Clinical outcome indicators : December 1994 / Clinical Outcomes Working Group.

  • Great Britain. National Health Service in Scotland. Clinical Outcomes Working Group.
Date:
1994
Catalogue details

Licence: Open Government Licence

Credit: Clinical outcome indicators : December 1994 / Clinical Outcomes Working Group. Source: Wellcome Collection.

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    FOREWORD These Clinical Outcome Indicators were produced by a Working Group of the Clinical Resource and Audit Group chaired by Dr Dorothy Moir, Director of Public Health for Lanarkshire Health Board. They are derived from information collected routinely by the Registrar General and the Information and Statistics Division of the Common_ Services Agency and ISD staff played a key role in assisting the Working Group. The 7 Indicators in Group A compare the populations of the 15 Health Boards; the 7 Indicators in Group B compare the average outcomes of patients treated by over 20 NHS Trusts and Directly Managed _ Units, most of them general hospitals; and the 3 Indicators in Group C compare average mortality rates after discharge from 29 psychiatric hospitals and units. How each Health Board compares with its neighbours and how each Trust compares’ with its competitors will attract considerable interest, not least from the Boards and Trusts themselves. That is indeed why these Clinical Outcome Indicators are being published in this format. It is essential, though, that everyone - particularly people who have recently been, or may soon be, treated in one of the _ hospitals involved - should understand the limitations of these comparisons. They do not constitute league tables and are not comparable to the information in the recently published Patients’ Charter : Raising the Standards in Scotland”. Comparisons of waiting times for Outpatient appointments or for admission to hospital, or cancellation rates for planned admissions, provide both patients and _ general practitioners with valuable information about the relative performance, and relative attractions, of different hospitals. These 17 Clinical Outcome Indicators do not provide comparable information, either about the efficacy of the treatment provided for particular conditions in different hospitals. or about the effectiveness of the services provided for the inhabitants of the different Health Boards by the NHS as a whole. This is because differences in clinical outcome - in mortality after a heart attack or a stroke, for example - are just as likely to be due to differences in the patients themselves as they are to be due to differences in the quality and efficacy of the treatment they received. Even though differences in age and sex have been allowed for, the _ patients attending different hospitals may differ considerably in a variety of other ways which affect how well they respond to. treatment, particularly if they are drawn from neighbourhoods with very different social and economic characteristics. Patients may differ, for example, in the length of time they have been ill before consulting their general practitioner or being referred for treatment, or in the extent to which they have other complicating conditions like diabetes or high blood pressure. There may also be unrecognised differences in the diagnostic criteria used by the staff of different hospitals, or in the extent to which they treat patients with comparatively mild conditions. Mild illnesses always tend to have a better outcome than more serious oneg-==—== INFORMATION SERVICE K PQ n ma my, 20DEC 1994 cgay, Wellcome Centre for Medical Science