Euroqol EQ5D-5L in community rehab services Andrew Bateman, NeuroRehab Manager Oliver Zangwill Centre, Ely UK Acknowledgements to Community Rehab Teams, Data warehouse team, especially Ian Moyes March 2015 Cambridgeshire Community Services NHS Trust: providing services across Cambridgeshire, Luton, Norfolk, Peterborough and Suffolk
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Euroqol EQ5D-5L
in community rehab services Andrew Bateman, NeuroRehab Manager
Oliver Zangwill Centre, Ely UK
Acknowledgements
to Community Rehab Teams,
Data warehouse team, especially Ian Moyes
March 2015
Cambridgeshire Community Services NHS Trust: providing services across Cambridgeshire, Luton, Norfolk, Peterborough and Suffolk
Our objectives
• Quality: to be recognised as a provider of safe and effective services that people want to use
• Quality: to collaborate with organisations to improve the care given to people who use our services
• Sustainability: to be recognised as a provider of safe and innovative services that helps commissioners achieve their outcomes
Cambridgeshire Community Services NHS Trust: providing services across Cambridgeshire, Luton, Norfolk, Peterborough and Suffolk
• We will only know if we are effective and if we are improving the care given to people if we ask our service users about their health and outcomes
• (process measures don’t tell us if what we do is working)
Cambridgeshire Community Services NHS Trust: providing services across Cambridgeshire, Luton, Norfolk, Peterborough and Suffolk
We built a read-coded data capture tool into our Electronic Patient Record
Using the EQ-5D-5L Value Sets
• A list of 3127 values is available. The values are set on a scale where
• 1 = full health through to • 0 = death (minus values are
states “worse than death” e.g. coma or severe intractable pain) So a Health State 11111 = 1 (Full health) 55555 = -0.594 (State worse than death)
• example: 2 3 4 2 1 = 0.516 (or, roughly, as a percentage of full health 51.6%)
11111 1.000 11112 0.879 11113 0.848 11114 0.635 11115 0.414 11121 0.837 11122 0.768 11123 0.750 11124 0.537 11125 0.316 11131 0.796 11132 0.740 11133 0.725 11134 0.512 11135 0.291 11141 0.584 11142 0.527 11143 0.513 etc
Slide from Chartered Society Physiotherapy
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Uses of the data
• 1) At the individual level
• 2) aggregated for a community team
• 3) aggregated across our trust
• 4) health economics
OZC “commissioned” © artwork by Lucy Driver https://www.facebook.com/pages/Lucy-Driver-Illustration/295208450629274
“Using the questionnaire opened the door for me to have a holistic conversation with my patient” (Community OT)
COUNTY WIDE TEAM PRIORITIES Our patients (n=9148) report severe problems with
40% of our patients report severe/extreme problems doing their usual activities
14%
20%
24%
8% - 680 people
Community Service Outcomes Our patients (n=4300) report improvements in all domains % reporting NO/SLIGHT problems
We can report nearly double (32%->58%) the number of people endorsing “no/slight problems” doing their usual activities. This is the aim of rehabilitation.
45 65
38 59
45 65
62 77
73 82
32 58
before after
Conclusions
• There is room for improvement
• We can look at variation across Cambridgeshire between different services
• …and between different patient groups
• More work to do on data quality, links to activity, and psychometric/econometric work
Thank you and questions
Keep the conversation going on twitter @ozcboss
Resources at http://www.scoop.it/t/eq-5d
Cambridgeshire Community Services NHS Trust: providing services across Cambridgeshire, Luton, Norfolk, Peterborough and Suffolk
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