Using data to identify good-quality care for older people. Research report

Nuffield Trust
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This report describes the results of a pilot analysis of the effectiveness of using routine health care data to determine areas that have made quality improvements in the care of frail and older people over time. There is a large amount of variation in the quality of care that is currently delivered to older people across England. Numerous initiatives have been set up with the aim of improving care, but much of the evidence of their effectiveness remains anecdotal. Furthermore, when multiple improvement activities are in place in one area, it is not always clear which parts improve outcomes and which do not. The report focuses on a few indicators that were mainly derived from acute emergency hospital use and applies statistical analyses to them at the local authority area level. Follow-up interviews and document reviews were then conducted in an attempt to ascertain whether the identified changes could be attributed to local initiatives to improve quality of care, and therefore whether these statistical methods were relevant signals of quality improvement. The study shows that there is scope for using more sophisticated analytical methods for identifying improvements in care quality, and that they have advantages in improving specificity and as continuous monitoring tools. This may be particularly true at the local level, or even at a lower level, such as individual GP practices. While the study applied these techniques retrospectively, there are likely to be advantages in using these methods for prospective monitoring and evaluation. (Edited publisher abstract)

Subject terms:
data collection, data analysis, information management, quality improvement, quantitative research, older people, performance evaluation, health care;
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