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英格兰国民保健署内镜服务现代化的独立评估:数据匮乏且无改善。

An independent evaluation of the modernization of NHS endoscopy services in England: data poverty and no improvement.

机构信息

Centre for Health Information, Research and Evaluation (CHIRAL), School of Medicine, Swansea University, Singleton Park, Swansea, UK.

出版信息

J Eval Clin Pract. 2010 Aug;16(4):693-9. doi: 10.1111/j.1365-2753.2009.01177.x. Epub 2010 Jun 10.

Abstract

RATIONALE, AIMS AND OBJECTIVES: The Modernising Endoscopy Services (MES) programme introduced a focussed modernization drive and data collection regime to English NHS endoscopy services. We independently evaluated the MES programme by comparing routinely collected, service-related endoscopy data from sites that participated in the MES programme and sites that did not.

METHODS

A random selection of 10 endoscopy units who had participated in the MES programme (intervention sites) were compared with a random selection of 10 endoscopy units who redesigned their services independently (control sites). Data on demand, numbers waiting, activity and cancellations were collected for eight time points between January 2003 and April 2006. Data were aggregated into intervention and control groups for statistical analysis using a two-way analysis of variance. Activity data were validated using an equivalent Hospital Episode Statistics dataset.

RESULTS

Data were not routinely collected by 11 of 19 endoscopy units. Trust-held datasets were subsequently included to address problems with data availability. The accuracy of the Activity data was successfully validated. Statistical analysis of the data showed that neither the intervention group nor the control group were able to significantly improve their services over time. There was also no significant difference between the intervention group and the control group in the improvement of their endoscopy services at any point time.

CONCLUSIONS

Based on the data collected, the intervention programme did not significantly improve NHS endoscopy services in England over and above what could have been achieved independently with only the intention to redesign.

摘要

背景、目的和目标:现代内镜服务(MES)计划为英国国民保健制度(NHS)的内镜服务引入了重点现代化推进和数据收集机制。我们通过比较参与 MES 计划和未参与 MES 计划的站点的常规收集、与服务相关的内镜数据,独立评估了 MES 计划。

方法

随机选择 10 个参与 MES 计划的内镜单位(干预组),并与 10 个独立重新设计服务的内镜单位(对照组)进行比较。在 2003 年 1 月至 2006 年 4 月之间的八个时间点收集需求、等待人数、活动和取消的数据。使用双向方差分析将数据汇总到干预组和对照组进行统计分析。使用等效的医院事件统计数据集验证活动数据。

结果

19 个内镜单位中,有 11 个未常规收集数据。随后包括信托数据集来解决数据可用性问题。活动数据的准确性得到了成功验证。数据分析显示,干预组和对照组都未能随着时间的推移显著改善其服务。在任何时间点,干预组和对照组在改善内镜服务方面也没有显著差异。

结论

根据收集的数据,干预计划并没有显著改善英格兰的 NHS 内镜服务,而仅通过重新设计的意图独立改进可能已经实现了这一点。

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