Evaluating the outcomes of health services when you can’t do an experiment - how about a quasi-experiment? Event as iCalendar

(School of Social Sciences)

01 April 2016

3 - 4pm

Venue: Room 104, Fale Pasifika Complex (273-104)

Contact info: Dr Barry Milne

Contact email: b.milne@auckland.ac.nz

Website: COMPASS

Tom Robinson, Auckland and Waitemata DHBs

Health services are constantly needing to change, and in many cases the outcomes of these changes need to be evaluated. However, usually RCTs cannot be undertaken. This presentation will consist of two parts:

  • A review of current NZ practice in health services - non-experimental outcome evaluation. After searching 4 databases and the NZ Medical Journal, 52 health service outcome evaluations were found that used non-experimental methods, and these were evaluated against the Cochrane Collaboration's Effective Practice and Organisation of Care group guidance. Most studies did not meet the criteria for inclusion in Cochrane reviews because of their study design.  Of those that could be included, only a minority had no or only few areas of potential bias.
  • A presentation of a quasi-experimental outcome evaluation which was completed in 2013 at Waitemata DHB. An outcome evaluation was undertaken of a programme that aimed to reduce readmission to hospital within a month of discharge.  The results will be presented of a number of different evaluation designs including uncontrolled before and after, an interrupted time series, and a regression discontinuity design. Some of the issues encountered in carrying out quasi-experimental studies will be discussed.

Tom Robinson is a public health physician and works three days a week in the Planning and Funding Team for Auckland and Waitemata DHBs. Some of this work involves advising on and undertaking evaluation of health services. He is also undertaking a PhD with the School of Population Health which is looking at the role of quasi-experimental methodology in evaluating the outcomes of our health service changes. Key questions are whether current practice is satisfactory, whether quasi-experimental designs can produce valid assessments of the causal effect of interventions, whether these methods are feasible, and how they should be undertaken.

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