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 Working Party 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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Measuring the productivity of the health care system

the experience of the United Kingdom by Anita Charlesworth

Measuring health care productivity is important as health is a large sector of the economy and with the majority of funding coming from public sources, the outlook for productivity growth is a critical factor in the debate about fiscal sustainability. The UK has over 20 years’ experience of measuring health care productivity. The UK measure of productivity is relatively comprehensive; measuring hospital, mental health and primary care services. It compares changes in the volume of quality-adjusted output with changes in the volume of quality-adjusted inputs. The productivity measure plays a role in budget setting, fiscal risk assessment and within the health system, hospital reimbursement. The UK experience has considerable strengths but also highlights some of the challenges of health care productivity measurement. Robust productivity measurement requires high quality, comprehensive data collected on a consistent basis over time. Even in a national health service this is challenging. The emerging evidence on allocative efficiency also highlights the importance of shifting the focus from the outputs of healthcare to outcomes. But, however productivity is measured, for fiscal sustainability the critical issue is how to realise potential productivity gains within the healthcare system and the mix of policy and managerial support needed to help the system optimise the trend rate of efficiency growth.

JEL codes: H51, I11, I18

Key words: United Kingdom, productivity, measurement


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