Dr Foster Unit
The Dr Foster Unit was established in 2000 within the Division of Epidemiology, Public Health and Primary Care, part of the Faculty of Medicine at Imperial College. The Unit is physically based at 12 Smithfield Street. The unit is headed by Sir Brian Jarman, with Dr Paul Aylin as Assistant Director. Its research is funded through a grant from Dr Foster Intelligence (A joint venture between Dr Foster Ltd and the NHS Information Centre).
The main objective of the unit was to develop methods to explain variations in mortality rates in medium and large acute hospital trusts across England. Since 2002, the unit has delivered a large variety of analyses related to variations in quality of healthcare.
Building on Professor Sir Brian Jarman’s work on Hospital Standardised Mortality Ratios, the unit applied statistical methods developed during previous work commissioned by the Shipman Inquiry to developing a tool to monitor health outcomes for a variety of diagnoses and procedures. In collaboration with the web development team at Dr Foster Intelligence, this led to the roll out of Real Time Monitoring System and the first commercial analysis tool to be sold by DFI to the NHS.
Before 2002, the unit acquired HES data annually, and was hence too out of date to be useful in a near real-time monitoring tool. The unit has since developed a system by which raw, uncleaned hospital episode data could be cleaned and processed monthly. Further value is added to the data by the unit in the form of HRG codes, socio-economic deprivation measures, MOSAIC, and several flags (e.g. emergency readmission within 28 days, patient safety indicators) designed to add functionality to the data.
A number of useful applications have followed including a method to identify high impact users of healthcare, a practice based commissioning tool and an application to monitor and analyse hospital activity. In the past year, after an analysis to assess its quality, we have added monthly outpatient data to our database amounting to some 50 million records a year. Currently the unit holds over 10 years of inpatient data, amounting to some 130 million records and 160 million outpatient records.
The unit has an excellent publication record with 30 papers published since 2002 in leading academic journals, including the BMJ and the Lancet.
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