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New Framework Aims to Enhance Efficiency and Productivity in England’s General Practices

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In an effort to address the increasing healthcare demands in England, a new study introduces a robust multi-dimensional framework for evaluating the efficiency and productivity of general practices. By integrating a variety of valued output indicators, this framework aims to provide a more comprehensive measurement of healthcare outcomes, ultimately enhancing market access to primary care services.

Framework Development and Validation

Existing evidence on the efficiency and productivity of general practices has been found lacking, primarily due to inadequate methodologies for measuring valued output. To rectify this, researchers conducted a targeted literature review to identify relevant primary care performance frameworks. From these, they distilled dimensions that align with the healthcare decision-maker’s perspective on valued output, particularly those impacting patient health outcomes. The National Institute for Health and Care Excellence (NICE) provided the evidence base and guidance necessary to develop specific indicators for each dimension.

Clinical experts and primary care stakeholders reviewed the framework to ensure its comprehensiveness and validity. Their input was crucial in refining the framework, which now encompasses 13 dimensions related to significant primary care conditions and services, along with 51 indicators that gauge valued output. Each indicator assesses the impact of a healthcare episode on patient health, facilitating a more precise evaluation of primary care productivity.

Implications for Market Access

The new framework is poised to significantly improve market access to primary care by providing a reliable tool for measuring outputs that matter most to patients and healthcare providers. By focusing on valued outputs, the framework ensures that resource allocation and policy decisions are driven by metrics that reflect real-world impacts on patient health.

Key benefits of this approach include more informed decision-making, enhanced allocation of resources, and the potential for more targeted interventions that meet the specific needs of the population. This comprehensive evaluation method stands to streamline the delivery of primary care services, making them more accessible and efficient.

Concrete Inferences

– The framework’s 13 dimensions and 51 indicators offer a nuanced approach to measuring primary care productivity, highlighting areas for improvement.
– Validated by clinical experts and stakeholders, the framework ensures practical relevance and applicability in real-world settings.
– By aligning with NICE guidelines, the framework integrates best practices, enhancing its credibility and utility in policy-making and resource allocation.

Future research should focus on the practical implementation of these indicators through available datasets. Analytical approaches for efficiency measurement will be crucial in realizing the full potential of this framework. The study suggests that a thorough exploration of these factors could drive significant advancements in how primary care productivity is measured and improved.

Original Article:

Appl Health Econ Health Policy. 2024 Jul 6. doi: 10.1007/s40258-024-00895-z. Online ahead of print.

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Improving efficiency and productivity are key aspects to ensure that general practices in England can meet the needs of a growing population with increasingly demanding and costly healthcare needs. However, current evidence on the efficiency and productivity of general practices is weak, partly due to suboptimal approaches to measure their ‘valued’ output. To overcome this limitation, this paper presents a multi-dimensional framework and indicators of valued output from the healthcare decision-maker’s perspective. We identified existing primary care performance frameworks through a targeted literature review. We reviewed the frameworks and selected the dimensions relating to the impact on patients’ health outcomes, corresponding with the definition of ‘valued’ output from the healthcare decision-maker perspective. For each dimension, we reviewed the National Institute for Health and Care Excellence (NICE) evidence base and guidance on best practice to develop indicators of valued output. Clinical experts and representatives of the main primary care stakeholders reviewed and validated the framework’s comprehensiveness and development process. Based on a review of three existing frameworks, we synthesised a multi-dimensional output framework comprising 13 dimensions for significant primary care-related conditions and services and 51 indicators of valued output. Each indicator of valued output measures a healthcare episode and the resulting impact on patient’s health. The multi-dimensional framework and indicators provide a theoretical tool to improve the measurement of primary care output in economic efficiency and productivity studies. Future research should explore the measurability of the indicators through available datasets and the implementation of the framework through analytical approaches for efficiency measurement.

PMID:38971899 | DOI:10.1007/s40258-024-00895-z

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