Evaluation of Health Services

Question 1

What is the definition of evaluation of health services?

Answer 1

Evaluation is the assessment of whether a service achieves it’s objectives

Question 2

What can be evaluated in health care?

Answer 2

Projects, processes, programmes, services

Question 3

What is an example of an evaluation of a single intervention?

Answer 3

RCT evaluates effectiveness of a new cancer drug

Question 4

What is an example of an evaluation of public health interventions?

Answer 4

Evaluation of the impact of the smoking ban on the health using epidemiological studies

Question 5

What is an example of a health economic evaluation?

Answer 5

Evaluating cost-effectiveness of a medical intervention

Question 6

What is a health technology assessment?

Answer 6

It incorporate a systematic review, economic evaluation and mathematical modelling

Question 7

What is the framework for a service in a health service evaluation?

Answer 7

Structure -> process -> [output] -> outcome

Question 8

What incorporates the structure in the health service evaluation?

Answer 8

Buildings, staff, equipment.

Question 9

Name some examples of a structure in the health service evaluation?

Answer 9

Number of ICU beds per 1000 population; Number of vascular surgeons per 1000 population; locations where screening is provided

Question 10

What incorporates the process in the health service evaluation?

Answer 10

What is done

Question 11

Give some examples of the process in the health service evaluation?

Answer 11

Number of patients seen in A&E; where and when a patient is first seen; who carries out triage; how is priority assessed

Question 12

What are the classifications of output in the health service evaluation?

Answer 12

Mortality, morbidity, quality of life and patient satisfaction or the 5 D’s (Death Disease, Disability, Discomfort, Dissatisfaction)

Question 13

What are the issues with health outcomes?

Answer 13

Link between healthcare provided and health outcomes will have lots of co-founders; time lag between service and outcome may be too long; large sample sizes may be needed to reach significance; data may not be available; issues with data quality

Question 14

What are the potential issues with data quality?

Answer 14

CART - completeness, accuracy, reliability, timeliness

Question 15

What can you use to assess quality of healthcare?

Answer 15

Maxwell’s dimensions of quality

Question 16

What are the points in Maxwell’s dimensions of quality?

Answer 16

3As, 3Es: Acceptability; Accessibility; Appropriateness; Equity, Efficiency; Effectiveness

Question 17

How do you assess the effectiveness in Maxwell’s dimensions of quality?

Answer 17

Does the intervention/service produce the desired effect?

Question 18

How do you assess the efficiency in Maxwell’s dimensions of quality?

Answer 18

Is the output maximised for the given input? OR Is the input minimised for the given level of output?

Question 19

How do you assess the equity in Maxwell’s dimensions of quality?

Answer 19

Are patients being treated fairly?

Question 20

How do you assess the acceptability in Maxwell’s dimensions?

Answer 20

How acceptable is the service to the people who need it?

Question 21

How do you assess the accessibility in Maxwell’s dimensions?

Answer 21

Is the service provided? Geographical access; costs for patients; information available; waiting times

Question 22

How do you assess the appropriateness in Maxwell’s dimensions?

Answer 22

Is the right treatment being given to the right people at the right time?

Question 23

What are the two ways of evaluating a health care system?

Answer 23

Qualitative and quantative

Question 24

What are the different qualitative methods of evaluation?

Answer 24

Observation (participant or non-participant); interviews; focus groups; review of documents

Question 25

What are the different quantitative methods of evaluation?

Answer 25

Routinely collected data (hospital admissions or mortality); review of records (medical or administrative); surveys

Question 26

What is the general framework for evaluating a healthcare service?

Answer 26

Define what the service is; What are the aims/objectives of the service; Framework of the service; Methodology used; Results, conclusions and recommendations