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Developing adjusted indicators of quality from survey data

2012 Conference Presentation

Outcomes and quality EnglandUnited Kingdom

6 September 2012

Developing adjusted indicators of quality from survey data

Juliette Malley, London School of Economics, United Kingdom
Jose-Luis Fernandez, London School of Economics, United Kingdom


The Adult Social Care Survey (ASCS) is a fundamental part of the new Adult Social Care Outcomes Framework (ASCOF), which is used by local areas and the English Department of Health to monitor and improve the quality of publicly-funded social care provision, through for example benchmarking exercises.

The ASCS is outcome oriented; it captures information on the social care-related quality of life (SCRQoL) of adults (18 and over) receiving all types of social care interventions, including equipment and adaptations, home care and residential care. At present an aggregate outcome score is reported for each local area for each ASCS-based indicator. Since these are raw outcomes, comparison between local areas is difficult as many other factors, such as the case-mix, may influence the raw outcome score.

We utilise individual-level case-mix information captured for each survey respondent to explore methods for adjusting the outcome indicators to enable ‘fairer’ comparisons between local areas. We utilise different regression techniques, including ordinary least squares, generalised linear models and survival models in an attempt to reflect the indicators’ distributional characteristics. The different models have good explanatory power and are highly consistent. We also are able to show that the adjusted scores differ from the raw scores. However, problems with specification remain. We discuss potential reasons for this and suggest further avenues for future research.