On Sun, 4 Jan 1998 12:26:20 -0500, you wrote:
Hi, Ian.
Ralph Burton and I within DIN have been examining the feasibility of
self-assessment for a practice using just its computer data in the
simplest possible way.
The idea is to put together a group of 'clinical ratios' which allow a
practice's performance in the areas both of clinical management and
prevention to be quickly and cheaply measured and compared with that
of its peers.
Needless to say such measurements have to be under practice control
(in the form of audit or audit-directed education)
We are currently using the mass of practice data on the 'Deep Thought'
system to test various ratios for fairness and relevance, but I am
able to report that our initial example (the nitrate/statin ratio)
appears to pass fairly severe scrutiny as a measure of quality of CHD
prevention in a practice.
We think that an arbitrary 70% of GP patients prescribed nitrates
should be on statin drugs based on our understanding of the
literature. This is a level to which we think it is reasonable for our
practice to aspire, although as one might expect, our current
performance figure is between 50 and 60% depending on the partner.
Putting together a list of, say, twenty similar clinical ratios, each
quickly calculated from the practice's data, would give we believe a
useful regular profile of a practice's performance in clinically
important areas.
This approach should be easily understood and appears to offer
mechanisms for comparison and either reward or self-improvement,
provided it is administered sensitively(by clinicians).
Kind regards,
Paul
>
>The health authority will want some "incentive" payments built in & we would
>prefer to have some attempt at looking at quality of care, preferably
>something useful - maybe something on the lines of "have all those on long
>term H2s or Losec been tested or treated for H Pylori?."
>
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Dr. Paul Steventon
Chairman Doctors Independent Network
Fitznells Manor Surgery, Ewell, Surrey
Tel:0181 394 1481 EMail [log in to unmask]
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