Indicators of clinical performance

BMJ 1997; 315 doi: https://doi.org/10.1136/bmj.315.7101.142 (Published 19 July 1997) Cite this as: BMJ 1997;315:142

Problematic, but poor standards of care must be tackled

  1. Martin McKee, Professor of European public healtha
  1. a London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT

    Last week, Baroness Jay announced that Britain's Department of Health, in association with the BMA, intends to publish measures of clinical performance. This means that, in future, potential patients can find out, for example, the percentage of patients admitted to their local hospital with a heart attack who die in hospital within 30 days, or how many undergoing prostate surgery have a second operation. Although similar information has been available in Scotland for several years, until now published league tables in England have been confined to indicators of managerial performance, such as waiting times. The theory is simple. Those hospitals that are shown to be performing worse than others will either improve their practices or lose patients, who, advised by their general practitioners, will go elsewhere. In practice, however, health care is rarely so straightforward. Two questions arise. Firstly, is the information meaningful and does it distinguish good performance from bad? Secondly, will it …

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