Ac. Faulkner et al., PROFILING OUTPATIENT WORKLOAD - PRACTICE VARIATIONS BETWEEN CONSULTANT FIRMS AND HOSPITALS IN SOUTH-WEST ENGLAND, Journal of epidemiology and community health, 51(3), 1997, pp. 310-314
Objectives-To describe the variation in outpatient new to old ratios b
etween consultants and between providers for seven high volume special
ties (four surgical, three medical). Design-This was a descriptive stu
dy at consultant and provider unit level based upon patient administra
tion system data from the South and West Regional Health Authority for
the financial year 1992-93. Additional components of variance analysi
s was used to distinguish individual consultant effects from host inst
itution effects. Setting-The former South Western Regional Health Auth
ority area from Gloucestershire to Cornwall. Subjects-Altogether 345 c
onsultant firms in seven specialties grouped into 13 provider unit gro
ups. Main Measures-New to old ratio, omitting elective inpatients foll
owed up as outpatients. Results-Variation between consultants is great
er in surgical than in medical specialties, while absolute levels of n
ew to old ratios tend to be higher in surgical specialties than in med
ical. Variation between provider unit groups is also greater in surgic
al specialties. Analysis of variance shows that more total variance is
attributable to provider unit group in gynaecology than in other spec
ialties. Conclusions-Within individual specialties there is evidence o
f substantial variation that is not attributable to underlying differe
nces in morbidity patterns. There is evidence of marked variation in t
erms of both individual consultants and institutions, a finding that p
rovides the springboard for further analytical work. Published routine
outpatient activity statistics should distinguish between new referra
ls, inpatient follow up, and clinic rebookings.