Improving productive efficiency in hospitals: findings from a review of international evidence

Research output: Contribution to journalArticlepeer-review


  • Benedict Rumbold
  • Judith Smith
  • Jeremy Hurst
  • Anita Charlesworth
  • Aileen Clarke

Colleges, School and Institutes

External organisations

  • University College London Hospitals NHS Foundation Trust
  • University of Warwick


At present, health systems across Europe face the same challenges: a changing demographic profile, a rise in multi-morbidity and long-term conditions, increasing health care costs, large public debts and other legacies of an economic downturn. In light of these concerns, this article provides an overview of the international evidence on how to improve productive efficiency in secondary care settings. Updating and expanding upon a recent review of the literature by Hurst and Williams (2012), we set out evidence on potential interventions in the policy environment, hospital management, and operational processes. We conclude with five key lessons for policy makers and practitioners on how to improve productive efficiency within hospital settings, and identify several gaps in the existing evidence base.


Original languageEnglish
Pages (from-to)21-43
JournalHealth economics, policy, and law
Early online date7 Aug 2014
Publication statusPublished - 1 Jan 2015


  • NHS funding, efficiency, finances, health policy