Outcomes versus Expenditure Tools
A very useful tool... that helps identify and provide evidence for service redesign potential which will improve quality, efficiency and clinical outcomes for both commissioner and patient”
Using the Outcomes versus Expenditure Tools you can compare expenditure and other aspects of services with a number of outcome measures at primary care trust (PCT) level.
As a commissioner, the Outcomes versus Expenditure Tools allow you to pinpoint opportunities to improve the quality of outcomes and productivity for services in your local area. You can use the tools to:
- Compare expenditure within a fixed area with service performance in terms of health and well-being outcomes.
- Identify where either your expenditure or performance is significantly different to that of other organisations including your statistical neighbours.
- See where you are an outlier.
- Find better performing organisations you might be able to learn from about what works well and how you can replicate it.
You will also find the tools useful if you are a provider of services, as a means of sparking discussion with local commissioners about ways to improve services.
The Outcomes versus Expenditure Tools currently available are:
- CAMHS (child and adolescent mental health services) updated
- Child Health
- Maternity and Newborn
You can find out more about each tool below or follow the link to use the tools.
Child and adolescent mental health (CAMHS)
The tool provides two charts. One chart shows spending and outcomes in 2010/11; the other chart compares the change in spending to the change in outcomes between 2009/10 and 2010/11.
The tool looks at the following outcome measures:
- Effectiveness of CAMHS services
- Accident and emergency attendances for self harm
- Hospital admissions for self harm
- Hospital admissions for alcohol abuse
- Hospital admissions for substance misuse
- Hospital admissions for mental health problems
The tool looks at the following cost measures:
- Programme budgeting
- All local authority camhs workforce
- Local authority workforce in other specialist teams (such as mental health)
- Local authority workforce in homes mainly for children with learning disabilities
- Local authority workforce in community homes for looked after children
- Local authority workforce in Specialist Needs Establishments
The tool provides two charts. One chart shows expenditure in 2009/10 compared to outcomes in a similar time period; the other chart compares the change in expenditure to the change in outcomes between 2008/09 and 2009/10. The tool looks at the following outcome measures:
- Percentage of children achieving a good level of development
- Percentage of children completing the MMR immunisation course
- Percentage of children completing the Diphtheria, Tetanus, Polio, Pertussis and Hib immunisation course
- Percentage of girls completing uptake of Human papillomavirus (HPV) vaccine
- Percentage of pupils eating five or more portions of fruit and vegetables a day
- Percentage of pupils who say they have been drunk
- Percentage of pupils who say they have taken cannabis or skunk
- Percentage of pupils classified as obese
- Percentage of children with tooth decay
- Emergency hospital admission rate
- Emergency hospital admission rate for long term conditions
- Accident and Emergency attendance rate
- Paediatric outpatient attendance rate
- Under 18 conception rate
- Percentage of young people testing positive for chlamydia
Maternity and Newborn
The tool provides two charts. One chart shows spending in 2010/11 compared to outcomes in a similar time period; the other chart compares the change in spending to the change in outcomes between 2009/10 and 2010/11. The tool looks at the following outcome measures:
- Percentage smoking at delivery
- Percentage low birthweight
- Percentage very low birthweight
- General fertility rate
- Stillbirth rate
- Normal delivery rate
- Caesarean section rate
- Percentage breastfeeding initiation
- Perinatal mortality rate
- Neonatal mortality rate
- Infant mortality rate
This tool is based on methodologies used within the PCT Spend and Outcomes Factsheets and Tool (SPOT) and Diabetes Outcomes Versus Expenditure (DOVE) tool developed by the Yorkshire and Humber Public Health Observatory.