TY - UNPB
T1 - Hospital trusts productivity in the English NHS:
T2 - uncovering possible drivers of productivity variations
AU - Aragon Aragon, Maria Jose Monserratt
AU - Castelli, Adriana
AU - Gaughan, James Michael
PY - 2015/10
Y1 - 2015/10
N2 - In 2009, the NHS Chief Executive warned that a potential funding gap of £20 billion should be met by
extensive efficiency savings by March 2015. Our study investigates possible drivers of differential
Trust performance (productivity) for the years 2010/11-2012/13. Productivity is measured as
Outputs/Inputs. We extend previous productivity work at Trust level by including a fuller range of
care settings, including Inpatient, A&E and Community Care, in our output measure. Inputs include
staff, equipment, and capital resources. We analyse variation in Total Factor and Labour
Productivity with ordinary least squares regressions. Explanatory variables include efficiency in
resource use measures, Trust and patient characteristics. We find productivity varies substantially
across Trusts but is consistent across time. Larger Trusts are associated with lower productivity.
Patient age groups treated is also found to be important. Foundation Trust status is associated with
lower Total Factor Productivity, while treating more patients in their last year of life is surprisingly
associated with higher Labour Productivity. Variation in productivity is persistent across years, and
not fully explained by case-mix adjustment. A lack of convergence in productivity may indicate
outstanding scope to improve Trust productivity based on mimicking the practises of the most
productive providers.
AB - In 2009, the NHS Chief Executive warned that a potential funding gap of £20 billion should be met by
extensive efficiency savings by March 2015. Our study investigates possible drivers of differential
Trust performance (productivity) for the years 2010/11-2012/13. Productivity is measured as
Outputs/Inputs. We extend previous productivity work at Trust level by including a fuller range of
care settings, including Inpatient, A&E and Community Care, in our output measure. Inputs include
staff, equipment, and capital resources. We analyse variation in Total Factor and Labour
Productivity with ordinary least squares regressions. Explanatory variables include efficiency in
resource use measures, Trust and patient characteristics. We find productivity varies substantially
across Trusts but is consistent across time. Larger Trusts are associated with lower productivity.
Patient age groups treated is also found to be important. Foundation Trust status is associated with
lower Total Factor Productivity, while treating more patients in their last year of life is surprisingly
associated with higher Labour Productivity. Variation in productivity is persistent across years, and
not fully explained by case-mix adjustment. A lack of convergence in productivity may indicate
outstanding scope to improve Trust productivity based on mimicking the practises of the most
productive providers.
KW - Hospital
KW - productivity indices
KW - productivity variation
M3 - Discussion paper
T3 - CHE Research Paper
SP - 1
EP - 27
BT - Hospital trusts productivity in the English NHS:
PB - Centre for Health Economics, University of York
CY - York, UK
ER -