A descriptive analysis of general acute Trust star ratings

Abstract

This paper examines the relationship between acute NHS Trust star ratings in England (generated by the Department of Health) in 2000/01 and 2001/02 with various other Trust characteristics and performance indicators from a Trust level database maintained by the Centre for Health Economics. The Trust star ratings system is a composite performance measure which places Trusts into one of four categories: from three stars, awarded to Trusts with the highest levels of performance to zero stars, awarded to Trusts showing the poorest levels of performance. We examine the descriptive statistics for the various variables in the dataset over the two years, according to each star rating as well as one-way Analysis of Variance (ANOVA) using zero star Trusts as the reference category and then least squares to fit a linear model to each of the variables in the dataset. Although zero star Trusts appear to perform better in terms of clinical outcomes such as death rates and readmissions, this is not statistically significant. However, zero star Trusts do worse than other Trusts across various patient satisfaction measures and financial and efficiency measures. Three star Trusts outperform others on two grounds fairly consistently: waiting times and financial balance suggesting either more efficient management or fewer capacity constraints. The labour market for consultants and nurses also appear to be utilised in different ways across the groups of Trusts. One hypothesis is that the different groups of Trusts focus on different elements of performance. The extent to which differences are due to exogenous factors or internal factors is a question for future research.analysis of variance (ANOVA), star rating, zero star Trusts