1. Atkinson Review - Health
Eurostat workshop 27 May 2005
Presenters: Phillip Lee and Aileen Simkins

2. Health UK health system in brief
Output measurement prior to Atkinson Review
Review findings
Developments during the Review
Developments planned
Measurement of change in quality of healthcare

3. The UK health system
NHS: publicly funded, mainly publicly provided but some private providers
limited private financing of healthcare
devolved responsibility
essentially free at point of use
Co-payment required in limited cases
prescriptions
dental treatment

4. Health output measures prior to Atkinson
Direct volume measure introduced in 1998, based on:
NHS in England
partial coverage of what NHS does
household survey for primary care consultations
activities rather than ‘treatments’
no allowance for change in quality

5. Review Findings #1
Potentially better sources for primary care (rec. 8.1)
databases of primary care medical records
data required as part of new general practice contract
longitudinal element to design
up-to-date weights
Coverage (recommendations 8.2 and 8.3)
all of UK, not just England
all institutions
all settings
all activities

6. Review Findings #2 Whole courses of treatment (recommendation 8.4)
as a better measure of health output
NHS Quality (recommendation 8.5)
more later from Aileen
Remainder of recommendations:
Improvements to deflators and matching weights (rec.8.6)
Publication of health productivity articles (rec. 8.7)
Satellite Accounts (recommendation 8.8)

7. Review Findings #3 Other findings:
output of collective services can be valued at input cost
range of expertise to include statisticians, economists, medical researchers, public health experts, accountants and so on
private sector prices not appropriate proxy
triangulation

8. Developments during the Review
Improved method for Blue Book 2004 (Jun 2004)
improved coverage
greater disaggregation (1700 separate items)
Article on whole courses of treatment (Sep 2004)
including impact on output from innovation and substitution
Health productivity article (Oct 2004)
including triangulation
excluding change in NHS quality

9. Developments planned Improved method for Blue Book 2005 (Jun 2005)
improved coverage (more activities, Northern Ireland)
Second productivity article (Oct 2005?)
Link to planned DH paper on quality adjustment
More analysis of inputs, deflators, triangulation