John Appleby: Variations in health care

9,428 views

Published on

John Appleby, Chief Economist at The King's Fund, looks at the good, the bad and the inexplicable of NHS health care variations alongside our new report.

Published in: Health & Medicine
0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total views
9,428
On SlideShare
0
From Embeds
0
Number of Embeds
7,036
Actions
Shares
0
Downloads
13
Comments
0
Likes
0
Embeds 0
No embeds

No notes for slide

John Appleby: Variations in health care

  1. 1. Variations in health care: The good, the bad and the inexplicable Maximising the good and minimising the bad in health care John Appleby Chief Economist, The King’s Fund April 2011
  2. 2. Figure 1: Mapping the causes of variation
  3. 3. Figure 3: Distribution of crude rates and age–gender standardised rates for primary hip replacement (English PCTs, 2009/10)
  4. 4. Figure 6: Age–gender standardised ratios for selected elective procedures (2009/10), England=100
  5. 5. Figure 9: Variation over time: SCVs for hip replacement, cataract removal and tonsillectomy 2005/06, 2009/10
  6. 6. <ul><li>Figure 11: Audit Commission basket of 25-day case procedures, 2009/10 Per cent carried out as day cases by PCT, ordered on size of coefficient of variation low = black medium = grey high = white </li></ul>
  7. 7. Figure 12: Measures of variation: selected low effectiveness procedures, 2009/10
  8. 8. <ul><li>‘ If all variation were bad, solutions would be easy. The difficulty is in reducing the bad variation, which reflects the limits of professional knowledge and failures in its application, while preserving the good variation that makes care patient-centred. </li></ul><ul><li>‘ When we fail, we provide services to patients who don’t need or wouldn’t choose them, while we withhold the same services from people who do or would, generally making far more costly errors of overuse than of underuse.’ </li></ul><ul><li>Al Mulley Director of the Dartmouth Center for Health Care Delivery Science at Dartmouth College and Professor of Medicine at Dartmouth Medical School </li></ul>
  9. 9. Download the full report: <ul><li>www.kingsfund.org.uk/variation </li></ul>

×