Commissioning for COPD care: a new, recordable metric that supports the patient interest
Healthcare metrics have been used to drive improvement in outcome and delivery in UK hospital stroke and cardiac care. This model is attractive for chronic obstructive pulmonary disease (COPD) care because of disease frequency and the burden it places on primary, secondary and integrated care servic...
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Veröffentlicht in: | Journal of public health (Oxford, England) England), 2016-06, Vol.38 (2), p.396-402 |
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creator | Walker, Paul Phillip Thompson, E. Hill, S.L. Holton, K. Bodger, K. Pearson, M.G. |
description | Healthcare metrics have been used to drive improvement in outcome and delivery in UK hospital stroke and cardiac care. This model is attractive for chronic obstructive pulmonary disease (COPD) care because of disease frequency and the burden it places on primary, secondary and integrated care services.
Using 'hospital episode statistics' (UK 'coding'), we examined hospital 'bed days/1000 population' in 150 UK Primary Care Trusts (PCTs) during 2006-07 and 2007-08. Data were adjusted for COPD prevalence. We looked at year-on-year consistency and factors which influenced variation.
There were 248 996 COPD admissions during 2006-08. 'Bed days/1000 PCT population' was consistent between years (r = 0.87; P < 0.001). There was a >2-fold difference in bed days between the best and worst performing PCTs which was primarily a consequence of variation in emergency admission rate (P < 0.001) and proportion of emergency admissions due to COPD (P < 0.001) and to only a lesser extent length of hospital stay (P < 0.001).
Bed days/1000 population appears a useful annual metric of COPD care quality. Good COPD care keeps patients active and out of hospital and requires co-ordinated action from both hospital and community services, with an important role for integrated care. This metric demonstrates that current care is highly variable and offers a measurable target to commission against. |
doi_str_mv | 10.1093/pubmed/fdv056 |
format | Article |
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Using 'hospital episode statistics' (UK 'coding'), we examined hospital 'bed days/1000 population' in 150 UK Primary Care Trusts (PCTs) during 2006-07 and 2007-08. Data were adjusted for COPD prevalence. We looked at year-on-year consistency and factors which influenced variation.
There were 248 996 COPD admissions during 2006-08. 'Bed days/1000 PCT population' was consistent between years (r = 0.87; P < 0.001). There was a >2-fold difference in bed days between the best and worst performing PCTs which was primarily a consequence of variation in emergency admission rate (P < 0.001) and proportion of emergency admissions due to COPD (P < 0.001) and to only a lesser extent length of hospital stay (P < 0.001).
Bed days/1000 population appears a useful annual metric of COPD care quality. Good COPD care keeps patients active and out of hospital and requires co-ordinated action from both hospital and community services, with an important role for integrated care. This metric demonstrates that current care is highly variable and offers a measurable target to commission against.</description><identifier>ISSN: 1741-3842</identifier><identifier>EISSN: 1741-3850</identifier><identifier>DOI: 10.1093/pubmed/fdv056</identifier><identifier>PMID: 25926524</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Aged ; Analysis of Variance ; Female ; Healthcare Disparities ; Hospitalization - statistics & numerical data ; Humans ; Interventions (services) ; Length of Stay - statistics & numerical data ; Male ; Pulmonary Disease, Chronic Obstructive - epidemiology ; Pulmonary Disease, Chronic Obstructive - therapy ; Quality of Health Care ; State Medicine ; United Kingdom - epidemiology</subject><ispartof>Journal of public health (Oxford, England), 2016-06, Vol.38 (2), p.396-402</ispartof><rights>The Author 2015</rights><rights>The Author 2015. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c271t-c7adfcf32052099c0b218f483c71196b356d649ae6f4ce1d07c53cde14b16d773</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.jstor.org/stable/pdf/48515546$$EPDF$$P50$$Gjstor$$H</linktopdf><linktohtml>$$Uhttps://www.jstor.org/stable/48515546$$EHTML$$P50$$Gjstor$$H</linktohtml><link.rule.ids>314,780,784,803,27924,27925,58017,58250</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25926524$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Walker, Paul Phillip</creatorcontrib><creatorcontrib>Thompson, E.</creatorcontrib><creatorcontrib>Hill, S.L.</creatorcontrib><creatorcontrib>Holton, K.</creatorcontrib><creatorcontrib>Bodger, K.</creatorcontrib><creatorcontrib>Pearson, M.G.</creatorcontrib><title>Commissioning for COPD care: a new, recordable metric that supports the patient interest</title><title>Journal of public health (Oxford, England)</title><addtitle>J Public Health (Oxf)</addtitle><description>Healthcare metrics have been used to drive improvement in outcome and delivery in UK hospital stroke and cardiac care. This model is attractive for chronic obstructive pulmonary disease (COPD) care because of disease frequency and the burden it places on primary, secondary and integrated care services.
Using 'hospital episode statistics' (UK 'coding'), we examined hospital 'bed days/1000 population' in 150 UK Primary Care Trusts (PCTs) during 2006-07 and 2007-08. Data were adjusted for COPD prevalence. We looked at year-on-year consistency and factors which influenced variation.
There were 248 996 COPD admissions during 2006-08. 'Bed days/1000 PCT population' was consistent between years (r = 0.87; P < 0.001). There was a >2-fold difference in bed days between the best and worst performing PCTs which was primarily a consequence of variation in emergency admission rate (P < 0.001) and proportion of emergency admissions due to COPD (P < 0.001) and to only a lesser extent length of hospital stay (P < 0.001).
Bed days/1000 population appears a useful annual metric of COPD care quality. Good COPD care keeps patients active and out of hospital and requires co-ordinated action from both hospital and community services, with an important role for integrated care. This metric demonstrates that current care is highly variable and offers a measurable target to commission against.</description><subject>Aged</subject><subject>Analysis of Variance</subject><subject>Female</subject><subject>Healthcare Disparities</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>Interventions (services)</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Male</subject><subject>Pulmonary Disease, Chronic Obstructive - epidemiology</subject><subject>Pulmonary Disease, Chronic Obstructive - therapy</subject><subject>Quality of Health Care</subject><subject>State Medicine</subject><subject>United Kingdom - epidemiology</subject><issn>1741-3842</issn><issn>1741-3850</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kEtLw0AURgdRbK0uXYmSpZvYufPMLCU-oVAXuh6SeUhKkqkzrdB_byRtV_dyv8PH5SB0DfgBsKLz9bbunJ17-4u5OEFTkAxyWnB8etwZmaCLlFYYE0UwP0cTwhURnLApuilD1zUpNaFv-u_Mh5iVy4-nzFTRXaIzX7XJXe3nDH29PH-Wb_li-fpePi5yQyRsciMr642nQzXBShlcEyg8K6iRAErUlAsrmKqc8Mw4sFgaTo11wGoQVko6Q_dj7zqGn61LGz18ZFzbVr0L26RBKl4ILoUY0HxETQwpRef1OjZdFXcasP73oUcfevQx8Hf76vF8oA8CBuB2BFZpE-IxZwUHzpmgf6x2ZOA</recordid><startdate>20160601</startdate><enddate>20160601</enddate><creator>Walker, Paul Phillip</creator><creator>Thompson, E.</creator><creator>Hill, S.L.</creator><creator>Holton, K.</creator><creator>Bodger, K.</creator><creator>Pearson, M.G.</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20160601</creationdate><title>Commissioning for COPD care</title><author>Walker, Paul Phillip ; Thompson, E. ; Hill, S.L. ; Holton, K. ; Bodger, K. ; Pearson, M.G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c271t-c7adfcf32052099c0b218f483c71196b356d649ae6f4ce1d07c53cde14b16d773</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Analysis of Variance</topic><topic>Female</topic><topic>Healthcare Disparities</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>Interventions (services)</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Male</topic><topic>Pulmonary Disease, Chronic Obstructive - epidemiology</topic><topic>Pulmonary Disease, Chronic Obstructive - therapy</topic><topic>Quality of Health Care</topic><topic>State Medicine</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Walker, Paul Phillip</creatorcontrib><creatorcontrib>Thompson, E.</creatorcontrib><creatorcontrib>Hill, S.L.</creatorcontrib><creatorcontrib>Holton, K.</creatorcontrib><creatorcontrib>Bodger, K.</creatorcontrib><creatorcontrib>Pearson, M.G.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of public health (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Walker, Paul Phillip</au><au>Thompson, E.</au><au>Hill, S.L.</au><au>Holton, K.</au><au>Bodger, K.</au><au>Pearson, M.G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Commissioning for COPD care: a new, recordable metric that supports the patient interest</atitle><jtitle>Journal of public health (Oxford, England)</jtitle><addtitle>J Public Health (Oxf)</addtitle><date>2016-06-01</date><risdate>2016</risdate><volume>38</volume><issue>2</issue><spage>396</spage><epage>402</epage><pages>396-402</pages><issn>1741-3842</issn><eissn>1741-3850</eissn><abstract>Healthcare metrics have been used to drive improvement in outcome and delivery in UK hospital stroke and cardiac care. This model is attractive for chronic obstructive pulmonary disease (COPD) care because of disease frequency and the burden it places on primary, secondary and integrated care services.
Using 'hospital episode statistics' (UK 'coding'), we examined hospital 'bed days/1000 population' in 150 UK Primary Care Trusts (PCTs) during 2006-07 and 2007-08. Data were adjusted for COPD prevalence. We looked at year-on-year consistency and factors which influenced variation.
There were 248 996 COPD admissions during 2006-08. 'Bed days/1000 PCT population' was consistent between years (r = 0.87; P < 0.001). There was a >2-fold difference in bed days between the best and worst performing PCTs which was primarily a consequence of variation in emergency admission rate (P < 0.001) and proportion of emergency admissions due to COPD (P < 0.001) and to only a lesser extent length of hospital stay (P < 0.001).
Bed days/1000 population appears a useful annual metric of COPD care quality. Good COPD care keeps patients active and out of hospital and requires co-ordinated action from both hospital and community services, with an important role for integrated care. This metric demonstrates that current care is highly variable and offers a measurable target to commission against.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>25926524</pmid><doi>10.1093/pubmed/fdv056</doi><tpages>7</tpages></addata></record> |
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source | MEDLINE; JSTOR Archive Collection A-Z Listing; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
subjects | Aged Analysis of Variance Female Healthcare Disparities Hospitalization - statistics & numerical data Humans Interventions (services) Length of Stay - statistics & numerical data Male Pulmonary Disease, Chronic Obstructive - epidemiology Pulmonary Disease, Chronic Obstructive - therapy Quality of Health Care State Medicine United Kingdom - epidemiology |
title | Commissioning for COPD care: a new, recordable metric that supports the patient interest |
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