Maria K. Goddard

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This paper examines the role of information in securing control of health care systems. The discussion focuses on the impact of the proposed 'Performance Framework', which entails a significant increase in the importance attached to formal performance indicators in the management of the UK National Health Service. The paper starts with a discussion of the(More)
OBJECTIVE To examine the impact of the publication of clinical outcomes data on NHS Trusts in Scotland to inform the development of similar schemes elsewhere. DESIGN Case studies including semistructured interviews and a review of background statistics. SETTING Eight Scottish NHS acute trusts. PARTICIPANTS 48 trust staff comprising chief executives,(More)
The pursuit of equity of access to health care is a central objective of many health care systems. This paper first sets out a general theoretical framework within which equity of access can be examined. It then applies the framework by examining the extent to which research evidence has been able to detect systematic inequities of access in UK, where(More)
The Labour government has outlined its plans to 'replace' the competitive internal market with a more collaborative system based on partnership. Agreement amongst purchasers and providers is to be based on co-operation rather than competition. Longer term agreements covering periods of 3-5 years are to replace annual contracts within this new environment.(More)
Managers interviewed in hospital trusts, health authorities and regional offices believed performance indicators to be broadly helpful. But our study found evidence that the role of the current performance indicators is distinctly limited. The indicators are primarily used to highlight instances of exceptionally poor performance. Frontline staff, such as(More)
A systematic review of the methods used to assess appropriateness of acute bed use and the evidence on the scale of inappropriate use in different patient groups is presented. Issues of generalisability of the findings are also addressed. Criteria based tools are the accepted way of measuring inappropriate days of stay and admissions, although opinion based(More)
Formal performance measurement systems have become a prominent feature throughout most of the public sector. The NHS is no exception and the government is developing and expanding on existing performance data to produce a new national framework which is to be at the heart of the 'performance-led' NHS. The success of formal performance measurement systems(More)
BACKGROUND Composite indices of healthcare performance are an aggregation of underlying individual performance measures. They are increasingly being used to rank healthcare organizations. Although composite indicators present the "big picture" in a way that is easy to interpret, misleading conclusions may be drawn if attention is not paid to key(More)
Performance measurement is playing an increasingly important role in health care systems around the world, and many countries are designing and implementing measurement systems to achieve a range of objectives. Yet, the production of research evidence to inform practice has not kept pace with this policy development. In this paper we employ a simple model(More)
OBJECTIVES To examine the effect on geographical equity of increases in the total supply of general practitioners (GPs) and the ending of entry restrictions in 2002 and to explore the factors associated with the distribution of GPs across England. METHODS Calculation of Gini coefficients to measure geographical equity in GPs per 100,000 population in(More)