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Regional Variation In The Productivity Of The English National Health Service

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  • Chris Bojke
  • Adriana Castelli
  • Andrew Street
  • Padraic Ward
  • Mauro Laudicella

Abstract

Variation in the provision of health care has long been a policy concern. We adapt the framework for productivity measurement used in the National Accounts, making it applicable for sub‐national comparisons using cross‐sectional data. We assess the productivity of the National Health Service (NHS) across regions of England, termed Strategic Health Authorities (SHAs). Productivity is calculated by comparing the total amount of healthcare output to total inputs for each region, standardised to the national average. Healthcare output comprises 6500 different categories, capturing the number and type of NHS patients treated and the quality of care received. Healthcare inputs include NHS and agency staff, supplies, equipment and capital. We find that productivity varies from 5% above to 6% below the national average. Productivity is highest in South West SHA and lowest in East Midlands, South Central and Yorkshire and The Humber SHAs. We estimate that if all regions were as productive as the most productive region in England, the NHS could treat the same number of patients with £3.2bn fewer resources each year. The methods developed lend themselves to investigate variations in productivity in other types of healthcare organisations and health systems. Copyright © 2012 John Wiley & Sons, Ltd.

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  • 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.
    • Handle: RePEc:wly:hlthec:v:22:y:2013:i:2:p:194-211
    DOI: 10.1002/hec.2794
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    1. 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(3), pages 313-335, July.
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    2. Adriana Castelli & Martin Chalkley & James Gaughan & Maria Lucia Pace & Idaira Rodriguez Santana, 2019. "Productivity of the English National Health Service: 2016/17 update," Working Papers 163cherp, Centre for Health Economics, University of York.
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    5. Zhichao Wang & Valentin Zelenyuk, 2021. "Performance Analysis of Hospitals in Australia and its Peers: A Systematic Review," CEPA Working Papers Series WP012021, School of Economics, University of Queensland, Australia.
    6. Zhichao Wang & Bao Hoang Nguyen & Valentin Zelenyuk, 2024. "Performance analysis of hospitals in Australia and its peers: a systematic and critical review," Journal of Productivity Analysis, Springer, vol. 62(2), pages 139-173, October.
    7. Alexander Karmann & Felix Roesel, 2017. "Hospital Policy and Productivity – Evidence from German States," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1548-1565, December.
    8. Adrian Gheorghe & Tracy Roberts & Thomas D. Pinkney & Dion G. Morton & Melanie Calvert, 2015. "Rational Centre Selection for RCTs with a Parallel Economic Evaluation—the Next Step Towards Increased Generalisability?," Health Economics, John Wiley & Sons, Ltd., vol. 24(4), pages 498-504, April.
    9. Wei Yang & Julien Forder & Olena Nizalova, 2017. "Measuring the productivity of residential long-term care in England: methods for quality adjustment and regional comparison," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 18(5), pages 635-647, June.

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