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Do targets matter? A comparison of English and Welsh National Health priorities

Author

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  • Katharina Hauck

    (Centre for Health Economics, Monash University, Australia)

  • Andrew Street

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

Abstract

National 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.

Suggested Citation

  • Katharina Hauck & Andrew Street, 2007. "Do targets matter? A comparison of English and Welsh National Health priorities," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 275-290.
  • Handle: RePEc:wly:hlthec:v:16:y:2007:i:3:p:275-290 DOI: 10.1002/hec.1153
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    References listed on IDEAS

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    1. 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.
    2. 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.
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    Cited by:

    1. 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.
    2. Carol Propper & Deborah Wilson, 2012. "The Use of Performance Measures in Health Care Systems," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 33 Edward Elgar Publishing.
    3. Maria Goddard, 2008. "Quality in and Equality of Access to Healthcare Services in England," Working Papers 040cherp, Centre for Health Economics, University of York.
    4. 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.
    5. Carol Propper & Deborah Wilson, 2012. "The Use of Performance Measures in Health Care Systems," Chapters,in: The Elgar Companion to Health Economics, Second Edition, chapter 33 Edward Elgar Publishing.
    6. Besley, Timothy & Burchardi, Konrad B. & Bevan, Gwen, 2009. "Naming and shaming: the impacts of different regimes on hospital waiting times in England and Wales," LSE Research Online Documents on Economics 33775, London School of Economics and Political Science, LSE Library.
    7. 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, pages 318-335.

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