Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

New system developed to monitor deaths in general practice

28.07.2003


Researchers from Imperial College London have developed a system using statistical control charts to help monitor mortality rates in general practice.

Although the system, details of which are published online today in The Lancet, was developed as a practical response to monitoring issues raised by the Harold Shipman case, it can also be used to monitor variations in the quality of care between GPs and practices.

Dr Paul Aylin, one of the paper’s authors, from Imperial College London comments: “Following the Shipman affair it became clear that no method existed to monitor mortality rates in general practice.



“One use of this system would be to help stop a repeat of the Shipman affair, but tools such as this could also help in monitoring the performance of GPs and their practices by continuously keeping track of mortality rates.

“We envisage these methods being used as a governance tool for monitoring performance since they enable a first-pass analysis of the data and can highlight units with an unusual outcome. We caution however, that the charts themselves cannot shed light on the reasons for apparent poor performance.

“Excess mortality will not necessarily mean bad practice or even criminal behaviour. Excess mortality could result from many different situations. For example, practices involved in terminal care for cancer patients or treating patients in a number of nursing homes. The system can also be used to help spot GPs or practices with particularly low mortality rates, which may be indicative of good practice.
“Any GPs or practices that are seen as having unusual mortality patterns could be investigated further through audit. This process could be improved by the collection of additional information on the death certificate.”

Dr Nicky Best, an author of the paper, from Imperial College London comments: “If the NHS is to deliver high quality cost effective care leading to improved health through guidance, audit and best practice, it needs high quality and timely information. Any method, for analysing and comparing performance, no matter how sophisticated, will founder if this is unavailable.”

The researchers collected data from more than 1000 GPs (including Shipman) or practices over five health authority areas between 1993 and 1999, linking information from death certificates and patient lists. From this they were able to work out how many patients died per GP or practice.

In order to calculate a figure from which abnormal mortality rates could be established, local reference rates were derived from the age and year specific mortality rates for the relevant Health Authority.

The researchers then plotted the mortality figures by year on to a graph using a CUSUM (Cumulative Sum) method. This allowed the researchers to monitor the mortality figure year on year, highlighting any unusual trends in mortality. If the cumulative difference between the observed mortality and the reference rates exceeded a pre-defined threshold, this signalled a warning that the mortality rates for the GP or practice in question warranted further investigation.

Tony Stephenson | alfa
Further information:
http://www.imperial.ac.uk

More articles from Health and Medicine:

nachricht Another reason to exercise: Burning bone fat -- a key to better bone health
19.05.2017 | University of North Carolina Health Care

nachricht Disrupted fat breakdown in the brain makes mice dumb
19.05.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Wafer-thin Magnetic Materials Developed for Future Quantum Technologies

Two-dimensional magnetic structures are regarded as a promising material for new types of data storage, since the magnetic properties of individual molecular building blocks can be investigated and modified. For the first time, researchers have now produced a wafer-thin ferrimagnet, in which molecules with different magnetic centers arrange themselves on a gold surface to form a checkerboard pattern. Scientists at the Swiss Nanoscience Institute at the University of Basel and the Paul Scherrer Institute published their findings in the journal Nature Communications.

Ferrimagnets are composed of two centers which are magnetized at different strengths and point in opposing directions. Two-dimensional, quasi-flat ferrimagnets...

Im Focus: World's thinnest hologram paves path to new 3-D world

Nano-hologram paves way for integration of 3-D holography into everyday electronics

An Australian-Chinese research team has created the world's thinnest hologram, paving the way towards the integration of 3D holography into everyday...

Im Focus: Using graphene to create quantum bits

In the race to produce a quantum computer, a number of projects are seeking a way to create quantum bits -- or qubits -- that are stable, meaning they are not much affected by changes in their environment. This normally needs highly nonlinear non-dissipative elements capable of functioning at very low temperatures.

In pursuit of this goal, researchers at EPFL's Laboratory of Photonics and Quantum Measurements LPQM (STI/SB), have investigated a nonlinear graphene-based...

Im Focus: Bacteria harness the lotus effect to protect themselves

Biofilms: Researchers find the causes of water-repelling properties

Dental plaque and the viscous brown slime in drainpipes are two familiar examples of bacterial biofilms. Removing such bacterial depositions from surfaces is...

Im Focus: Hydrogen Bonds Directly Detected for the First Time

For the first time, scientists have succeeded in studying the strength of hydrogen bonds in a single molecule using an atomic force microscope. Researchers from the University of Basel’s Swiss Nanoscience Institute network have reported the results in the journal Science Advances.

Hydrogen is the most common element in the universe and is an integral part of almost all organic compounds. Molecules and sections of macromolecules are...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Dortmund MST Conference presents Individualized Healthcare Solutions with micro and nanotechnology

22.05.2017 | Event News

Innovation 4.0: Shaping a humane fourth industrial revolution

17.05.2017 | Event News

Media accreditation opens for historic year at European Health Forum Gastein

16.05.2017 | Event News

 
Latest News

New approach to revolutionize the production of molecular hydrogen

22.05.2017 | Materials Sciences

Scientists enlist engineered protein to battle the MERS virus

22.05.2017 | Life Sciences

Experts explain origins of topographic relief on Earth, Mars and Titan

22.05.2017 | Physics and Astronomy

VideoLinks
B2B-VideoLinks
More VideoLinks >>>