Monitoring regional performance in general hospital psychiatry: England, Wales and Czechoslovakia

The purpose of this article is to consider how the regional performance of general hospital psychiatry may be adequately monitored using routine information. Limitations on the types of information available for monitoring regional performance are discussed, in the context of the main functions which a routine information service may be expected to fulfill. English and Welsh routine data are used in a study of the utilisation of general hospital psychiatric beds, and then compared with similar data for Czechoslovakia. The findings suggest that regional equity in the provision of beds: as measured by the coefficient of variation of the bed supply rate, and national performance, as measured by the 'marginal throughput' of these beds; is superior in Czechoslovakia despite recent additions to such beds in England and Wales. The model of utilisation, which was used to assess national performance, may be used to identify the regions whose performance is substandard when compared to other regions or countries. Finally, the relevance of these proposals for monitoring Health Service performance generally is discussed.