Reducing inequalities in care at an Acute Trust
PHE ePoster Library. Emmett H. 09/12/19; 274458; 252
Dr. Hannah Emmett
Dr. Hannah Emmett
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Abstract
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Abstract Reducing inequalities in care at an acute Trust.IntroductionBarts Health serves a deprived population. Equity is an crucial element of quality, but is rarely routinely assessed via national data sets or by commissioners.For the last 3 years the Trust has begun a programme of using routine data to investigate equity.
Methods
We have used a mixture of hospital data, including post-code, age, disability and ethnicity, to assess access, the process of care, patient experience and outcomes. We have worked closely with clinicians from a range of specialties to review and address findings.
Results
Access: issues included much longer waits in A+E for older people, e,g. 60% breaching 4 hours over 70, higher DNAs for people from lower social class areas, less than expected cases from some age and ethnic groups in sexual health.Process: we reviewed areas such as complaints, 28 day readmissions (significantly higher rates for older and homeless people), uptake of insulin pumps (revealing a social class gradient).Patient experience: we have reviewed complaints data and will be doing interviews with people with learning disabilities.Outcomes: we reviewed standardised hospital mortality by a range of variables, with as yet unexplained lower rates amongst some ethnic minority groups.DiscussionWe have investigated an important, but neglected dimension of quality and found important variations which we are working with clinicians and managers to address. External funding details
Abstract Reducing inequalities in care at an acute Trust.IntroductionBarts Health serves a deprived population. Equity is an crucial element of quality, but is rarely routinely assessed via national data sets or by commissioners.For the last 3 years the Trust has begun a programme of using routine data to investigate equity.
Methods
We have used a mixture of hospital data, including post-code, age, disability and ethnicity, to assess access, the process of care, patient experience and outcomes. We have worked closely with clinicians from a range of specialties to review and address findings.
Results
Access: issues included much longer waits in A+E for older people, e,g. 60% breaching 4 hours over 70, higher DNAs for people from lower social class areas, less than expected cases from some age and ethnic groups in sexual health.Process: we reviewed areas such as complaints, 28 day readmissions (significantly higher rates for older and homeless people), uptake of insulin pumps (revealing a social class gradient).Patient experience: we have reviewed complaints data and will be doing interviews with people with learning disabilities.Outcomes: we reviewed standardised hospital mortality by a range of variables, with as yet unexplained lower rates amongst some ethnic minority groups.DiscussionWe have investigated an important, but neglected dimension of quality and found important variations which we are working with clinicians and managers to address. External funding details
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