TITLE

The Public Health Impact score: a new measure of public health effectiveness for general practices in England

AUTHOR(S)
Ashworth, Mark; Schofield, Peter; Doran, Tim; Cookson, Richard; Sutton, Matthew; Seed, Paul T.; Howe, Amanda; Fleetcroft, Robert
PUB. DATE
April 2013
SOURCE
British Journal of General Practice;Apr2013, Vol. 63 Issue 609, pe291
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Background: Health policy in the UK is increasingly focused on the measurement of outcomes rather than structures and processes of health care. Aim: To develop a measure of the effectiveness of primary care in terms of population health outcomes. Design and setting: A cross-sectional study of general practices in England. Method: Twenty clinical quality of care indicators for which there was evidence of mortality reduction were identified from the national Quality and Outcomes Framework (QOF) payfor- performance scheme. The number of lives saved by 8136 English practices (97.97% of all practices) in 2009/2010 was estimated, based on their performance on these measures, and a public health impact measure, the PHI score, was constructed. Multilevel regression models were used to identify practice and population predictors of PHI scores. Results: The mean estimated PHI score was 258.9 (standard deviation [SD] = 73.3) lives saved per 100 000 registered patients, per annum. This represents 75.7% of the maximum potential PHI score of 340.9 (SD = 91.8). PHI and QOF scores were weakly correlated (Pearson r = 0.28). The most powerful predictors of PHI score were the prevalence of the relevant clinical conditions (ß = 0.77) and the proportion of patients aged =65 years (ß = 0.22). General practices that were less successful at achieving their maximum potential PHI score were those with a lower prevalence of relevant conditions (ß = 0.29), larger list sizes (ß = -0.16), greater area deprivation (ß = -0.15), and a larger proportion of patients aged =65 years (ß = -0.13). Conclusion: The PHI score is a potential alternative metric of practice performance, measuring the estimated mortality reduction in the registered population. Rewards under the QOF pay-forperformance scheme are not closely aligned to the public health impact of practices.
ACCESSION #
86439540

 

Related Articles

  • DUQuE quality management measures: associations between quality management at hospital and pathway levels. Wagner, Cordula; Groene, Oliver; Thompson, Caroline A.; Dersarkissian, Maral; Klazinga, Niek S.; Arah, Onyebuchi A.; Suñol, Rosa // International Journal for Quality in Health Care;Apr2014 Supplement, Vol. 26, p66 

    Objective The assessment of integral quality management (QM) in a hospital requires measurement and monitoring from different perspectives and at various levels of care delivery. Within the DUQuE project (Deepening our Understanding of Quality improvement in Europe), seven measures for QM were...

  • Las unidades de hemodiálisis en México: una evaluación de sus características, procesos y resultados. Tirado-Gómez, Laura Leticia; Durán-Arenas, Juan Luis; Rojas-Russell, Mario Enrique; Venado-Estrada, Aída; Pacheco-Domínguez, Reyna Lizzete; López-Cervantes, Malaquías // Salud Pública de México;nov/dic2011 supplement 4, Vol. 53, pS491 

    Objective. To evaluate the characteristics, processes, outcomes and structure of a sample of hemodialysis units (HU) in Mexico. Material and Methods. Cross-sectional study in 83 public and private HU from the 32 states in Mexico. The HU were stratified, according to a score, in five categories:...

  • Drug-related visits to the emergency department in a Spanish university hospital. Castro, Isabel; Guardiola, José; Tuneu, Laura; Sala, Mª; Faus, Mª; Mangues, Mª // International Journal of Clinical Pharmacy;Oct2013, Vol. 35 Issue 5, p727 

    Background Negative outcomes of medications (NOMs) are a major public health problem that impact on patients' quality of life. As many NOMs are avoidable, it is necessary to determine their causes in each health setting in order to plan preventive strategies. Objective The aims of this study...

  • Relationship between commuting and health outcomes in a cross-sectional population survey in southern Sweden.  // BMC Public Health;2011, Vol. 11 Issue 1, p834 

    The article focuses on a cross-sectional population survey in southern Sweden, which studies the relationship between commuting and health outcomes. Data from two cross-sectional population-based public health surveys conducted in 2004 and 2008 in Scania, was used in the survey. The background,...

  • Reducing Neonatal Mortality in India: Critical Role of Access to Emergency Obstetric Care. Rammohan, Anu; Iqbal, Kazi; Awofeso, Niyi // PLoS ONE;Mar2013, Vol. 8 Issue 3, p1 

    Background: Neonatal mortality currently accounts for 41% of all global deaths among children below five years. Despite recording a 33% decline in neonatal deaths between 2000 and 2009, about 900,000 neonates died in India in 2009. The decline in neonatal mortality is slower than in the...

  • Infant mortality in northeastern Anatolia and associated factors. Vançelik, Serhat; Işik, Memet; Toraman, Ahmet Ruhi; Aktürk, Zekeriya // Turkish Journal of Medical Sciences;Feb2012, Vol. 42 Issue 1, p157 

    Aim: To explore the causes of infant mortality. Infant mortality is the most important criterion for the evaluation of the sufficiency of mother and child health care and the planning of health care provision. In this study, we investigated infant mortality and associated factors in 7 provinces...

  • Comparing measures of multimorbidity to predict outcomes in primary care: a cross sectional study. Brilleman, Samuel L; Salisbury, Chris // Family Practice;Apr2013, Vol. 30 Issue 2, p172 

    Background. An increasing proportion of people are living with multiple health conditions, or ‘multimorbidity’. Measures of multimorbidity are useful in studies of interventions in primary care to take account of confounding due to differences in case-mix. Objectives. Assess the...

  • Quality earnings: your three steps to heaven.  // Pulse;1/12/2004, Vol. 64 Issue 2, p24 

    Outlines the British quality and outcomes framework for treating coronary heart disease. Ways by which general practitioners can maximize the pay raise associated with the framework; Chronic diseases and patient experience areas covered by the initial scheme; Factors that should be considered...

  • Secondary prevention in CHD and LVD subset.  // Pulse;1/12/2004, Vol. 64 Issue 2, p25 

    Focuses on how to get the maximum points from the British quality and outcomes framework governing secondary prevention of coronary heart disease subset. Ways of keeping the patient register; Maximum average GMS value per partner.

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics