Gladman, J, Buckell, J, Young, J et al. (11 more authors) (2017) Understanding the Models of Community Hospital rehabilitation Activity (MoCHA): a mixed-methods study. BMJ Open, 7 (2). e010483. ISSN 2044-6055
Abstract
Introduction To understand the variation in performance between community hospitals, our objectives are: to measure the relative performance (cost efficiency) of rehabilitation services in community hospitals; to identify the characteristics of community hospital rehabilitation that optimise performance; to investigate the current impact of community hospital in-patient rehabilitation for older people on secondary care and the potential impact if community hospital rehabilitation was optimised to best practice nationally; to examine the relationship between the configuration of intermediate care and secondary care bed use; and to develop toolkits for commissioners and community hospital providers to optimise performance. Methods and analysis Four linked studies will be performed. Study 1: Cost efficiency modelling will apply econometric techniques to datasets from the NHS Benchmarking Network surveys of community hospital and intermediate care. This will identify community hospitals’ performance and estimate the gap between high and low performers. Analyses will determine the potential impact if the performance of all community hospitals nationally was optimised to best performance, and examine the association between community hospital configuration and secondary care bed use. Study 2: A national community hospital survey gathering detailed cost data and efficiency variables will be performed. Study 3: In-depth case studies of three community hospitals, two high and one low performing, will be undertaken. Case studies will gather routine hospital and local health economy data. Ward culture will be surveyed. Content and delivery of treatment will be observed. Patients and staff will be interviewed. Study 4: Co-designed web-based quality improvement toolkits for commissioners and providers will be developed, including indicators of performance and the gap between local and best community hospitals performance. Ethics and dissemination Publications will be in peer reviewed journals, reports will be distributed through stakeholder organisations. Ethical approval was obtained from the Bradford Research Ethics committee (reference: 15/YH/0062).
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017, The Authors. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/. |
Keywords: | Community hospitals; Mixed method research; Health economics; Geriatric medicine; Health services administration and management |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Health Economics (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Elderly Care and Rehabilitation (Leeds) |
Funding Information: | Funder Grant number National Inst for Health Research (NIHR) 12/177/04 |
Depositing User: | Symplectic Publications |
Date Deposited: | 18 Aug 2016 10:08 |
Last Modified: | 19 Jul 2017 22:50 |
Status: | Published |
Publisher: | BMJ Publishing Group |
Identification Number: | 10.1136/bmjopen-2015-010483 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:103835 |