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NDPH/0005/MT15

Supervisor

Marian KnightProfessor Marian Knight

Second supervisor

Jenny KurinczukProfessor Jenny Kurinczuk

Summary of the Project

Background

Continuing improvement in the quality of health services is dependent on good information on the outcomes of care, as well as acting on that information. Maternity services are facing a number of current challenges due to the rising birth population, and monitoring and improving the outcomes of care is particularly important. Information is more easily available on the outcomes of maternity care for infants rather than mothers, partly because the severest outcome, death, is more common amongst infants, whereas maternal death is very rare. Severe complications for mothers although individually rare, however, are collectively common.

The WHO has developed a “near-miss tool” for monitoring severe complications in pregnancy, but there are challenges with applying this approach including the availability of appropriate routine data. An approach has been developed in Australia to use routine hospital admission and discharge data to monitor the maternal outcomes of care, termed the Maternal Morbidity Outcome Indicator (MMOI) (Roberts, Cameron et al. 2008; Roberts, Ford et al. 2009) and another approach is currently under development in the US.

This project will investigate developing and validating an MMOI, or similar, using English Hospital Episode Statistics data, with the possibility of extending this to other UK countries and/or exploring the added value of linked data. In addition, the project will investigate trends in the outcome indicator developed, exploring which elements of the outcome indicator are driving any observed trends and the possibilities of using this information within maternity services to improve outcomes for mothers.

Research experience, research methods and skills training

The project will provide an extensive range of training opportunities in epidemiological and health services research methods, including design and conduct of epidemiological studies and use of routine data. In addition, the project will develop statistical expertise in basic comparative analytic techniques, measures of agreement and multivariable regression analyses, with the possibility of more complex modelling techniques for interested individuals.

Prospective candidates

This project would suit a highly numerate candidate wishing to develop expertise in epidemiology and health services research, with a focus on pregnancy and childbirth.