Report proposes better ways of measuring NHS output
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《英国医生杂志》
New ways of measuring the productivity of the NHS are being considered. An ongoing review by a leading economist into refining the methods used to measure government output has welcomed reforms made in health but has added that more needs to be done.
Tony Atkinson, warden of Nuffield College, Oxford University, made the warning this week as he issued a progress report on his review for the Office for National Statistics.
He welcomed the new health output measures introduced for the 2004 National Accounts but said further reforms were necessary to bring standards up to those expected of EU countries by 2006.
These measures, introduced in June, take account of 1700 different treatment types together with their unit costs and incidence. They provide a more direct measure of NHS output, compared with the previous system, which looked at activity in just 16 different areas, such as inpatient cases and district nurse episodes.
But Mr Atkinson had concerns about dependence on the general household survey as a source of information for use of GP services. In the survey—a random sample of 20000 British people—respondents are asked if they have visited their GP in the last two weeks.
"It does not seem to be robust as a way of measuring changes from year to year," said Mr Atkinson.
Output measures should also take better account of the quality of care given, he added. Readmission soon after treatment, for example, may be a sign that the treatment has been unsuccessful and this should ideally be flagged in the way the data are collected.
Mr Atkinson acknowledged that any quality adjustments would be politically sensitive.
"The risks are there, but you have to manage that partly by having transparent processes. There will be a need for external review which stands back from the immediate concerns of government. Measuring quality is very difficult, but it doesn抰 mean we shouldn抰 try," he said.
Atkinson Review: Interim Report. Measurement of Government Output and Productivity for the National Accounts is available online ( www.statistics.gov.uk/about/methodology_by_theme/atkinson/) and the revised health output estimates, published 30 June in the Quarterly National Accounts, are at www.statistics.gov.uk/CCI/article.asp?ID=911(London Rebecca Coombes)
Tony Atkinson, warden of Nuffield College, Oxford University, made the warning this week as he issued a progress report on his review for the Office for National Statistics.
He welcomed the new health output measures introduced for the 2004 National Accounts but said further reforms were necessary to bring standards up to those expected of EU countries by 2006.
These measures, introduced in June, take account of 1700 different treatment types together with their unit costs and incidence. They provide a more direct measure of NHS output, compared with the previous system, which looked at activity in just 16 different areas, such as inpatient cases and district nurse episodes.
But Mr Atkinson had concerns about dependence on the general household survey as a source of information for use of GP services. In the survey—a random sample of 20
"It does not seem to be robust as a way of measuring changes from year to year," said Mr Atkinson.
Output measures should also take better account of the quality of care given, he added. Readmission soon after treatment, for example, may be a sign that the treatment has been unsuccessful and this should ideally be flagged in the way the data are collected.
Mr Atkinson acknowledged that any quality adjustments would be politically sensitive.
"The risks are there, but you have to manage that partly by having transparent processes. There will be a need for external review which stands back from the immediate concerns of government. Measuring quality is very difficult, but it doesn抰 mean we shouldn抰 try," he said.
Atkinson Review: Interim Report. Measurement of Government Output and Productivity for the National Accounts is available online ( www.statistics.gov.uk/about/methodology_by_theme/atkinson/) and the revised health output estimates, published 30 June in the Quarterly National Accounts, are at www.statistics.gov.uk/CCI/article.asp?ID=911(London Rebecca Coombes)