Attribution of patient reported outcomes to the effects of care providers

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Until this year, the NHS has not collected information routinely on the health of patients receiving different types of treatments from different health care providers. Consequently, it has been limited in its ability to perform three important functions: (1) spot well-performing and poorly-performing hospitals and general practices; (2) identify where its resources are best spent; and (3) offer useful information to patients when they have a choice of where to go for treatment or of the types of treatment they could receive. The collection of information on health and well-being is being rapidly introduced for all patients across the country. This is likely to show substantial variations between providers and treatments. Variations like these may reflect differences in the effectiveness and quality of different providers. However, there is a substantial amount of variation in levels of health experienced by different individuals that has little or nothing to do with the care they have received. To compare providers and interventions on a ?like-for-like? basis, and be sure we are really seeing variations in effect, we need to examine how the outcomes for the same (or very similar) patients change when they receive treatment from different providers. This is complicated by the fact that patients with long-term health problems often receive treatment from many different providers. We propose to use methods that economists have recently developed to separate out the effects of care providers from the large variation we observe between individual patients. We will apply these to the data that the NHS is currently collecting on patient outcomes and five datasets that have been collected in other recent research projects. By comparing the results across these six datasets, we will be able to make recommendations on the amount of data that needs to be collected from patients and how variations between care providers should be interpreted. Our team involves individuals with expertise in different types of analysis and medicine. These include two senior NHS managers who have responsibility for promoting the effective use of resources. They will ensure we communicate our findings effectively to local and national decision-makers.