NEWS
How do patients use information on health providers? E
xpectations are high that the public will use performance data to
choose their health providers and so drive improvements in quality. But in a paper published on
bmj.com, two experts question whether this is realistic.
They think patient choice is not at present a strong lever for change, and suggest ways in which currently available information can be improved to optimise its effect.
Research conducted over the past 20 years in several countries provides little support for the belief that most patients behave in a consumerist fashion as far as their health is concerned,
say Martin Marshall and Vin McLoughlin from The Health Foundation.
Although patients are clear that they want information to be made publicly available, they rarely search for it, often do not understand or trust it, and are unlikely to use it in a rational way to choose the best provider, they write.
They suspect that these problems are not just due to inadequate data, but may be the result of “unrealistic expectations” and “inappropriate assumptions” by advocates of public disclosure where health decisions are concerned.
They argue that the public “has a clear right to know how well their health system is working, irrespective of whether they want to use the information” and they suggest several ways in which currently available performance data could be made more useful.
For example, it is important that users perceive the information as coming from a trusted source, they say. It also needs to be of interest to the target audience and presented in a visually attractive way.
Patients also need to know how the NHS works before they can realistically judge comparative performance data, they add, while personal stories can also be
compelling and influential when used alongside numeric data.
“In this paper, we present a significant challenge to those who believe that providing information to patients to enable them to make choices between providers will be a major driver for improvement in the near or medium term,” they write. “We suggest that, for the foreseeable future, presenting high quality information to patients should be seen as having the softer and longer term benefit of creating a new dynamic between patients and providers, rather than one with the concrete and more immediate outcome of directly driving improvements in quality of care.”
Hospital admissions for intentional self harm increase by 10 per cent in three years, says new report
H
ospital admissions for intentional self harm have increased by
nearly 10,000 – just over 10 per cent - in three years, according to a report from The NHS Information Centre.
There were 104,340 admissions for intentional self harm in 2009/10; a 3,130 (3.1 per cent) rise on 2008/09 and a 9,960 (10.6 per cent) rise on 2006/07.
Provisional monthly data from August 2008 to July 2010 also highlights early summer as a hotspot for higher than average admissions while December has the lowest number of recorded admissions.
In May 2010, 10,340 hospital admissions were recorded for intentional self harm –the highest of any of the 12 months to July 2010. During the same time period December 2009
4 nhe
had the lowest recorded figure overall (7,490).
A similar pattern occurred in the previous 12 month period, with 9,250 admissions recorded in May 2009 – the second highest figure after July 2009 (9,320 admissions). The lowest was in December 2008 (6920).
The report also provisionally shows that for intentional self harm admissions between August 2009 and July 2010:
• Intentional self-poisoning admissions were most common, with 58,280 admissions among women and 37,750 admissions among men. Intentional self harm by a sharp or blunt object was the second most common reason, with 4,170 admissions among women and 3,770 admissions among men.
• The North East of England has the highest rate of admissions of all strategic health authorities (SHAs) in the country at 367 women and 288 men per 100,000 of the population, while London SHA had the lowest at 158 women and 96 men per 100,000 of the population.
• As well as the North East, a cluster of primary care trusts in the North West had much higher than average admission rates per 100,000 of the population; as did several other PCTs around the country. These were Hull, Leeds, Derby, Leicester, Bristol, Swindon, Torbay, Southampton, Portsmouth and Brighton.
NHS Information Centre chief executive Tim Straughan said:
“This report highlights self Nov/Dec 10
poisoning as the most likely reason for a person to be admitted for intentional self harm; with the use of pain killers or prescription drugs a common factor.
“It also shows that the North East and North West of England have higher than average rates of admissions, along with pockets of the country that includes several areas of the south coast.
“As we head towards December it is interesting to note that provisional information points to this particular month as previously having the lowest number of intentional self harm admissions, while May appears to be near the opposite end of the scale.”
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100