Performance Evaluations and League Tables: Do They Capture Variation Between Organizational Units? An Analysis of 5 Swedish Pharmacological Performance Indicators.
Ohlsson, Henrik LU ; Librero, Julian LU ; Sundquist, Jan LU ; Sundquist, Kristina LU and Merlo, Juan LU
(2011)
In Medical Care
49(3).
p.327-331
- Abstract
- BACKGROUND:: The use of league tables during the last decade has frequently been employed to assess quality in health care. However, few studies have attempted to assess quality by quantifying the variability across the organizational units or attempted to investigate whether the units are the correct context that really influences the outcome under study. OBJECTIVES:: To quantify the variation between different organizational units regarding 5 different Swedish national pharmacological performance indicators and to examine whether the organizational units under study are a valid construct of the context that influences the specific outcome. RESEARCH DESIGN:: A multilevel model with patients nested within health care units that in turn... (More)
- BACKGROUND:: The use of league tables during the last decade has frequently been employed to assess quality in health care. However, few studies have attempted to assess quality by quantifying the variability across the organizational units or attempted to investigate whether the units are the correct context that really influences the outcome under study. OBJECTIVES:: To quantify the variation between different organizational units regarding 5 different Swedish national pharmacological performance indicators and to examine whether the organizational units under study are a valid construct of the context that influences the specific outcome. RESEARCH DESIGN:: A multilevel model with patients nested within health care units that in turn were nested within County councils was used. By using measures of variance (intraclass correlation [ICC]), we quantified the extent to which the 5 indicators of health care quality were conditioned by the specified units. RESULTS:: For all 5 studied indicators, the variation between county councils was small (ICC ranged from 2% to 7%), whereas the variation among health care units seemed to be more important (ICC ranged from 20% to 40%). CONCLUSION:: As the variation between county councils was small, using league tables for performance evaluation seems to be inappropriate. If league tables are to be presented, the relative size of the variation at the higher levels and an analysis regarding the possible influence of the context for the specific outcome should be included. This approach provides useful information for identifying relevant contexts to capture health care variation. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1777082
- author
- Ohlsson, Henrik
LU
; Librero, Julian
LU
; Sundquist, Jan
LU
; Sundquist, Kristina
LU
and Merlo, Juan
LU
- organization
- publishing date
- 2011
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Medical Care
- volume
- 49
- issue
- 3
- pages
- 327 - 331
- publisher
- Lippincott Williams & Wilkins
- external identifiers
-
- wos:000287240300015
- pmid:21263360
- scopus:79951680386
- pmid:21263360
- ISSN
- 1537-1948
- DOI
- 10.1097/MLR.0b013e31820325c5
- project
- Social Pharmacoepidemiology
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Social Epidemiology (013241850), Family Medicine (013241010), Psychiatry/Primary Care/Public Health (013240500)
- id
- 34c6734e-89bb-4275-8810-90140864b2b9 (old id 1777082)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/21263360?dopt=Abstract
- date added to LUP
- 2016-04-01 14:27:02
- date last changed
- 2022-01-28 00:40:53
@article{34c6734e-89bb-4275-8810-90140864b2b9,
abstract = {{BACKGROUND:: The use of league tables during the last decade has frequently been employed to assess quality in health care. However, few studies have attempted to assess quality by quantifying the variability across the organizational units or attempted to investigate whether the units are the correct context that really influences the outcome under study. OBJECTIVES:: To quantify the variation between different organizational units regarding 5 different Swedish national pharmacological performance indicators and to examine whether the organizational units under study are a valid construct of the context that influences the specific outcome. RESEARCH DESIGN:: A multilevel model with patients nested within health care units that in turn were nested within County councils was used. By using measures of variance (intraclass correlation [ICC]), we quantified the extent to which the 5 indicators of health care quality were conditioned by the specified units. RESULTS:: For all 5 studied indicators, the variation between county councils was small (ICC ranged from 2% to 7%), whereas the variation among health care units seemed to be more important (ICC ranged from 20% to 40%). CONCLUSION:: As the variation between county councils was small, using league tables for performance evaluation seems to be inappropriate. If league tables are to be presented, the relative size of the variation at the higher levels and an analysis regarding the possible influence of the context for the specific outcome should be included. This approach provides useful information for identifying relevant contexts to capture health care variation.}},
author = {{Ohlsson, Henrik and Librero, Julian and Sundquist, Jan and Sundquist, Kristina and Merlo, Juan}},
issn = {{1537-1948}},
language = {{eng}},
number = {{3}},
pages = {{327--331}},
publisher = {{Lippincott Williams & Wilkins}},
series = {{Medical Care}},
title = {{Performance Evaluations and League Tables: Do They Capture Variation Between Organizational Units? An Analysis of 5 Swedish Pharmacological Performance Indicators.}},
url = {{http://dx.doi.org/10.1097/MLR.0b013e31820325c5}},
doi = {{10.1097/MLR.0b013e31820325c5}},
volume = {{49}},
year = {{2011}},
}