strategic plans. analysis in joint commissioning cycle >analysis key part of commissioning cycle....
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Strategic Plans
Analysis in Joint Commissioning Cycle
> Analysis key part of commissioning cycle.> Analysis sets out thinking, reasoning, decisions for rest
of plan.> Without robust analysis rest of plan will be weak and
lack credibility.> Good information allows partnerships to analyse
effectively and sets basis for rest of plan.
Patient level data linking
> Health and social care linked data at patient/client level has a number of benefits.
> Total resource across total population, segment of population, by deprivation category, high resource cohorts.
> Who uses joint services, does level of social care make a difference to hospital admissions?
> Follow cohort through time to see if change to service/care pathway is having desired effect.
Alcohol and Drug
> Define substance misuse cohort.− Use data from criminal justice and ADP services
to augment data− Prevalence and population characteristics
> Size and distribution of spend.> Comparative to non substance misuse population.> Follow as service is redesigned.
Breakdown of costs
Non-substance
misuse:
Substance
misuse:
Anticipatory Care Plans
> Health resource of 120 patients given ACPs.> 2009/10 – 2012/13
− 583 A and E attendances (£60,000)− 1345 outpatient appointments (£170,000)− 6743 days in hospital (£2m)− 31,455 Dispensed items (£311,000)
> Follow this cohort and non ACP cohort to analysis impact of ACPs.
Health and Social Care by SIMD 65+ cost per capita
Dementia
> Define dementia cohort - from GP LTC register.> Prevalence and population characteristics> What health and social resources do dementia patients
use?− Comparative to non dementia population
> Forecast future demand as a result of demographic pressure
> Assist with planning and evaluating services redesign
Cost Attributable to Dementia
NHS Board X– individual level analysis
> Inpatient services at maximum capacity
> Requirement to understand current utilisation of services. Who? how old? how often? how long? Why?
> Exploratory work – acute and community activity (SMR01 and SMR01E linkage), length of stay analysis, admissions, allocated bed day analysis, available beds, forecasting.
> Granular analysis - study cohort of long stay patients
− 400 acute inpatients - linked to length of stay information (acute, community, outwith HB treatment, total bed days)
− Categorised by partnership (CHP), age band, admission type− Linked to delayed discharge, SPARRA, other local information info not on SMRs
> Benefits of linked individual level data - understanding full hospital pathway, delayed discharge prevention, informed decisions
• Explorative analysis of acute bed days in 2011/12 by partnership indicates a potential saving of 40 acute beds if occupied bed days consistent for all residents. This is due to a marked divergence in acute length of stay between the two partnership groups.
• A study cohort of long stay patient showed that Partnership A used 35% more bed days than partnership B with the associated number of stays only 2% higher.
• Community Hospital stay linked to delayed discharge - 50% of study cohort with a stay in a community hospital were recorded as having a delayed discharge. Less than 1 % who only had an acute hospital stay resulted in a delay.
• 60% of partnership A residents with a community element to their stay also had a delayed discharge episode, this compares to 30% for partnership B residents.
• IRF mapping for 2010/11 shows partnership A 75+ per capita spend approximately 30% higher for emergency acute inpatients than partnership B.
Service UtilisationAnalysis Results
> For more information on Integrated Resource Framework (IRF) and patient/client level data linking contact:
> Andrew Lee [email protected] 0131 275 7594. > Ishbel Robertson [email protected] 0141 282
2276.> Christine McGregor
[email protected] 0131 244 3394 or 07867 375242.