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SURGICAL THRESHOLD

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					Productivity Metrics
Methodology
SURGICAL THRESHOLD DATA SOURCE The Surgical Threshold Indicator is calculated using the monthly data extract received by Dr Foster Intelligence from the Secondary Uses Service. 6th working day –A data extraction is run for Dr Foster. This is guaranteed to include submissions from providers received by BT during the previous month. 7th working day - Foster receives data extract from BT. Below is a rough indication of the data extract date for each of the published quarters: Quarter 1 = Mid August Quarter 2 = Mid November Quarter 3 = Mid February Quarter 4 = Mid June The data extract is initially put through a cleansing process that is based on the HES data cleaning rules which can be found at http://www.hesonline.nhs.uk/Ease/servlet/ContentServer?siteID=1937&categoryID=246 EXPECTED VALUES The expected numbers of surgical procedures are calculated from national admissions/attendances and GP practise population data. Expected values are adjusted by: Procedure – primary procedure in the spell that is one of the ACS procedures which are 2517; 2521; 2651; 2026+2608; 2516.  Age, - age of the patient on the date of admission as defined by the STARTAGE field. (Age at start of episode). For case-mix adjustment we use 5-year age bands (0*, 1-4, 5-9, ... , 90+)  Sex  Admission Type – We use Elective only.  Deprivation quintile - Each patient is given a deprivation value based on the Index of Multiple Deprivation ( IMD ) 2004 score for the Super Output Area (SOA) that corresponds to their postcode. This value is one of 5 quintiles from "Least deprived" to "Most deprived" or "Unknown" if the postcode is missing or cannot be allocated to an SOA. It is an aggregate of 7 "domains" in which people can be considered to be deprived: Income deprivation  Employment deprivation  Health deprivation and disability  Education, skills and training deprivation  Barriers to Housing and Services  Living environment deprivation  Crime  Financial year and applied as a benchmark to each patient. The overall figure for the selected patients is the average of these benchmarks. Benchmarks have been calculated

Productivity Metrics
Methodology
for each of the years up to and including the latest complete year for which we have HES data (currently 2004/05). Non-elective and unknown deprivation spells are removed from the calculation. The calculated figures, based on populations and national admission rates are then adjusted according to the Acute and Maternity Needs Weighting index from the resource allocation formula. Calculate the Actual Number of spells This is the number of elective hospital spells where the primary procedure is one of the ACS procedures which are 2517; 2521; 2651; 2026+2608; 2516 and where the Discharge Date of the spell falls within the report period. Calculate the Indicator value This indicator is expressed as a Standardised Admission Ratio (SAR) The indicator is calculated by dividing the Actual Number of Spells by the Expected Number of Spells. . Using Elective admissions only the expected rate is calculated from the national admissions, based on the age, sex and social deprivation of the PCT population. The population figures are those based on the GP practise populations reported for 2004/05 Each patient is given a deprivation value based on the Index of Multiple Deprivation ( IMD ) 2004 score for the Super Output Area (SOA) that corresponds to their postcode. This value is one of 5 quintiles from "Least deprived" to "Most deprived" or "Unknown" if the postcode is missing or cannot be allocated to an SOA.

This estimate is based on the number of admissions that would be expected given the population and demographics of the area. EXAMPLE The actual number of spells is compared to the expected number for the basket of procedures. NUMBER OF EXPECTED SURGICAL PROCEDURES = 199 ACTUAL NUMBER OF SURGICAL PROCEDURES = 186 PRODUCTIVITY OPPORTUNINTY = £347,000 UPPER CONFIDENCE LIMIT = 108 LOWER CONFIDENCE LIMIT = 81


				
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