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Improving the measurement of health system output growth

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  • Adriana Castelli
  • Diane Dawson
  • Hugh Gravelle
  • Andrew Street

Abstract

National income accounting practice is to weight health service activities by their cost so that they can be aggregated into an output index. Quality changes are ignored. We propose an ‘ideal’ value weighted output index in which the value attached to each output reflects its contribution to health outcomes and other characteristics valued by patients. Calculation of the index for the health system as a whole is currently infeasible because of a lack of data, especially on health outcomes. We demonstrate alternative ways of combining health outcome data with existing information on post‐treatment survival, life expectancy and waiting times to construct quality adjusted cost weighted and health outcome weighted indices for a small set of hospital activities for which there are health outcome data. Copyright © 2007 John Wiley & Sons, Ltd.

Suggested Citation

  • Adriana Castelli & Diane Dawson & Hugh Gravelle & Andrew Street, 2007. "Improving the measurement of health system output growth," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1091-1107, October.
    • Handle: RePEc:wly:hlthec:v:16:y:2007:i:10:p:1091-1107
    DOI: 10.1002/hec.1211
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    References listed on IDEAS

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    1. Cutler, David M. & Huckman, Robert S., 2003. "Technological development and medical productivity: the diffusion of angioplasty in New York state," Journal of Health Economics, Elsevier, vol. 22(2), pages 187-217, March.
    2. Mary O'Mahony & Lucy Stokes, 2005. "Developing new approaches to measuring NHS outputs and productivity," National Institute of Economic and Social Research (NIESR) Discussion Papers 264, National Institute of Economic and Social Research.
    3. Diane Dawson & Hugh Gravelle & Mary O'Mahony & Andrew Street & Martin Weale & Adriana Castelli & Rowena Jacobs & Paul Kind & Pete Loveridge & Stephen Martin & Philip Stevens & Lucy Stokes, 2005. "Developing new approaches to measuring NHS outputs and productivity," Working Papers 006cherp, Centre for Health Economics, University of York, revised Dec 2005.
    4. Alan Diener & Bernie O'Brien & Amiram Gafni, 1998. "Health care contingent valuation studies: a review and classification of the literature," Health Economics, John Wiley & Sons, Ltd., vol. 7(4), pages 313-326, June.
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    Cited by:

    1. Edwin Lau & Zsuzsanna Lonti & Rebecca Schultz, 2017. "Challenges in the Measurement of Public Sector Productivity in OECD 180 Countries," International Productivity Monitor, Centre for the Study of Living Standards, vol. 32, pages 180-195, Spring.
    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. France R. M. Portrait & Onno van der Galiën & Bernard Van den Berg, 2016. "Measuring Healthcare Providers' Performances Within Managed Competition Using Multidimensional Quality and Cost Indicators," Health Economics, John Wiley & Sons, Ltd., vol. 25(4), pages 408-423, April.
    4. Troels Kristensen & Peter Bogetoft & Kjeld Pedersen, 2010. "Potential gains from hospital mergers in Denmark," Health Care Management Science, Springer, vol. 13(4), pages 334-345, December.
    5. Kerry Hickson, 2014. "The GDP Value of Twentieth-Century Health Improvements in Developed Economies: Initial Estimates for England," Review of Income and Wealth, International Association for Research in Income and Wealth, vol. 60(2), pages 385-399, June.
    6. Chris Bojke & Adriana Castelli & Andrew Street & Padraic Ward & Mauro Laudicella, 2013. "Regional Variation In The Productivity Of The English National Health Service," Health Economics, John Wiley & Sons, Ltd., vol. 22(2), pages 194-211, February.
    7. Francette Koechlin & Paul Konijn & Luca Lorenzoni & Paul Schreyer, 2017. "Comparing Hospitals and Health Prices and Volumes Across Countries: A New Approach," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 131(1), pages 43-64, March.
    8. Paul Schreyer & Matilde Mas, 2016. "Measuring Health Services in the National Accounts: An International Perspective," NBER Chapters, in: Measuring and Modeling Health Care Costs, pages 25-52, National Bureau of Economic Research, Inc.
    9. Idaira Rodriguez Santana & María José Aragón & Nigel Rice & Anne Rosemary Mason, 2020. "Trends in and drivers of healthcare expenditure in the English NHS: a retrospective analysis," Health Economics Review, Springer, vol. 10(1), pages 1-11, December.
    10. 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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