London School of Hygiene & Tropical Medicine

1. Saving limbs and lives: amputation-free survival following lower limb revascularisation procedures in England

Dr Katriina Heikkila, CEU, London School of Hygiene & Tropical Medicine.

Summary: Surgical and endovascular lower limb revascularisation procedures have become more common and the types of procedures available more diverse over the past decade. However, the long term outcomes of these procedures is unclear. In this talk I will explore lower limb amputations and patient survival following lower limb revascularisation procedures in England in 2005-10, using patient-level data from Hospital Episode Statistics (HES).

2. Can variation in quality and outcomes of healthcare be explained by organisational factors?

Dr Kate Walker, CEU, London School of Hygiene & Tropical Medicine

Summary: There is evidence from national clinical audits that the quality and outcomes of care can vary widely between healthcare providers. This talk draws on examples from national audits to explore whether these variations can be explained by organisational factors measured at the level of the healthcare provider. For example, there is wide variation in length of hospital stay after major surgery for bowel cancer. The National Bowel Cancer Audit recently carried out an organisational survey of hospital trusts and collected information on service provision and structure, including the provision of enhanced recovery services, weekend consultant review, and discharge coordinators. In one of the examples the talk will look at whether any of these factors explain the variation in length of hospital stay. The methodological issues with this type of analysis and the clinical implications of the findings will be discussed.