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The Number of Publicly Funded Hospital Discharges by DHB with primary Diagnosis of Gout - by Year

Basic Facts

Stage of development

Designed

Potential or current usage

This indicator is used by the Health Quality and Safety Commission for the New Zealand Atlas of Variation.

Brief overview of the measure

General description

Broad subject area: Gout Specific aspect of care: Hospital discharges with a primary diagnosis of gout Population of interest: People aged 20 – 79 years with a publicly funded hospital discharge with a primary diagnosis of gout Setting: Health services Level of focus: District Health Board

Rationale for selection

Variation in admission rates to hospital due to gout may indicate different admission criteria between DHBs, poor gout control or limited access to primary care.

Type of measure

Outcomes

Domain(s) of quality

Effectiveness

Application and interpretation of the measure

Stated intent of the measure

The aim of this measure is to compare levels of publicly funded hospital discharges with a primary diagnosis of gout between various District Health Boards in New Zealand. It can be used for quality improvement and benchmarking purposes regarding treatment of gout.

Caveats - Considerations

• Data is not presented where the number of people was less than 10. This is to preserve confidentiality. • People were assigned to their district health board (DHB) of domicile; where more than one domicile was recorded, the most recent value was selected. • Ethnicity data was analysed by prioritised ethnic group (Māori, Pacific peoples, Asian, European/other). For people reporting multiple ethnic groups, the most recent value was selected. The rates for the Asian population were similar to the European/other group, aand in some DHBs the Asian population was small, so it was decided to combine these groups into non- Māori/non-Pacific. Data where ethnicity was not specified was excluded from ethnicity analysis, meanting the sum of ethnicity data does not equal the total. Exclusions: • The date of dispensing is after the date of death, OR • The patient category is either J or Y (juvenile or youth).

Links to other measures

New Zealand Atlas of Variation

Level of health care delivery/setting

Any health setting

Target population

People aged 20 - 79 years with a publicly funded hospital discharge with a primary diagnosis of gout.

Calculation of the measure

Output of calculation

Data are presented as standard deviation from the mean. Standard deviation is a statistical measure of variation from a mean. Assuming that recorded instances are normally distributed (i.e. they are in the usual ‘bell-shaped curve’) 95% of all recorded instances would be expected to be within 2 standard deviations either side of the mean. The two ‘middle’ shades will be within one standard deviation of the mean.

Numerator description

The number of publicly funded hospital discharges in people aged 20-79 years, with primary diagnosis of gout (ICD code M10) for years 1 July 2008-30 June 2011.

Denominator description

New Zealand resident population aged 20-79 years.

Time period

Three years

Criteria/standard for optimal performance

There are no criteria for optimal performance; this measure is intended to benchmark regional differences in hospital discharges with primary diagnosis of gout.

Data source

The data is extracted from the National Minimum Data Set and the Ministry of Health (numerator) and Statistics New Zealand population projections (denominator)

Method of extraction

No information available.

Appraisal of the measure

Availability of evidence to support application of the measure

The measure has been developed or endorsed by an organization that promotes rigorous development and use of clinical performance measures (at an international, national, regional or local level).

Evidence of feasibility and reliability of implementation

Availability of data - Required data elements for the measure can be gathered during routine practice activities

Development approach

The subjects in the Atlas were chosen by a group of clinical experts and consumers based on clear criteria regarding the importance of the area and the likelihood there was unexplained variation in services.

Other items

Links to educational activities

http://www.hqsc.govt.nz/our-programmes/health-quality-evaluation/projects/atlas-of-healthcare-variation/

Owner details

Reference number

4314

Date of entry to library

2013-10-22 16:11:33

Owner (Organisation name)

Health Quality and Safety Commission

Owner (Email contact)

Richard.Hamblin@hqsc.govt.nz

Creator (Organisation name)

Health Quality and Safety Commission

Creator (Email contact)

Richard.Hamblin@hqsc.govt.nz