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League Tables (league + table)

Distribution by Scientific Domains

Medical Sciences	53%

Selected Abstracts

Do League Tables Contribute to the Development of a Quality Culture?

HIGHER EDUCATION QUARTERLY, Issue 1 2000
Football, Higher Education Compared
The increasing use of league tables to summarise the relative performance of universities suggests an explicit analogy with association football. The extent to which this analogy is useful is explored through a comparison between the operation of the Premier and Nationwide Football Leagues and Universities and Colleges in England and Wales. This comparison considers issues such as what the league tables actually measure, how performance is linked to rewards or penalties, what mechanisms are available for improving performance, and what similarities there are between the locations of more or less successful football clubs and universities. [source]

The trouble with clinical indicators: Intact lower genital tract following childbirth in NSW Hospitals, 2003,2005

AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2010
Peter A. BAGHURST
Background:, The federal government wants outcomes of hospital care to be made publicly available. League tables based on single clinical indicators are misleading, largely because of their inability to take case-complexity into account. Aim:, To demonstrate the application of a graphical tool (the risk-adjusted funnel plot) to the comparison of clinical outcomes across hospitals; and its advantages over league tables. Methods:, We looked at publicly available data on intact lower genital tract (ILGT), for all hospitals in New South Wales at which more than 200 births occurred in 2005. The ,excess' percentage of women at each hospital with an ILGT following a vaginal birth, was calculated after adjustment for instrumental assistance, the use of epidural analgesia/anaesthesia, the use of induction/augmentation, and the number of births per annum. Results:, In 2005, ILGT ranged from 13.1 to 55.8%. A plot of ILGT against vaginal births per annum (a funnel plot) revealed huge heterogeneity among hospitals, and an inverse association with the number of births per annum. A residual funnel plot, constructed from the differences between observed and expected ILGT identified four hospitals (three public and one private) with consistently better ILGT than expected , and four public hospitals with ILGT consistently worse than expected. Some of these hospitals were not located at the extremes of the league table. Conclusion:, The risk-adjusted funnel plot is a useful graphical tool which may overcome the shortcomings of league tables. We need to become more sophisticated in our use of clinical indicators for comparing hospital performances. [source]

Towards a multi-criteria approach for priority setting: an application to Ghana

HEALTH ECONOMICS, Issue 7 2006
Rob Baltussen
Abstract Background: Many criteria have been proposed to guide priority setting in health, but their relative importance has not yet been determined in a way that allows a rank ordering of interventions. Methods: In an explorative study, a discrete choice experiment was carried out to determine the relative importance of different criteria in identifying priority interventions in Ghana. Thirty respondents chose between 12 pairs of scenarios that described interventions in terms of medical and non-medical criteria. Subsequently, a composite league table was constructed to rank order a set of interventions by mapping interventions on those criteria and considering the relative weights of different criteria. Results: Interventions that are cost-effective, reduce poverty, target severe diseases, or target the young had a higher probability of being chosen than others. The composite league table showed that high priority interventions in Ghana are prevention of mother to child transmission in HIV/AIDS control, and treatment of pneumonia and diarrhoea in childhood. Low priority interventions are certain interventions to control blood pressure, tobacco and alcohol abuse. The composite league table lead to a different and more differentiated rank ordering of interventions compared to pure efficiency ratings. Conclusion: This explorative study has introduced a multi-criteria approach to priority setting. It has shown the feasibility of accounting for efficiency, equity and other societal concerns in prioritization decisions, and its potentially large impact on priority setting. Copyright © 2006 John Wiley & Sons, Ltd. [source]

The trouble with clinical indicators: Intact lower genital tract following childbirth in NSW Hospitals, 2003,2005

Hearing aid fitting in adults: results of a cost-effectiveness study

CLINICAL OTOLARYNGOLOGY, Issue 4 2000
L.J.C. Anteunis For The Sihi Study Group
Objective. Despite its high prevalence (, 20% in adults) and the adverse impact on daily life, hearing impairment is a neglected problem. Despite the fact that <,25% of the hearing-impaired seek help and acquire hearing aids in the Netherlands, hearing aid provision and rules for reimbursment are questioned. This is the reason for a cost-effectiveness study. Materials and methods. Self-reported hearing disability and its impact on quality of life was studied in 60 first-time-users, followed prospectively for 16 weeks after hearing aid fitting. They reported significant benefits in hearing ability, experienced an increased number and quality of social contacts and improved self-assessed personal health. Integrating the positive and negative effects of the intervention in a gain in quality of life, a utility value was obtained. Multiplying this utility value by the number of years the effect is expected to last, yielded Quality Adjusted Life Years. Results. In an economic evaluation, based on a model of tracing and referral and costs per QALY, hearing aid fitting in hearing-impaired adults was compared to the effectiveness of other health care interventions and, as a result, placed near the top of a QALY league table. Conclusions. Hearing aid fitting is a very cost-effective intervention. [source]

A MASTER CLASS IN UNDERSTANDING VARIATIONS IN HEALTHCARE

CYTOPATHOLOGY, Issue 2006
M. Mohammed
That there is wide-spread variation in healthcare outcomes cannot be denied. The question is what does the variation mean and what can we do about it? Using a series of well-known case-studies, which include data from the Bristol and Shipman Inquiries, fundamental limitations of traditional methods of understanding variation will be highlighted. These methods, which include comparison with standards, league tables and statistical testing, have flaws and they offer little or no guidance on how to re-act to the variation. Fortunately, there is a theory of variation that overcomes these limitations and provides useful guidance on re-acting to variation, which was developed by Walter Shewhart in the 1920s in an industrial setting. Shewhart's theory of variation found widespread application and won him the accolade ,Father of modern quality control'. His work is central to philosophies of continual improvement. Application of Shewhart's theory of variation, also known as Statistical Process Control (SPC), to case-studies from healthcare will be demonstrated, whilst highlighting the implications and challenges for performance management/monitoring and continual improvement in the healthcare. References:, 1. M A Mohammed, KK Cheng, A Rouse, T Marshall. "Bristol, Shipman and clinical governance: Shewhart's forgotten lessons" The Lancet 2001; 357: 463,7. 2. P Adab, A Rouse, M A Mohammed, T Marshall. "Performance league tables: the NHS deserves better" British Medical Journal 2002; 324: 95,98 [source]

Stochastic league tables: an application to diabetes interventions in the Netherlands

HEALTH ECONOMICS, Issue 5 2005
Raymond C. W. Hutubessy
Abstract The aim of this paper is to discuss the use of stochastic league tables approach in cost-effectiveness analysis of diabetes interventions. It addresses the common grounds and differences with other methods of presenting uncertainty to decision-makers. This comparison uses the cost-effectiveness results of medical guidelines for Dutch diabetes type 2 patients in primary and secondary care. Stochastic league tables define the optimum expansion pathway as compared to baseline, starting with the least costly and most cost-effective intervention mix. Multi-intervention cost-effectiveness acceptability curves are used as a way to represent uncertainty information on the cost-effectiveness of single interventions as compared to a single alternative. The stochastic league table for diabetes interventions shows that in case of low budgets treatment of secondary care patients is the most likely optimum choice. Current care options of diabetes complications are shown to be inefficient compared to guidelines treatment. With more resources available one may implement all guidelines and improve efficiency. The stochastic league table approach and multi-intervention cost-effectiveness acceptability curves in uncertainty analysis lead to similar results. In addition, the stochastic league table approach provides policy makers with information on affordability by budget level. It fulfils more adequately the information requirements to choose between interventions, using the efficiency criterion. Copyright © 2004 John Wiley & Sons, Ltd. [source]

Employers, Quality and Standards in Higher Education: Shared Values and Vocabularies or Elitism and Inequalities?

HIGHER EDUCATION QUARTERLY, Issue 3 2007
Louise Morley
This paper is based on a research project funded by the Higher Education Funding Council for England which investigated employers' needs for information on higher education quality and standards. A key issue was identifying the type of knowledge that employers utilise in graduate recruitment. A finding of the study was that information on quality and standards was being used by some employers in a way that could undermine equity and widening participation initiatives. Whereas employers reported that, in initial recruitment, they placed least emphasis on information about quality and standards and most emphasis on graduates' interpersonal and communication skills, over a quarter used league tables/Top 20 lists in their decision-making processes and 80 per cent of employers cited the importance of the reputation of the higher education institution in their decision making about marketing and individual recruitment of graduates. Reputation was based on real or imagined league tables, ,grapevine' knowledge, personal, regional and professional networks, performance of past graduates and prejudice against new universities. The hierarchy of opportunity within the labour market often appeared to correspond to a highly stratified higher education sector. [source]

Do League Tables Contribute to the Development of a Quality Culture?

Simultaneous modelling of multiple traffic safety performance indicators by using a multivariate generalized linear mixed model

JOURNAL OF THE ROYAL STATISTICAL SOCIETY: SERIES A (STATISTICS IN SOCIETY), Issue 3 2004
Trevor C. Bailey
Summary., Traffic safety in the UK is one of the increasing number of areas where central government sets targets based on ,outcome-focused' performance indicators (PIs). Judgments about such PIs are often based solely on rankings of raw indicators and simple league tables dominate centrally published analyses. There is a considerable statistical literature examining health and education issues which has tended to use the generalized linear mixed model (GLMM) to address variability in the data when drawing inferences about relative performance from headline PIs. This methodology could obviously be applied in contexts such as traffic safety. However, when such models are applied to the fairly crude data sets that are currently available, the interval estimates generated, e.g. in respect of rankings, are often too broad to allow much real differentiation between the traffic safety performance of the units that are being considered. Such results sit uncomfortably with the ethos of ,performance management' and raise the question of whether the inference from such data sets about relative performance can be improved in some way. Motivated by consideration of a set of nine road safety performance indicators measured on English local authorities in the year 2000, the paper considers methods to strengthen the weak inference that is obtained from GLMMs of individual indicators by simultaneous, multivariate modelling of a range of related indicators. The correlation structure between indicators is used to reduce the uncertainty that is associated with rankings of any one of the individual indicators. The results demonstrate that credible intervals can be substantially narrowed by the use of the multivariate GLMM approach and that multivariate modelling of multiple PIs may therefore have considerable potential for introducing more robust and realistic assessments of differential performance in some contexts. [source]

School league tables: Have they outlived their usefulness?

PUBLIC POLICY RESEARCH, Issue 4 2001
Joe Hallgarten
[source]

School Performance in Australia: Is There a Role for Quasi-Markets?

THE AUSTRALIAN ECONOMIC REVIEW, Issue 3 2004
Steve Bradley
Recent changes to the organisation of Australia's education system have raised the possibility of implementing wide-ranging market reforms. In this article we discuss the scope for introducing reforms similar to the United Kingdom's ,quasi-market' model. We discuss the role of school league tables in providing signals and incentives in a quasi-market. Specifically, we compare a range of unadjusted and model-based league tables of primary school performance in Queensland's public education system. These comparisons indicate that model-based tables which account for socio-economic status and student intake quality vary significantly from the unadjusted tables. [source]