Examines the nature of performance measurement in the NHS in its relation to the principal objectives of a public health service. Argues that existing measures (bed and theatre utilization, budget deficits, and so on) can give rise to situations which are in conflict with such objectives. Suggests performance measures should reflect the purpose of a public health services. One way this may be achieved is by use of an adjusted or weighted throughout measure which provides an indication of the level of utilization of (largely) fixed resources. Once adopted as a performance measure, throughput efficiency, established in the context of clinical objectives and available resources at unit level gives rise to quite different conclusions as to the effectiveness of existing health care delivery than has traditionally been the case.
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