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Performance signals in the public sector: the case of health care

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Author Info
Hugh Gravelle
Peter Smith
Ana Xavier

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Abstract

Although there are no traditional markets and money prices in the public sector, consumers and providers may respond to signals of organisational performance. We present a simple dynamic model of the demand and supply for elective surgery in the UK National Health Service in which waiting time acts as the prime indicator of performance. The model is tested using a panel of quarterly data for 123 English health authorities over an eight-year period. We find that supply is increasing and demand is decreasing in measures of the previous period waiting time. The results imply that health care systems which are rationed by waiting do respond to indicators of waiting times. The paper adds to the small but consistent body of research which demonstrates that public sector systems respond to important aspects of reported performance. Copyright 2003, Oxford University Press.

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Publisher Info
Article provided by Oxford University Press in its journal Oxford Economic Papers.

Volume (Year): 55 (2003)
Issue (Month): 1 (January)
Pages: 81-103
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Handle: RePEc:oup:oxecpp:v:55:y:2003:i:1:p:81-103

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  1. Fabrizio Iacone & Steve Martin & Luigi Siciliani & Peter C Smith, 2007. "Modelling the Dynamics of a Public Health Care System: Evidence from Time-Series Data," Working Papers 029cherp, Centre for Health Economics, University of York. [Downloadable!]
    Other versions:
  2. Sofia Dimakou & David Parkin & Nancy Devlin & John Appleby, 2006. "The impact of government targets on waiting times for elective surgery: new insights from time-to-event analysis," City University Economics Discussion Papers 06/05, Department of Economics, City University, London. [Downloadable!]
  3. Diane Dawson & Hugh Gravelle & Rowena Jacobs & Stephen Martin & Peter C. Smith, 2007. "The effects of expanding patient choice of provider on waiting times: evidence from a policy experiment," Health Economics, John Wiley & Sons, Ltd., vol. 16(2), pages 113-128. [Downloadable!]
  4. Anurag Sharma & Anthony Harris & Jeff Richardson, 2008. "Use of Elective Surgery in Public hospitals:Modeling Access-Cost Quality Trade-offs in a Spatial Framework," Centre for Health Economics Research Papers 26/08, Monash University, Centre for Health Economics. [Downloadable!]
  5. Hugh Gravelle & Luigi Siciliani, 2007. "Third degree waiting time discrimination: optimal allocation of a public sector health care treatment under rationing by waiting," Discussion Papers 07/22, Department of Economics, University of York. [Downloadable!]
  6. Hugh Gravelle & Luigi Siciliani, 2007. "Ramsey Waits: Allocating Public Health Service Resources when there is Rationing by Waiting," Discussion Papers 07/15, Department of Economics, University of York. [Downloadable!]
  7. Diane Dawson & Hugh Gravelle & Rowena Jacobs & Stephen Martin & Peter C Smith, 2005. "The effects on waiting times of expanding provider choice:evidence from a policy experiment," Working Papers 001cherp, Centre for Health Economics, University of York. [Downloadable!]
  8. Jacco Thijssen, 2007. "Ramsey Waits: A Computational Study on General Equilibrium Pricing of Derivative Securities," Discussion Papers 07/16, Department of Economics, University of York. [Downloadable!]
  9. Brekke, Kurt Richard & Siciliani, Luigi & Straume, Odd Rune, 2007. "Competition and Waiting Times in Hospital Markets," CEPR Discussion Papers 6285, C.E.P.R. Discussion Papers. [Downloadable!] (restricted)
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  10. Luigi Siciliani, 2005. "Does more choice reduce waiting times?," Health Economics, John Wiley & Sons, Ltd., vol. 14(1), pages 17-23. [Downloadable!]
  11. Luigi Siciliani, 2008. "A note on the dynamic interaction between waiting times and waiting lists," Health Economics, John Wiley & Sons, Ltd., vol. 17(5), pages 639-647. [Downloadable!]
  12. Frank Windmeijer & Hugh Gravell & Pierre Hoonhout, 2004. "Waiting lists, waiting times and admissions: an empirical analysis at hospital and general practice level," IFS Working Papers W04/35, Institute for Fiscal Studies. [Downloadable!]
    Other versions:
  13. Luigi Siciliani, 2007. "Optimal Contracts for Health Services in the Presence of Waiting Times and Asymmetric Information," Contributions to Economic Analysis & Policy, Berkeley Electronic Press, vol. 7(1), pages 1661-1661. [Downloadable!] (restricted)
  14. Mike Damiani & Jennifer Dixon & Carol Propper, 2004. "Mapping choice in the NHS: Analysis of routine data," The Centre for Market and Public Organisation 04/095, Department of Economics, University of Bristol, UK. [Downloadable!]
  15. Diane Dawson & Rowena Jacobs & Stephen Martin & Peter Smith, 2006. "The impact of patient choice and waiting time on the demand for health care: results from the London Patient Choice project," Applied Economics, Taylor and Francis Journals, vol. 38(12), pages 1363-1370, July. [Downloadable!] (restricted)
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