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Estimating the marginal productivity of the English National Health Service from 2003/04 to 2012/13

Author

Listed:
  • James Lomas

    (Centre for Health Economics, University of York, York, UK)

  • Stephen Martin

    (Department of Economics and Related Studies, University of York, York, UK)

  • Karl Claxton

    (Centre for Health Economics, University of York, York, UK)

Abstract

Estimates of the marginal productivity of the health sector are required for a wide range of resource allocation decisions. Founding these estimates on robust empirical analysis can inform these decisions and improve allocative efficiency as a result. This paper estimates the marginal productivity of the English NHS for a ten year period between 2003/04 and 2012/13. Data on expenditure and mortality by programme budget categories from this period are used in conjunction with socio-economic and demographic variables from the censuses from 2001 and 2011, as part of an econometric strategy that employs an established instrumental variable approach that is subjected to a number of sensitivity analyses. The results of the econometric analysis, along with additional data on burden of disease, are used to generate an estimate of marginal productivity. This paper finds that the point estimates of the amount of resources, in nominal terms, to produce an additional unit of health benefit has ranged from £5,000 to £15,000 per quality-adjusted life year between 2003/04 and 2012/13. These results are discussed in the context of the existing literature, and the potential policy implications for decisions about resource allocation are explored.

Suggested Citation

  • James Lomas & Stephen Martin & Karl Claxton, 2018. "Estimating the marginal productivity of the English National Health Service from 2003/04 to 2012/13," Working Papers 158cherp, Centre for Health Economics, University of York.
    • Handle: RePEc:chy:respap:158cherp
    as

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    References listed on IDEAS

    as
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    Blog mentions

    As found by EconAcademics.org, the blog aggregator for Economics research:
    1. Brendan Collins’s journal round-up for 18th March 2019
      by Bren Collins in The Academic Health Economists' Blog on 2019-03-18 12:00:58

    Citations

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    Cited by:

    1. James Love-Koh & Susan Griffin & Edward Kataika & Paul Revill & Sibusiso Sibandze & Simon Walker, 2019. "Incorporating concerns for equity into health resource allocation. A guide for practitioners," Working Papers 160cherp, Centre for Health Economics, University of York.
    2. James Love-Koh & Richard Cookson & Karl Claxton & Susan Griffin, 2020. "Estimating Social Variation in the Health Effects of Changes in Health Care Expenditure," Medical Decision Making, , vol. 40(2), pages 170-182, February.
    3. Daniel Howdon & Sebastian Hinde & James Lomas & Matthew Franklin, 2022. "Economic Evaluation Evidence for Resource-Allocation Decision Making: Bridging the Gap for Local Decision Makers Using English Case Studies," Applied Health Economics and Health Policy, Springer, vol. 20(6), pages 783-792, November.
    4. Emanuele Arcà & Francesco Principe & Eddy Van Doorslaer, 2020. "Death by austerity? The impact of cost containment on avoidable mortality in Italy," Health Economics, John Wiley & Sons, Ltd., vol. 29(12), pages 1500-1516, December.
    5. Stephen Martin & James Lomas & Karl Claxton, 2019. "Is an ounce of prevention worth a pound of cure? Estimates of the impact of English public health grant on mortality and morbidity," Working Papers 166cherp, Centre for Health Economics, University of York.

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    More about this item

    Keywords

    productivity; econometric modelling; programme budgeting; health opportunity costs; allocative efficiency;
    All these keywords.

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