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Using the EQ-5D as a performance measurement tool in the NHS

Devlin, N., Parkin, D. & Browne, J. (2009). Using the EQ-5D as a performance measurement tool in the NHS (09/03). London, UK: Department of Economics, City University London.


In a landmark move, the UK Department of Health (DH) is introducing the routine use of Patient Reported Outcome Measures (PROMs) as a means of measuring the performance of health care providers in improving patient health. From April 2009 all patients will be asked to complete both generic (EQ-5D) and condition specific PROMs before and after surgery for four elective procedures; the intention is to extend this to a wide range of other NHS services. The aim of this paper is to report analysis of the EQ-5D data generated from a pilot study commissioned by the DH, and to consider the implications of the results for their use as performance indicators and measures of patient benefit. The EQ-5D has the potential advantage in the context of PROMs of enabling comparisons of performance across services as well as between providers; and in facilitating assessments of the cost effectiveness of NHS services. We present two new methods we have developed for analysing and displaying EQ-5D profile data: a Paretian Classification of Health Change, and a Health Profile Grid. Using these methods, we show that EQ-5D data can readily be used to generate useful insights into differences between providers in improving overall changes in health; results are also suggestive of striking differences in changes in health between surgical procedures. We conclude by noting a number of issues that remain to be addressed in the use of PROMs data as a basis for performance indicators.

Publication Type: Monograph (Discussion Paper)
Additional Information: © 2009 the authors.
Publisher Keywords: EQ-5D, PROMs, health outcomes, performance indicators
Subjects: H Social Sciences > HB Economic Theory
Departments: School of Policy & Global Affairs > Economics > Discussion Paper Series
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