Statistical methods for healthcare regulation: rating, screening and surveillance

Current demand for accountability and efficiency of healthcare organizations, combined with the greater availability of routine data on clinical care and outcomes, has led to an increased focus on statistical methods in healthcare regulation. We consider three different regulatory functions in which...

Full description

Saved in:
Bibliographic Details
Published in:Journal of the Royal Statistical Society. Series A, Statistics in society Statistics in society, 2012-01, Vol.175 (1), p.1-47
Main Authors: Spiegelhalter, David, Sherlaw-Johnson, Christopher, Bardsley, Martin, Blunt, Ian, Wood, Christopher, Grigg, Olivia
Format: Article
Language:English
Subjects:
Accountability
Algebra
Applications
Applied statistics
Commutative rings and algebras
Data analysis
Exact sciences and technology
Funnel plot
General topics
Global analysis, analysis on manifolds
Health care
Health care industry
Health care policy
Health outcomes
Indicators
Inspections
League table
Mathematics
Monitoring
Mortality
Null hypothesis
Organizational effectiveness
Organizations
Outliers
Overdispersion
P values
Probability and statistics
Ratings
Regulation
Risk-adjusted cumulative sum
Risk-based inspection
Sciences and techniques of general use
Screening
Statistical analysis
Statistical methods
Statistical process control
Statistical variance
Statistics
Surveillance
Topology. Manifolds and cell complexes. Global analysis and analysis on manifolds
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Current demand for accountability and efficiency of healthcare organizations, combined with the greater availability of routine data on clinical care and outcomes, has led to an increased focus on statistical methods in healthcare regulation. We consider three different regulatory functions in which statistical analysis plays a vital role: rating organizations, deciding whom to inspect and continuous surveillance for arising problems. A common approach to data standardization based on (possibly overdispersed) Z-scores is proposed, although specific tools are used for assessing performance against a target, combining indicators when screening for inspection, and continuous monitoring using risk-adjusted sequential testing procedures. We pay particular attention to the problem of simultaneously monitoring over 200000 indicators for excess mortality, both with respect to the statistical issues surrounding massive multiplicity, and the organizational aspects of dealing with such a complex but high profile process.
ISSN:0964-1998
1467-985X
DOI:10.1111/j.1467-985X.2011.01010.x