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Performance Indicators for Primary Care Management in the NHS

Antonio GiuffridaHugh GravelleMartin Roland

出版	Centre for Health Economics, University of York, 1998
URL	http://books.google.com.hk/books?id=3BGaQAAACAAJ&hl=&source=gbs_api

註釋There is increased emphasis on the measurement of performance in the NHS. Following the White Paper, additional high level indicators for measuring primary care performance at Health Authority level have been proposed by the NHS Executive. These include measures based on pescribing and on hospital admission rates for certain acute and chronic conditions. It is suggested that highier hospital admission rates for some conditions may indicate deficiencies in their management in primary care. In this paper the authors argue that there are difficulties with some of the proposed measures. The difficulties arise because individual single indicators are used to attempt to reflect more than one aspect of performance, mayhave large year to yea variation and be subject to confounding. Using data on Family Health Services Authorities (FHSAs) from 1989/90 to 1994/95 the authors investigate how admission rates, and the ranking of FHSAs by admission rates vary as socio-economic and secondary and primary care supply conditions are allowed for. The impact of socio-economic factors on admission rates and rankings is at least as large as the impact of the age and sex structure of FHSA populations. Allowing also for secondary care supply conditions has a smalller, but still noticeable, effect. The authors suggest that if admission rates are used as performance indicators in primary care they should be standardised for socio-economic and supply conditions, as well as for demographic factors. They also make a number of other suggestions for improving the indicators. Authors