Evaluation of a system of monitoring allied health service provision, quality and outcomes

Abstract

Allied health professionals provide a diverse range of patient care. However funders and purchasers of allied health services have few mechanisms for defining the interventions carried out by allied health providers; for defining episodic care; or for monitoring the quality and outcomes of allied health provider interventions. As a result, third party funders tend to allocate allied health services by establishing a ceiling on the number of appointments allowed, or capping regardless of the condition or patient need. This paper reports on the effect of the monitoring systems by a third party funder to introduce more patient centred funding models. Aim: To evaluate a system of monitoring allied health service provision, quality and outcomes. Method: A large third party funder piloted the introduction of a comprehensive care planning tool to investigate the potential for post-payment monitoring of service quality. Results: Practitioner perceptions of provider quality were quite different from what was measured and audited. The heterogeneity of allied health services means that no standardised classification system of interventions is appropriate for service benchmarking. There were large variations in service provision, within and between practitioners. Conclusions: Ongoing monitoring should include easily auditable measures, such as occasions of service mapped against broad indicators of type of appointment. There is a need for ongoing systems of quality improvement to ensure the quality of patient care is optimised.