Evaluation of health sevices

Question 1

Uses of evaluation

Answer 1

effectiveness of new drug.
effectiveness of public health intervention.
Cost-effectiveness & health economic evaluation.
Health technology assessment.
Improve individuals treatment and influence services available.

Question 2

definition of evaluation

Answer 2

Assessment of whether a service achieves

its objectives. Assess relevance, effectiveness and impact.

Question 3

Framework for health service evaluation

Answer 3

Structure - what is there, staff, beds, think of denominator (e.g. per 100 of population)
Process - what is done (e.g. number of operations performed)
[Output]
Outcome - mortality, morbidity, quality of life/PROMs, patient satisfaction or 5Ds

Question 4

5 Ds for outcome

Answer 4

death, disease, disability, discomfort, dissatisfaction

Question 5

Examples of patient reported outcome measures

Answer 5

e.g. Oxford Hip Score

Question 6

Drawbacks of health outcomes

Answer 6

Co-founding factors may contribute to cause and effect between health service provided and health outcome seen.
Time lag between services provided and outcome measured.
Large sample sizes needed to find statistically significant effects.
Data may not be available.
Data quality may not be good.

Question 7

Maxwell’s dimensions of quality

Answer 7

Effectiveness
􏰀 Efficiency
􏰀 Equity
􏰀 Acceptability
􏰀 Accessibility
􏰀 Appropriateness

Question 8

Methods of evaluation

Answer 8

quantitive or qualitative

Question 9

Framework for evaluating health service

Answer 9

1) Define service
2) Aims/objectives of service
3) Structure, Process, Outcome.
4) Methodology for evaluation.
5) Results, conclusions, recommendations.