OECD Journal on Budgeting

The OECD Journal on Budgeting is published three times per year. It draws on the best of the recent work of the OECD Committee of Senior Budget Officials (SBO), as well as special contributions from finance ministries, academics and experts in the field and makes it available to a wider community in an accessible format. The journal provides insight on leading-edge institutional arrangements, systems and instruments for the allocation and management of resources in the public sector.

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Can performance measurement make health care systems more sustainable? Or at least more efficient?

In light of the many discussions advocating the use of pay-for-performance and performance budgeting, this paper argues that discouraging experience with both approaches should temper expectations that performance measurement can be a reform that will make health care systems more "sustainable" or even more efficient. The link between sustainability and efficiency is tenuous, and attention to performance is not new. Measurement's accuracy tends to be overstated and its costs understated or ignored. Nor does it easily lead to changed behaviour. Yet some measurement is useful for managing any complex activity. In particular, there are situations in which measures are more accurate and the proper responses to shortfalls are generally agreed. Policymakers should look for those conditions and encourage the more limited, targeted improvement that measures then can make possible.


Keywords: sustainability, measurement, budgeting, Performance
JEL: I11: Health, Education, and Welfare / Health / Analysis of Health Care Markets; H51: Public Economics / National Government Expenditures and Related Policies / Government Expenditures and Health; I18: Health, Education, and Welfare / Health / Health: Government Policy; Regulation; Public Health
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