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. the authors investigate this possibility by examining the response of the English National Health Service to high profile waiting time targets. They exploit a natural policy experiment between two countries of the UK (England and Scotland) to establish the global effectiveness of the targets. They 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. They 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. (Author/publisher)
Abstract