| Health services productivity | |||
Increasing pressures on health sector resources have stimulated attempts over the last decade to improve health service productivity. These have included technological and managerial innovations. The outcomes are unclear but anecdotal evidence suggests that they are mixed at best. This seminar series reviewed the current state of knowledge on health services productivity. Its objectives were to lay the foundation for international comparative research designed to identify the key ways in which health services can be delivered more efficiently in different settings and to build international networks interested in participating in follow-on research projects. The series addressed the following themes: techniques for measuring production functions, analysis of productivity in OECD, transitional and low income countries, the effects on productivity of changes in skill mix and incentives and the effects of managerial and technological innovations on productivity. The seminars were hosted by organisations with which OPI has an association. OPI is keen to know about the results of other studies related to health service efficiency and productivity. It particularly welcomes expressions of interest from organisations interested in collaborating in further research on this topic. |
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The research seminar series was supported by the Economic and Social Research Council and organised in association with the Centre for Health Management, Imperial College , University of London , LSE Health & Social Care, London School of Economics and Political Science , Office of Health Economics, London and Queen Elizabeth House, University of Oxford. | ||
| Most of the PowerPoint presentations used at the seminars are available on request. For more information email admin@opi.org.uk. Meeting notes can be found below (ISSN 1748-832X). | |||
| Damien Walker & Rianna Mohammed (2004) Producing health services efficiently: a review of measurement tools and empirical evidence (ISBN 978-0-9551123-0-0) | (PDF) | |
An introduction to measuring efficiency and productivity in health and health care Andy Street , University of York & Bruce Hollingsworth, University of Monash |
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| This two-day workshop provided an introduction to techniques used to measure the relative efficiency of health care service delivery; in particular, Stochastic Frontier Analysis (SFA) and Data Envelopment Analysis (DEA). Further details about the seminar contents can be obtained by contacting Andrew Street or Bruce Hollingsworth . | ||
| Observing health service productivity & technology diffusion | ||
| This seminar examined some of the conceptual issues involved in measuring health care productivity, with particular reference to the UK NHS. Hugh Gravelle reviewed the interpretation of productivity estimates and the conceptual issues complicating alternative measurement approaches. Nicola Mai demonstrated how technological improvements and substitution between different treatments might be incorporated in productivity measures. Alistair McGuire explored the possible incentives for treatment innovation using cross-country patient-level data on acute myocardial infarction. | ||
Developing new approaches to measuring NHS outputs & productivity Hugh Gravelle, University of York Improving measures of health service output Nicola Mai, Office of National Statistics Regulation & the diffusion of health care technology |
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Health services productivity in low-income countries: measurement and policy issues Ravi Rannan-Eliya, Institute of Policy Studies , Colombo, Sri Lanka and others |
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| Aparnaa Somanathan reviewed conceptual issues underlying productivity measurement in developing countries and recent applications with Ravi Rannan-Eliya. One such was a comparative study of efficiency in public hospitals in Bangladesh and Sri Lanka. Another example, was presented by Prof D. Varatharajan: from Kerala, India. Ravi Rannan-Eliya explored possible reasons for inter-country differences in health service costs, including their institutional history, and concluded the day by exploring productivity trends in different countries. | ||
Measuring health service productivity in developing countries: methods Aparnaa Somanathan, Institute of Policy Studies, Sri Lanka Measuring health service productivity in developing countries: applications Aparnaa Somanathan & Ravi Rannan-Eliya, Institute of Policy Studies, Sri Lanka D. Varatharajan, Sree Chitra Tirunal Institute for Medical Sciences & Technology, Kerala, India Measuring health service productivity in developing countries: comparisons between countries & over time Ravi Rannan-Eliya, Institute of Policy Studies |
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| Skill mix and incentives and their effects on productivity | ||
| This seminar reviewed the productivity measures used in the UK NHS and some of the policy issues raised by the results. Roy Carr-Hill discussed relationships between health workforce structure and productivity. He presented findings from a survey of secondary care NHS Trusts on the search for greater productivity from changing the workforce skill mix, the constraints on introducing new team structures and approaches to collecting evidence about what works. Karen Bloor reviewed the economic and psychological theories used to explain relationships between productivity and incentives. She discussed the problems of designing incentive-compatible payment regimes in the context of health market failures, the importance of trust and the difficulties of observing outcomes. She also reviewed the issue of incentive design in the context of organisational theory and explored the relationships between financial and non-financial incentives. Finally she presented the preliminary results of a productivity study, explored the possible effects of team and individual performance-related incentives and laid out a possible research agenda. Carol Propper presented the results of a study on the effects of competition and quality in a sample of NHS hospitals. Alan Maynard concluded the day by reviewing changes in NHS general practitioner contracts since 1948 and analysing the likely effects of the 2004 contract reforms on skill mix, organisational arrangements, activity, quality, costs and productivity, as well as on the relationship between the NHS and private practice. | ||
Incentives & healthcare: theory & practice Karen Bloor, University of York Case studies in incentives & productivity Roy Carr Hill, University of York, Carol Propper, CMPO University of Bristol & Alan Maynard, University of York |
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