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The blog reports on an article published recently by HCD Health Economist Idaira Rodriguez Santana <idaira.rodriguez@hcdeconomics.com . Idaira is lead author on the study, published in Health Economics Review, entitled Trends in and drivers of healthcare expenditure in the English NHS: a retrospective analysis. The full paper is available now on Biomed Central: https://healtheconomicsreview.biomedcentral.com/articles/10.1186/s13561-020-00278-9
The study was undertaken to contribute data to inform decisions about which and how healthcare services should be delivered by the National Health Service in England, at a point when healthcare expenditure consistently outpaces growth in both GDP and total public expenditure.
Routine data on NHS expenditure was analysed over nine years from 2008 to 2016. Trends in fourteen healthcare settings were analysed to quantify the relative contribution of different care settings. Three broad categories were adopted by the authors, Hospital Based Care, Diagnostics and Therapeutics and Community Care. Primary Care and Community Mental Health services settings were excluded due to lack of consistent data. The study employed a set of indices to aggregate diverse outputs and to disentangle growth in healthcare expenditure that is driven by activity from that due to cost pressures. The study identified potential drivers of the observed trends from published studies.
The study results show that NHS health care expenditure grew by approximately 50% over the nine-year study period driven mainly by a 40% rise in activity, and a comparatively modest growth in costs (7%). Aggregate trends in healthcare expenditure mask enormous variation across healthcare settings, the breakdown of results clarifies whether cost pressures or rising activity are the principal reason for rising healthcare expenditure in the different healthcare settings.
The study is oversight of historical trends in activity and cost across the whole system, and an appreciation of how these vary by healthcare setting and why. This information is useful for policy makers in charge of planning as it can help to identify “pressure points”, inefficiencies, wasteful health spending and drivers leading to improved performance. For further information on the study , its conclusions and what the authors propose in terms of future research in this field, please contact idaira.rodriguez@hcdeconomics.com