Monday, March 23, 2009


The HSE "healthstat" system has been in the news throughout the day. I have not given this a thorough look yet but its worth thinking about whether this could be used to provide some baby-steps in measuring the effect of inputs into better healthcare in Irish hospitals. In general, the structure of Irish hospital data makes publishing in academic journals and building up a science around health policy very difficult. At first glance, this looks like a potential improvement.

I would strongly encourage the people working on it to make the data available in a standard analytical form and to get some people to start analysing it. At present, the charts are available for each hospital so its clearly not the case that there is a major issue with sensitivity of this data.

Looking at how some of these measures react to inputs into the hospitals would be good. For example, Mayo has been hauled through the press as the worst hospital in terms of scores. But is this correcting for resources? In general, it would be really interesting for someone to do some simple regressions on these output metrics on things like scale, staff-size, staff composition and so on.


Martin Ryan said...

This reminds me of HealthGrades, the American firm that produces data on medical centers; they get get one, three or five stars based on how many patients develop complications and die after receiving treatment.

The rankings are based on three years of data from Medicare and are adjusted to account for how sick the hospital's patients are.

We discussed it on the blog before here:

You made the point Liam that it would be necessary to control for the characteristics at intake. Hospitals in low SES areas treating patients with multiple other conditions on intake are likely to score lower. This ties into the comments Alan was making about private-schools on Cathy's recent post about the ESRI paper.

Martin Ryan said...


Kevin Denny said...

I imagine that information on patients (i.e. their state of health) is critical.If a hospital gets sicker people than another it may seem to be doing worse. Obviously treating some conditions are more resource intensive than others. This may all be very difficult to measure accurately. It will also give hospitals an incentive to try cream off the not-so-sick.

Liam Delaney said...

i agree - sampling patients in all hospitals at admission and exit on health scores and lining this up would allow a very interesting set of tests that would be relevant to policy in this area.