ArticleBMJ (Clinical research ed.)1999
Measuring quality of care with routine data: avoiding confusion between performance indicators and health outcomes.
Article in BMJ (Clinical research ed.), 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
46 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- A systematic review of the magnitude and cause of geographic variation in unplanned hospital admission rates and length of stay for ambulatory care sensitive conditions.BMC health services research · 2015Pooled it
- Public release of performance data in changing the behaviour of healthcare consumers, professionals or organisations.The Cochrane database of systematic reviews · 2011Pooled it
- Review
- Assessing needs-based supply of physicians: a criteria-led methodological review of international studies in high-resource settings.BMC health services research · 2023Review
- Primary care visits and ambulatory care sensitive diabetes hospitalizations among adult Alabama Medicaid beneficiaries.Primary care diabetes · 2022Article
- Addressing Quality of Care in Pediatric Units using a Digital Tool: Implementation Experience from 18 SNCU of India.Journal of tropical pediatrics · 2021Article
- Article
- Article
- Impact of Disease Prevalence Adjustment on Hospitalization Rates for Chronic Ambulatory Care-Sensitive Conditions in Germany.Health services research · 2018Article
- Prioritizing novel and existing ambulance performance measures through expert and lay consensus: A three-stage multimethod consensus study.Health expectations : an international journal of public participation in health care and health policy · 2018Article
- Differences in the prevalence of hospitalizations and utilization of emergency outpatient services for ambulatory care sensitive conditions between asylum-seeking children and children of the general population: a cross-sectional medical records study (2015).BMC health services research · 2017Article
- Health system frameworks and performance indicators in eight countries: A comparative international analysis.SAGE open medicine · 2017Article
- Article
- The impact of multiple chronic diseases on hospitalizations for ambulatory care sensitive conditions.BMC health services research · 2016Article
- [Analysis of the influence of the process of care in primary health care on avoidable hospitalizations for heart failure].Atencion primaria · 2016Article
- Using Avoidable Admissions to Measure Quality of Care for Cardiometabolic and Other Physical Comorbidities of Psychiatric Disorders: A Population-Based, Record-Linkage Analysis.Canadian journal of psychiatry. Revue canadienne de psychiatrie · 2015Article
- Observational
- Sociodemographic and health characteristics, rather than primary care supply, are major drivers of geographic variation in preventable hospitalizations in Australia.Medical care · 2015Article
- Does the quality and outcomes framework reduce psychiatric admissions in people with serious mental illness? A regression analysis.BMJ open · 2015Article
- Quality of Type II Diabetes Care in Primary Health Care Centers in Kuwait: Employment of a Diabetes Quality Indicator Set (DQIS).PloS one · 2015Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo investigate the impact of factors outside the control of primary care on performance indicators proposed as measures of the quality of primary care.
designMultiple regression analysis relating admission rates standardised for age and sex for asthma, diabetes, and epilepsy to socioeconomic population characteristics and to the supply of secondary care resources.
setting90 family health services authorities in England, 1989-90 to 1994-5.
resultsAt health authority level socioeconomic characteristics, health status, and secondary care supply factors explained 45% of the variation in admission rates for asthma, 33% for diabetes, and 55% for epilepsy. When health authorities were ranked, only four of the 10 with the highest age-sex standardised admission rates for asthma in 1994-5 remained in the top 10 when allowance was made for socioeconomic characteristics, health status, and secondary care supply factors. There was also substantial year to year variation in the rates.
conclusionHealth outcomes should relate to crude rates of adverse events in the population. These give the best indication of the size of a health problem. Performance indicators, however, should relate to those aspects of care which can be altered by the staff whose performance is being measured.
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