Treatment of circulatory disease in the NHS

This report studies the feasibility of measuring growth in outputs, costs and productivity for hospital treatment of circulatory diseases.

Background

There has been great interest in measuring the productivity growth of the NHS as a whole. But until recently, such information has not been available for individual programmes of care. This report looks at trends in inputs, activities and outputs for a single programme of care – circulatory disease – in the hospital setting.

About QQUIP

QQUIP (Quest for Quality and Improved Performance) is a five-year research initiative of The Health Foundation. It provides independent reports on a wide range of data about the quality of healthcare in the UK.

Measuring trends

The report highlights trends in the volume of activity, costs and survival rates for selected hospital resource groups (HRGs) over a six-year period, from 1998/99 to 2003/04. The main chapters cover:

• the background (including literature review and analytical framework)
• data sources used
• data on circulatory diseases
• trends in activity, unit costs and survival rates for selected treatments
• cost-weighted output measures of circulatory diseases
• implications for policy and future research.

Getting the right data

The only consistent, universal and reliable measures of outcomes currently available relate to mortality. Ideally, other measures of health outcome would be included in the analysis, such as gains in quality of life following treatment. But the NHS does not routinely collect health outcomes data.

Using a small sample of outcomes data for two procedures collected by the healthcare company BUPA, the report shows how health outcome data could be used to augment other measures. It argues that the NHS should move rapidly towards routine collection of such data.

Conclusions

This study found that changes in productivity for treatment of circulatory disease depend to a large extent on the measure of input growth used. It draws a very tentative conclusion that the NHS has used its resources efficiently to secure improvements in physical productivity of up to 2 per cent per year. But because it has paid more for the inputs, cost-effectiveness has fallen by up to 0.8 per cent.

Overall, the study has shown that it is feasible to develop models of productivity growth for a single programme of NHS care. The authors advocate further investigation of other programmes of care, in particular those embracing significant community and prescribing activities.

Who should read this report?

This report is intended for healthcare decision makers, including policy makers, managers, clinical leaders, researchers and patient groups. They should use this independent source of data to inform decisions and take actions that will lead to better quality of patient care.

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