Do targets matter? A comparison of English and Welsh National Health priorities
AbstractNational priorities and performance management regimes in the National Health Services of England and Wales diverged following devolution, most notably with respect to the use of waiting time targets, which have been progressively strengthened in England but were abandoned in Wales in the immediate post-devolution period. We analyse routine data collected over a six-year period from three English and one Welsh hospital trust close to the English-Welsh border to ascertain whether: (a) there is evidence of differential performance over time that relates to the country where the hospital is located; (b) within each hospital, there is evidence that English and Welsh patients faced different waiting times. Over the period the English hospitals recorded increased levels of activity, undertook proportionately more day case activity, and mortality rates fell. Activity levels remained constant in Wales, the proportion of day case activity fell, proportionately more non-elective patients were admitted, and mortality rates rose. There is partial evidence that English patients faced lower waiting times than their Welsh counterparts and were more likely to be admitted within a target waiting period. The stronger performance management regime operating in England appears to have contributed to higher levels of performance in the English hospitals over the period. Copyright © 2006 John Wiley & Sons, Ltd.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoArticle provided by John Wiley & Sons, Ltd. in its journal Health Economics.
Volume (Year): 16 (2007)
Issue (Month): 3 ()
Contact details of provider:
Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- 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,"
006cherp, Centre for Health Economics, University of York, revised Dec 2005.
- Mary OMahony & Philip Stevens & Lucy Stokes & Pete Loveridge, 2005. "Developing new approaches to measuring NHS outputs and productivity," NIESR Discussion Papers 264, National Institute of Economic and Social Research.
- Siciliani, Luigi & Hurst, Jeremy, 2005. "Tackling excessive waiting times for elective surgery: a comparative analysis of policies in 12 OECD countries," Health Policy, Elsevier, vol. 72(2), pages 201-215, May.
- Maria Goddard, 2008. "Quality in and Equality of Access to Healthcare Services in England," Working Papers 040cherp, Centre for Health Economics, University of York.
- Carol Propper & Matt Sutton & Carolyn Whitnall & Frank Windmeijer, 2008.
"Incentives and Targets in Hospital Care: Evidence from a Natural Experiment,"
The Centre for Market and Public Organisation
08/205, Department of Economics, University of Bristol, UK.
- Propper, Carol & Sutton, Matt & Whitnall, Carolyn & Windmeijer, Frank, 2010. "Incentives and targets in hospital care: Evidence from a natural experiment," Journal of Public Economics, Elsevier, vol. 94(3-4), pages 318-335, April.
- Besley, Timothy J. & Bevan, Gwyn & Burchardi, Konrad B., 2009. "Naming & Shaming: The impacts of different regimes on hospital waiting times in England and Wales," CEPR Discussion Papers 7306, C.E.P.R. Discussion Papers.
- Siciliani, Luigi & Stanciole, Anderson & Jacobs, Rowena, 2009.
"Do waiting times reduce hospital costs?,"
Journal of Health Economics,
Elsevier, vol. 28(4), pages 771-780, July.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Wiley-Blackwell Digital Licensing) or (Christopher F. Baum).
If references are entirely missing, you can add them using this form.