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Getting out what we put in: productivity of the English National Health Service

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  • Castelli, Adriana
  • Laudicella, Mauro
  • Street, Andrew
  • Ward, Padraic

Abstract

Many countries are incorporating direct measures of non-market outputs in the national accounts. For any particular output to be included there has to be data about it for two adjacent periods. This is problematic because the classification of non-market outputs is often subject to wholesale revision. We outline the challenges associated with classification changes and propose a solution. To illustrate we construct output and input indices and estimate productivity growth of the English National Health Service (NHS) for the period 2003–2004 to 2007–2008. Our index of output growth incorporates all care provided to NHS patients and captures improvements in survival rates, waiting times and disease management. We find that more patients are being treated and the quality of the care they receive has been improving. We implement our approach to dealing with changes as to how health services are defined and show what effect this has on estimates of output growth. Our index of input growth captures all labour, intermediate and capital inputs into health service production and we improve on how capital has been measured in the past. Inputs have increased over time but there has also been a slowdown since 2005–2006, primarily the result of a levelling off in staff recruitment and less reliance on the use of agency staff. Productivity is assessed by comparing output growth with growth in inputs, the net effect being constant productivity growth between 2003–2004 and 2007–2008.

Suggested Citation

  • 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(03), pages 313-335, June.
  • Handle: RePEc:cup:hecopl:v:6:y:2011:i:03:p:313-335_00
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    Cited by:

    1. 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.
    2. Chris Bojke & Adriana Castelli & Rosalind Goudie & Andrew Street & Padraic Ward, 2012. "Productivity of the English National Health Service 2003-4 to 2009-10," Working Papers 076cherp, Centre for Health Economics, University of York.
    3. 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.
    4. Chris Bojke & Adriana Castelli & Katja Grasic & Andrew Street, 2014. "Productivity of the English National Health Service from 2004/5: updated to 2011/12," Working Papers 094cherp, Centre for Health Economics, University of York.
    5. Chris Bojke & Adriana Castelli & Katja Grasic & Andrew Street & Padraic Ward, 2013. "NHS Productivity from 2004/5 to 2010/11," Working Papers 087cherp, Centre for Health Economics, University of York.
    6. Chris Bojke & Adriana Castelli & Katja Grasic & Andrew Street, 2015. "Productivity of the English NHS: 2012/13 update," Working Papers 110cherp, Centre for Health Economics, University of York.
    7. Maria Jose Aragon Aragon & Adriana Castelli & James Gaughan, 2015. "Hospital trusts productivity in the English NHS: uncovering possible drivers of productivity variations," Working Papers 117cherp, Centre for Health Economics, University of York.

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