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

  • Benedict E. Rumbold (a1), Judith A. Smith (a2), Jeremy Hurst (a3), Anita Charlesworth (a4) and Aileen Clarke (a5)...


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.


Corresponding author

*Correspondence to: Benedict E. Rumbold, School of Public Policy, The Rubin Building, 29/31 Tavistock Square, London WC1H 9QU, UK. Email:


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