swales, 2006. "Pricing public health care services using DEA: Methodology versus politics," Annals of Operations Research, Springer, vol. 145(1), pages 265-280, July.
    5. M. Stone, 2002. "How not to measure the efficiency of public services (and how one might)," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 165(3), pages 405-434, October.
    6. Anatoly I. Pilyavsky & William E. Aaronson & Patrick M. Bernet & Michael D. Rosko & Vivian G. Valdmanis & Mikhail V. Golubchikov, 2006. "East–west: does it make a difference to hospital efficiencies in Ukraine?," Health Economics, John Wiley & Sons, Ltd., vol. 15(11), pages 1173-1186, November.
    7. Peter C Smith & Andrew Street, 2007. "The measurement of non-market output in education and health," Economic & Labour Market Review, Palgrave Macmillan;Office for National Statistics, vol. 1(6), pages 46-52, June.
    8. Bruce Hollingsworth & Andrew Street, 2006. "The market for efficiency analysis of health care organisations," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1055-1059, October.
    9. Newhouse, Joseph P., 1994. "Frontier estimation: How useful a tool for health economics?," Journal of Health Economics, Elsevier, vol. 13(3), pages 317-322, October.
    10. Peter Smith, 1997. "Model misspecification in Data Envelopment Analysis," Annals of Operations Research, Springer, vol. 73(0), pages 233-252, October.
    11. Panzar, John C & Willig, Robert D, 1981. "Economies of Scope," American Economic Review, American Economic Association, vol. 71(2), pages 268-272, May.
    12. Street, Andrew & Sivey, Peter & Mason, Anne & Miraldo, Marisa & Siciliani, Luigi, 2010. "Are English treatment centres treating less complex patients?," Health Policy, Elsevier, vol. 94(2), pages 150-157, February.
    13. Peter C. Smith & Andrew Street, 2005. "Measuring the efficiency of public services: the limits of analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 168(2), pages 401-417, March.
    14. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    15. Jeffrey E. Harris, 1977. "The Internal Organization of Hospitals: Some Economic Implications," Bell Journal of Economics, The RAND Corporation, vol. 8(2), pages 467-482, Autumn.
    16. Street, Andrew & Maynard, Alan, 2007. "Payment by results: qualified ambition?," Health Economics, Policy and Law, Cambridge University Press, vol. 2(4), pages 445-448, October.
    17. Andrew Street & Padraic Ward, 2009. "NHS input and productivity growth 2003/4 - 2007/8," Working Papers 047cherp, Centre for Health Economics, University of York.
    18. Silvio Daidone & Andrew Street, 2011. "Estimating the costs of specialised care," Working Papers 061cherp, Centre for Health Economics, University of York.
    19. Street, Andrew & Maynard, Alan, 2007. "Activity based financing in England: the need for continual refinement of payment by results," Health Economics, Policy and Law, Cambridge University Press, vol. 2(4), pages 419-427, October.
    20. Castelli, Adriana & Dawson, Diane & Gravelle, Hugh & Jacobs, Rowena & Kind, Paul & Loveridge, Pete & Martin, Stephen & O'Mahony, Mary & Stevens, Philip Andrew & Stokes, Lucy & Street, Andrew & Weale, , 2007. "A New Approach to Measuring Health System Output and Productivity," National Institute Economic Review, National Institute of Economic and Social Research, vol. 200, pages 105-117, April.
    21. Silvio Daidone & Andrew Street, 2011. "Estimating the Costs of Specialised Care: Updated Analysis Using Data for 2009/10," Working Papers 071cherp, Centre for Health Economics, University of York.
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    Cited by:

    1. Alexander Karmann & Felix Roesel, 2017. "Hospital Policy and Productivity – Evidence from German States," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1548-1565, December.
    2. María Jose Aragon Aragon & Adriana Castelli & James Gaughan, 2017. "Hospital Trusts productivity in the English NHS: Uncovering possible drivers of productivity variations," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-14, August.
    3. María José Aragón & Martin Chalkley & Adriana Castelli & James Gaughan, 2016. "Hospital productivity growth in the English NHS 2008/09 to 2013/14," Working Papers 138cherp, Centre for Health Economics, University of York.
    4. Fernando Gascón & Jesús Lozano & Borja Ponte & David Fuente, 2017. "Measuring the efficiency of large pharmaceutical companies: an industry analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(5), pages 587-608, June.
    5. Fengyi Lin & Yung-Jr Deng & Wen-Min Lu & Qian Long Kweh, 2019. "Impulse response function analysis of the impacts of hospital accreditations on hospital efficiency," Health Care Management Science, Springer, vol. 22(3), pages 394-409, September.
    6. Roberto Colombi & Gianmaria Martini & Giorgio Vittadini, 2017. "Determinants of transient and persistent hospital efficiency: The case of Italy," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 5-22, September.
    7. See, Kok Fong & Ng, Ying Chu, 2021. "Do hospital reform and ownership matter to Shenzhen hospitals in China? A productivity analysis," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 145-155.
    8. Yia-Wun Liang & Wen-Yi Chen & Yu-Hui Lin, 2015. "Estimating a Hospital Production Function to Evaluate the Effect of Nurse Staffing on Patient Mortality in Taiwan: The Longitudinal Count Data Approach," Journal for Economic Forecasting, Institute for Economic Forecasting, vol. 0(4), pages 154-169, December.
    9. Cristian Barra & Raffaele Lagravinese & Roberto Zotti, 2022. "Exploring hospital efficiency within and between Italian regions: new empirical evidence," Journal of Productivity Analysis, Springer, vol. 57(3), pages 269-284, June.
    10. María José Aragón Aragón & Adriana Castelli & Martin Chalkley & James Gaughan, 2019. "Can productivity growth measures identify best performing hospitals? Evidence from the English National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 28(3), pages 364-372, March.
    11. Annika Maren Schneider & Eva-Maria Oppel & Jonas Schreyögg, 2020. "Investigating the link between medical urgency and hospital efficiency – Insights from the German hospital market," Health Care Management Science, Springer, vol. 23(4), pages 649-660, December.
    12. Choon C. Cheng & Anthony Scott & Vijaya Sundararajan & Wenda Yan & Jongsay Yong, 2020. "An Examination of Public Hospital Productivity and its Persistence: An Index Number Approach," Australian Economic Review, The University of Melbourne, Melbourne Institute of Applied Economic and Social Research, vol. 53(3), pages 343-359, September.
    13. Johannessen, Karl Arne & Kittelsen, Sverre A.C. & Hagen, Terje P., 2017. "Assessing physician productivity following Norwegian hospital reform: A panel and data envelopment analysis," Social Science & Medicine, Elsevier, vol. 175(C), pages 117-126.
    14. Kosycarz, Ewa & Dędys, Monika & Ekes, Maria & Wranik, Wiesława Dominika, 2023. "The effects of provider contract types and fiscal decentralization on the efficiency of the Polish hospital sector: A data envelopment analysis across 16 health regions," Health Policy, Elsevier, vol. 129(C).
    15. Ho, Foo Nin & Huang, Chin-wei, 2020. "The interdependencies of marketing capabilities and operations efficiency in hospitals," Journal of Business Research, Elsevier, vol. 113(C), pages 337-347.
    16. Aziz Jamal & Akira Babazono & Yunfei Li & Takako Fujita & Shinichiro Yoshida & Sung A Kim, 2021. "Elucidating variations in outcomes among older end-stage renal disease patients on hemodialysis in Fukuoka Prefecture, Japan," PLOS ONE, Public Library of Science, vol. 16(5), pages 1-21, May.
    17. Chris Bojke & Adriana Castelli & Katja Grašič & Andrew Street, 2017. "Productivity Growth in the English National Health Service from 1998/1999 to 2013/2014," Health Economics, John Wiley & Sons, Ltd., vol. 26(5), pages 547-565, May.

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    More about this item

    Keywords

    Hospital sector; Productivity; Production functions; DEA; C21; C43; D24; I11; I18;
    All these keywords.

    JEL classification:

    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
    • C43 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: Special Topics - - - Index Numbers and Aggregation
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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