Incentives and targets in hospital care: Evidence from a natural experiment

• 成果类型: Article
• 署名作者: Propper, Carol; Sutton, Matt; Whitnall, Carolyn; Windmeijer, Frank
• 署名单位: University of Bristol; University of Bristol; Imperial College London; Centre for Economic Policy Research - UK; University of Manchester; University of Aberdeen
• 刊物名称: JOURNAL OF PUBLIC ECONOMICS
• ISSN/ISSBN: 0047-2727
• DOI: 10.1016/j.jpubeco.2010.01.002
• 发表日期: 2010
• 页码: 318-335
• 关键词: Health care; Waiting times; targets; incentives

摘要

Performance targets are commonly used in the public sector, despite their well known problems when organisations have multiple objectives and performance is difficult to measure. It is possible that such targets may work where there is considerable consensus that performance needs to be improved. We investigate this possibility by examining the response of the English National Health Service to high profile waiting time targets. We exploit a natural policy experiment between two countries of the UK (England and Scotland) to establish the global effectiveness of the targets. We then use a within-England hospital analysis to confirm that responses vary by treatment intensity and to control for differences in resources which may accompany targets. We find that targets met their goals of reducing waiting times without diverting activity from other less well monitored aspects of health care and without decreasing patient health on exit from hospital. (C) 2010 Elsevier B.V. All rights reserved.