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• W2435640973 abstract "We assessed NHS progress between 2004/5 and 2011/12 in reducing inequality in healthcare access and outcomes, with the aim of developing the first systematic approach to monitoring socioeconomic inequalities in NHS access and outcomes. Indicators of healthcare access and outcomes at different stages of the patient pathway were constructed for all English small areas (2001 LSOAs) from 2004/5 to 2011/12 using GMS, QOF, HES and ONS mortality and population data – (1) GP supply: full time equivalent (FTE) GPs per 100,000 population, need-weighted adjustment, (2) primary care quality: quality and outcomes framework performance, weighted by public health impact, (3) hospital waiting time: days from referral-to-treatment, allowing for patient-level casemix, (4) post-hospital mortality: 12-month mortality after discharge, allowing for patient-level casemix, (5) amenable mortality: deaths from causes amenable to health care per 100,000 population, indirectly age-sex-standardised. Slope and relative indices of inequality were calculated through small-area-level regression using all 32,482 Index of Multiple Deprivation 2010 ranks, with regression-based tests of change over time. Nationally, all unadjusted relative indices of inequality fell from 2004/5 to 2011/12 (with 95% CIs in brackets, where negative indices represent “pro-poor” inequality): (1) for GP supply from -2.2% [-2.9% to -1.6%] to -9.5% [-10.2% to -8.8%], (2) for primary care quality from 4.1% [3.6% to 4.6%] to 1.1% [0.6% to 1.6%], (3) for hospital waiting time from 3.2% [2% to 4.4%] to 2.7% [1.5% to 3.8%], (4) for post-hospital mortality from 0.6% [2.3% to -1.2%] to -4.5% [-2.6% to -6.4%], and (5) for amenable mortality from 34% [36.5% to 31.4%] to 11.9% [14.6% to 9.2%]. Socioeconomic inequality in healthcare access and outcomes in the English NHS reduced between 2004/5 and 2011/12 in both relative and absolute terms on all our indicators (unadjusted), though all indicators except GP supply and post-hospital mortality continue to exhibit “pro-rich” inequality." @default.
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• W2435640973 date "2015-11-01" @default.
• W2435640973 modified "2023-10-18" @default.
• W2435640973 title "Measuring Health Care Performance on Equity: A Framework Using National Administrative Data from 2004/5 to 2011/12" @default.
• W2435640973 doi "https://doi.org/10.1016/j.jval.2015.09.1776" @default.
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