Resource management or managing resources?

Claims made by Stilwell and Hamlyn to have recorded reductions of 25% in average cost per patient in an out-patient clinic where detailed patient costing data was collected and employed are examined critically. Their failure to allow for case-mix differences is shown to nullify the apparent gain in resource efficiency. This raises issues concerning the value of providing managers with detailed patient costings, and throws doubt on the wisdom of current initiatives in Clinical Budgeting and Resource Management.