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Atkinson Review recommendations for improving the measure of output of the health and social care sector in England (Atkinson 2005, chapter 8: Health). It focuses on specific technical points and should be read in conjunction with 'Accounting for Quality Change' which sets out many of the concepts and general principles discussed below. 2. The paper is structured as follows: (1) Atkinson Recommendation sets out the research question from the Atkinson Review; (2) The Patient Survey Programme presents details of the Healthcare Commission led Patient Survey Programme, outlining service areas covered, timings of different surveys and their rationale and objectives; (3) The Patient Experience PSA commitment explains how the patient survey data are already used to measure quality as part of the PSA target monitoring arrangements; (4) Patient Survey data: Practical issues considers empirical issues in using patient survey data to construct a measure of quality changes that can be used to ...
In this book the authors explore the state of the art on efficiency measurement in health systems and international experts offer insights into the pitfalls and potential associated with various measurement techniques. The authors show that: - The core idea of efficiency is easy to understand in principle - maximizing valued outputs relative to inputs, but is often difficult to make operational in real-life situations - There have been numerous advances in data collection and availability, as well as innovative methodological approaches that give valuable insights into how efficiently health care is delivered - Our simple analytical framework can facilitate the development and interpretation of efficiency indicators.
With the United States and other developed nations spending as much as 14 percent of their GDP on medical care, economists and policy analysts are asking what these countries are getting in return. Yet it remains frustrating and difficult to measure the productivity of the medical care service industries. This volume takes aim at that problem, while taking stock of where we are in our attempts to solve it.
This paper sets out an approach to including quality when measuring the output of primary care medical services. The paper makes a proposal for how to adjust the National Accounts measure of GP output, based on number of consultations, to take account of quality change. It identifies a framework for quality in primary care medical services and discusses data sources including the Quality and Outcomes Framework. It proposes a method of quality adjustment for clinical care based on partial outcome indicators, which are supported by other research as areas where primary care medical services can improve patients life expectancy and quality of life. It analyses preliminary results from January 2002 to July 2004, from the QRESEARCH database of over 3 million patient records, for data underlying the QOF indicators for blood pressure control and cholesterol control for patients with coronary heart disease, and blood pressure control for patients with hypertension (jointly covering about 13% ...
Diagnosis Related Group (DRG) systems were introduced in Europe to increase the transparency of services provided by hospitals and to incentivise greater efficiency in the use of resources invested in acute hospitals. In many countries, these systems were also designed to contribute to improving – or at least protecting – the quality of care. After more than a decade of experience with using DRGs in Europe, this book considers whether the extensive use of DRGs has contributed towards achieving these objectives. Written by authors with extensive experience of these systems, this book is a product of the EuroDRG project and constitutes an important resource for health policy-makers and researchers from Europe and beyond. The book is intended to contribute to the emergence of a ‘common language’ that will facilitate communication between researchers and policy-makers interested in improving the functioning and resourcing of the acute hospital sector. The book includes: A clearly structured introduction to the main ‘building blocks’ of DRG systems An overview of key issues related to DRGs including their impact on efficiency, quality, unintended effects and technological innovation in health care 12 country chapters - Austria, England, Estonia, Finland, France, Germany, Ireland, the Netherlands, Poland, Portugal, Spain and Sweden Clearly structured and detailed information about the most important DRG system characteristics in each of these countries Useful insights for countries and regions in Europe and beyond interested in introducing, extending and/ or optimising DRG systems within the hospital sector
The National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue.
The purpose of this paper is to provide additional background material about the routine use of Patient Reported Health Outcomes Measures (PROMs), as discussed in Accounting for Quality Change. The first section outlines a DHs commissioned research programme to assess the suitability and efficacy of PROMs for monitoring the outcomes of five key elective procedures in specific settings. The second section reports on the experience of a UK independent sector provider that routinely uses PROMs to measure outcomes.
This paper provides estimates of the health benefits resulting from changes in ambulance response times from 2001/2 to 2004/5. 2. The paper also provides information on expenditure on ambulance activity, and the amount of activity provided by the ambulance service. This enables a measure of the unit costs of providing ambulance services to be calculated. 3. Comparison of changes in unit costs and changes in quality of service enables investigation into the efficiency of provision of ambulance services. 4. This paper is linked to the DH paper Accounting for Quality Change which describes ways of improving measures of NHS output and productivity. This follows the Atkinson Review into Measurement of Government Output and Productivity for the National Accounts, of which a major recommendation was that measurement of output should take account of the quality of service provided.
It has become trite to observe that increases in health care costs have become unsustainable. How best for policy to address these increases, however, depends in part on the degree to which they represent increases in the real quantity of medical services as opposed to increased unit prices of existing services. And an even more fundamental question is the degree to which the increased spending actually has purchased improved health. Accounting for Health and Health Care addresses both these issues. The government agencies responsible for measuring unit prices for medical services have taken steps in recent years that have greatly improved the accuracy of those measures. Nonetheless, this book has several recommendations aimed at further improving the price indices.
In a world where there is increasing demand for the performance of health providers to be measured, there is a need for a more strategic vision of the role that performance measurement can play in securing health system improvement. This volume meets this need by presenting the opportunities and challenges associated with performance measurement in a framework that is clear and easy to understand. It examines the various levels at which health system performance is undertaken, the technical instruments and tools available, and the implications using these may have for those charged with the governance of the health system. Technical material is presented in an accessible way and is illustrated with examples from all over the world. Performance Measurement for Health System Improvement is an authoritative and practical guide for policy makers, regulators, patient groups and researchers.