Observational studyHealth policy (Amsterdam, Netherlands)2020
The measurement and improvement of maternity service performance through inspection and rating: An observational study of maternity services in acute hospitals in England.
Observational study in Health policy (Amsterdam, Netherlands), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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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.
The trial behind it
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
4 citing papers in PubMed, 16 citations in OpenAlex.
- A Comparison of Regulatory Maternity Unit Ratings With Clinical Outcomes and Practice Measures: An Observational Study Using Routinely Collected Data.BJOG : an international journal of obstetrics and gynaecology · 2025Observational
- Article
- Involving Service Users in Care Regulation: A Scoping Review of Empirical Literature.International journal of health policy and management · 2025Article
- Association between regulator inspection and ratings on primary care prescribing: an observational study in England 2014 to 2019.BMC health services research · 2024Observational
Corrections and comments
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesTo determine whether the prior performance of maternity services, as measured by Royal College of Obstetricians and Gynaecologists performance indicators, is associated with ratings by the Care Quality Commission at subsequent inspection, and whether performance changes occur after inspection.
methodsWe used hospital activity data from 176 maternity sites inspected between October 2013 and March 2016 to generate a set of performance indicators developed by the Royal College of Obstetricians and Gynaecologists. We linked these data to Care Quality Commission data on inspection dates and rating scores and used regression models, controlling for site level effects, to estimate the relationships between inspection ratings and performance indicators before and after inspections.
resultsCoefficients measuring the relationship between indicator performance and subsequent inspection rating score had wide confidence intervals which crossed zero suggesting no statistically significant relationship prior to inspection. The same absence of statistical significance was observed for changes in indicator performance after inspection.
conclusionsThe use of routine data for performance monitoring is becoming increasingly important as regular inspection is costly and regulators require accurate and timely intelligence. However, we found no statistically significant relationships between inspection ratings and performance indicators before or after inspections in maternity services. This calls into question the validity and reliability of the performance indicators, the inspection process and ratings, or both, as measures of performance.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.