Evaluation of health services

Question 1

What is evaluation of health services?

Answer 1

Evaluation of whether a service achieves its objectives

Question 2

What’s the framework for service evaluation? Give examples of each.

Answer 2

Structure: what’s there (staff, buildings, equipment)
Number of NICU beds, vascular surgeons per 1000 patients

Process: what is done, happens to the patient, number of patients seen
How patients are triaged, number of patients seen in A+E, who sees them.

Outcome: death, disease, disability, discomfort, dissatisfaction

Question 3

What are the 5 areas analysed when assessing outcome in service evaluation?

Answer 3

Death
Disease
Disability
Discomfort
Dissatisfaction

Question 4

What two types of measures are there for measuring service evaluation?

Answer 4

Qualitative

Quantitative

Question 5

What methods are there for measuring qualitative? Who would you use?

Answer 5

Observation

Interviews

Focus groups

Review of documents

Staff, patients, relatives, carers, policy makers

Question 6

What methods are there for measuring quantitative?

Answer 6

Data

Review of records

Surveys

Studies: epidemiological methods

Question 7

What are the dimensions of quality? (What’s the name of them?)

Give examples of each.

Answer 7

Maxwells

Effectiveness
- does the service produce the desired effect

Efficiency
- is there maximum output for a given input

Equity
- are patients being treated fairly

Acceptability
- how acceptable is the service to the people? (not too painful etc)

Accessibility:
- waiting times, are patients able to get to the service?, geographical

Appropriateness
- is the right treatment being given at the right time

Question 8

Overall, what’s the general framework of evaluating health services?

Answer 8

Define what the service is

What are the aims/objectives

Framework: structure, process, outcome

Methodology: qualitative, quantitative

Results, conclusions, recommendations

Question 9

How would you evaluate sexual health services in Sheffield?

Answer 9

1. What is the service?
   - drop in clinics
   - self-testing kits
2. What’re the aims and objectives
   - reduce STDs
3. Framework:
   - structure: no of drs,
   - process: process of being seen (by who, what happens)
   - outcome: 5 Ds
4. Methodology
   - qualitative: 3Es, 3As
   - quantitative:
5. results, conclusion

Question 10

What are the issues/limitations of health outcomes?

Answer 10

May be other factors involved

Time lag between service provided and outcome may be long

Large sample sizes are needed to detect statistically significant effects

Data may not be available

Issues with data quality

Question 11

What are the main issues with data quality?

Answer 11

CART

Completeness
Accuracy
Relevance
Timeliness

Question 12

What does it mean by denominator?

Answer 12

Number per 1000 for example