Cost and performance information for doctors: an international comparison

Abstract In the last decade many OECD countries have undertaken substantial changes to their system of healthcare administration and funding. These changes have been characterised as being economically and managerially focused. However, doctors remain central to any system of healthcare and therefore to the implementation of these reforms. Therefore, if these changes have had any real impact on doctors then there should be a clear interest in and access to information on the cost and outcome of clinical activity. This paper attempts to evaluate whether this is the case. We have conducted a case study of hospital sites in the UK, Germany and Italy. We have found that although there was some interest in cost and activity information that clinical staff generally did not have access to it. Cost and activity information were only available to clinical staff at the most senior levels. Therefore, serious questions must be raised about the extent of penetration that these reforms have had at the clinical level.