KEY POINTS:
The Health Ministry has shied away from publicising a full report that shows declining public hospital efficiency and productivity, which it considers is only part of the picture on how to measure hospital performance.
It is cited in a more comprehensive report released this week on the same topic by the Business Roundtable, but is only available from the ministry to those who request it.
It is not on the ministry website, although an excerpt is in the 2007 Health and Independence Report, which is on the website.
The report, largely paid for by the Roundtable, found a greater decline in productivity but a smaller worsening of efficiency than the ministry found. The ministry's analysis, however, was confined to doctors and nurses in medical and surgical services, making up 27 per cent of their costs.
"These trends reflect the fact that health care delivery is labour intensive and the cost of labour is rising. New Zealand must compete in an international market for doctors and nurses. In this environment, growth in wages is difficult to control," the report says.
It also notes that any analysis of hospital productivity and efficiency is incomplete without considering changes in quality of care.
The ministry report charts four measures of quality. Two, in-hospital mortality and hospital-acquired blood infections, have shown improvement; two others, patient satisfaction and the rate of acute case readmission within 30 days of discharge, are relatively unchanged.
But the instigator of the Business Roundtable study, former Treasury Secretary Graham Scott, questions the extent to which declining productivity reflects improved quality. "The evidence is fragmentary and the scale of the effect is swamped by the much larger deterioration in productivity."
GOOD AND BAD
* Nurse and doctor cost per "output" rose by 22 per cent, on top of general inflation, from 2000/1 to 2005/6, when it reached $1380. An output is a standardised amount of care or treatment.
* Nurse and doctor productivity declined by 7.4 per cent.
* The death rate of hospital patients declined by 9 per cent.
* Hospital-acquired blood infections rose slightly from 2003 to 2004, then declined by more than 11 per cent to mid-2006.
Source: Ministry of Health
