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 Organ-on-a-chip mimics heart's biomechanical properties
23.02.2017 | Vanderbilt University

nachricht Researchers identify cause of hereditary skeletal muscle disorder
22.02.2017 | Klinikum der Universität München

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: Safe glide at total engine failure with ELA-inside

On January 15, 2009, Chesley B. Sullenberger was celebrated world-wide: after the two engines had failed due to bird strike, he and his flight crew succeeded after a glide flight with an Airbus A320 in ditching on the Hudson River. All 155 people on board were saved.

On January 15, 2009, Chesley B. Sullenberger was celebrated world-wide: after the two engines had failed due to bird strike, he and his flight crew succeeded...

Im Focus: Breakthrough with a chain of gold atoms

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

In the field of nanoscience, an international team of physicists with participants from Konstanz has achieved a breakthrough in understanding heat transport

Im Focus: DNA repair: a new letter in the cell alphabet

Results reveal how discoveries may be hidden in scientific “blind spots”

Cells need to repair damaged DNA in our genes to prevent the development of cancer and other diseases. Our cells therefore activate and send “repair-proteins”...

Im Focus: Dresdner scientists print tomorrow’s world

The Fraunhofer IWS Dresden and Technische Universität Dresden inaugurated their jointly operated Center for Additive Manufacturing Dresden (AMCD) with a festive ceremony on February 7, 2017. Scientists from various disciplines perform research on materials, additive manufacturing processes and innovative technologies, which build up components in a layer by layer process. This technology opens up new horizons for component design and combinations of functions. For example during fabrication, electrical conductors and sensors are already able to be additively manufactured into components. They provide information about stress conditions of a product during operation.

The 3D-printing technology, or additive manufacturing as it is often called, has long made the step out of scientific research laboratories into industrial...

Im Focus: Mimicking nature's cellular architectures via 3-D printing

Research offers new level of control over the structure of 3-D printed materials

Nature does amazing things with limited design materials. Grass, for example, can support its own weight, resist strong wind loads, and recover after being...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Booth and panel discussion – The Lindau Nobel Laureate Meetings at the AAAS 2017 Annual Meeting

13.02.2017 | Event News

Complex Loading versus Hidden Reserves

10.02.2017 | Event News

International Conference on Crystal Growth in Freiburg

09.02.2017 | Event News

 
Latest News

New pop-up strategy inspired by cuts, not folds

27.02.2017 | Materials Sciences

Sandia uses confined nanoparticles to improve hydrogen storage materials performance

27.02.2017 | Interdisciplinary Research

Decoding the genome's cryptic language

27.02.2017 | Life Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>