by project funding of £10m - £10m made available release of emergency admissions tariff Under changes to the emergency admissions tariff introduced in 2010, local commissioners pay 100% of the tariff for an emergency admission but the trust retains only 30% for emergency admissions above 2008/9 levels; the remaining 70% goes to NHS London. NHS London, following negotiations with NWL PCTs, agreed to release this money back into the sector to fund the pilot.
1 – each MDG holds a register of all patients over 75 and/or with diabetes 2. MDG uses ICP information tool to stratify patients by risk of emergency admission 3. Providers agree to provide the care as recommendment in the ICP parthways and protocols 4. Each patient given an individual IC plan 5. Patients receive care from range of providers – all sharing information on the joint IT tool 6. Small number of most complex cases are discussed at the MDT conference – aim to plan and coordinate care 7. MDG meets regularly to review its performance.
Information from patients based on relatively small numbers – so should be treated with some caution. : duplication of data entry, problems with interoperability and functionality
Nuffield First, we monitored the service use of the general population of inner North West London and the pilot's target population by observing patterns of activity in administrative data sets. Eligibility was determined by age and diagnoses on admission to hospital, and represented a rolling cohort of patients. These were contrasted with other areas of London and national data sets. The second part of the analysis examined a fixed cohort of patients who had received a care plan compared to matched individuals taken from other areas with similar population characteristics– this represented changes associated with ‘usual care’. Patterns of hospital use for both groups were compared using a generalized difference-in-differences regression approach at the person level. This approach has been used in a number of earlier studies [19-20]. A wide range of variables were used for matching participants to controls. These were a predictive risk score for emergency hospital admission in the next 12 months, age, sex, prior hospital utilisation, total number of chronic health conditions, area-level deprivation score and history of 15 specific health needs. We assessed the similarity of the matched control group to the group of the pilot’s patients by using the standardised difference, where a value greater than 10 per cent is indicative of a meaningful difference between the groups .In both approaches we tested the level of service utilisation before and after the start point of the pilot or the care plan.
Holly Holder & Ian Blunt: Integrated care pilot evaluation