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[Efficiency versus quality in the NHS, in Portugal: methodologies for evaluation]
1Administração Central do Sistema da Saúde, Ministério da Saúde, Lisbon.
Acta Medica Portuguesa
|February 4, 2009
Summary
This study evaluates healthcare efficiency and quality using management, benchmarking, and outcome indicators. Composite indicators offer a valid, interpretable method for assessing healthcare performance and cost-effectiveness.
Area of Science:
- Health Services Research
- Healthcare Management
- Quality Improvement
Background:
- The 1980s and 1990s saw a rise in process indicators for healthcare control, particularly in managed care systems.
- Recent shifts focus on outcome indicators over process indicators to measure healthcare results.
- Quality indicators are developed in Europe for both hospital and primary care settings.
Purpose of the Study:
- To evaluate healthcare efficiency and quality in the NHS using management, benchmarking, process, and outcome indicators.
- To identify quality indicators and benchmarking strategies for measuring healthcare quality.
- To establish a quantitative relationship between healthcare quality and cost-effectiveness.
Main Methods:
- A Delphi method was used with senior General Practitioners (GPs) in the UK to identify key process indicators for primary care quality.
- Analysis of composite indicators for efficiency and quality in health centers and hospitals.
- Mathematical modeling to select optimal indicators for performance evaluation.
Main Results:
- Seven key process indicators were identified for primary care quality, including cervical screening, generic prescribing, and immunization rates.
- Composite indicators were found to be easy to construct, interpret, acceptable, and valid for evaluating healthcare performance.
- Studies demonstrated regional variations in health center efficiency and quality, with specific sub-regions showing higher performance.
Conclusions:
- Process indicators are more sensitive to quality differences than outcome indicators in healthcare.
- Composite indicators provide a valid and practical approach to assessing healthcare efficiency and quality.
- Further research is needed on the effects of management indicators on health outcomes.
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