Do managers pay their way ? The impact of management input on hospital productivity in the NHS internal market.
Levels of management staffing in the UK National Health Service (NHS) have received considerable political and media attention in the last four years or so.
Both the previous and current governments committed themselves to reducing management expenditure in the heath service, and significant cuts appear to have been made in this area in the last year or so.
Few systematic evaluations have been undertaken of the value of general management input, however, and policy changes appear to have been largely determined by popular opinion.
This study attempts to quantify the effect of management input on hospital productivity for the first three years of the NHS internal market (1991/2-1993/4).
An average cost function was used to model the effect of management inputs on hospital costs after adjustment for the levels of outputs produced, input costs, and internal and external exogenous constraints on hospital functioning.
Two measures of management input were used : the proportion of total spending consumed by top level management, and the proportion consumed by all administrative activities.
Cross-sectional and longitudinal models with contemporaneous and lagged management input effects were estimated.
Higher spending on top level management was associated with poorer productivity levels in most instances.
Total administrative inputs had a weaker, but still generally negative, association with productivity. (...)
Mots-clés Pascal : Gestion, Travail, Productivité, Economie industrielle, Hôpital, Protection sociale, Analyse coût efficacité, Sciences économiques, Enquête, Etude transversale, Epidémiologie, Méthode étude, Incidence, Aspect économique, Evaluation, Méthodologie, Système santé
Mots-clés Pascal anglais : Management, Work, Productivity, Industrial economy, Hospital, Welfare aids, Cost efficiency analysis, Economics, Survey, Cross sectional study, Epidemiology, Investigation method, Incidence, Economic aspect, Evaluation, Methodology, Health system
Notice produite par :
ORS Auvergne - Observatoire Régional de la Santé d'Auvergne
Code Inist : 002B30A11. Création : 31/05/1999.