In response to the sizeable proportion of national income devoted to
the health care sector, policy makers in most high-income countries
have become increasingly concerned with improving the efficiency of
the health care sector. Meanwhile, econometricians, statisticians and
management scientists have been developing increasingly sophisticated
tools that seek to measure organisational efficiency. The question
therefore arises: do these techniques offer policy makers useful
tools with which to assess and regulate health care performance?
In collaboration with colleagues at the Centre for Health Economics
and elsewhere, we have been involved in many studies seeking to
address that question, and this book summarises our experience to
date. As the reader will see, our findings are equivocal. We find much
of value in the techniques of efficiency analysis, not least their rigour
and the insights they give into complex data sets. These virtues deserve
to be acknowledged. However, we also identify some important intellectual
weaknesses and practical difficulties associated with implementing
the techniques in health care, and we view with concern the
claims made for them by some of their more ardent advocates.