Journal of health services research & policy
-
J Health Serv Res Policy · Apr 2004
Comparative StudyCounting in-hospital deaths in England: a comparison of hospital computer systems and mortuary registers.
In-hospital death counts derived from hospital computer systems have been used in England by an independent company, 'Dr Foster', to rank the quality of care of hospitals, but the validity of the underlying data remains unclear. This study compares counts of in-hospital deaths using two different sources - the hospital computer system and the mortuary register - to determine: whether the counts of in-hospital deaths from these two sources differed; qualitative explanations for possible sources of discrepancy; the direction and magnitude of any differences; and the possible impact of any differences on the Dr Foster rankings. ⋯ The differences between the two sources of in-hospital death counts were not large enough to influence the Dr Foster ranks but were sufficient to raise concern about the validity and completeness of mortality data in the NHS.
-
J Health Serv Res Policy · Apr 2004
Modelling in the economic evaluation of health care: selecting the appropriate approach.
To provide an overview of alternative approaches to modelling in economic evaluation, and to highlight situations where each of the alternative modelling techniques should be employed. ⋯ The paper highlights the crucial question to be answered when selecting the approach to modelling: can the individuals being simulated in the model be regarded as independent? This issue is very commonly not recognised by analysts but is fundamental to the appropriate application of modelling in economic evaluation.