Letter: Hospital league tables: statistics that confuse efficiency with effectiveness

Sir: The percentage of operations carried out as day-case surgery (reports and leading article, 30 June) is not an indicator of quality in health care. A low percentage for a given hospital may reflect poor day-stay provision and suggest that some patients are being denied such a facility but, unless we know the percentage that could be treated in this way on clinical grounds, and that would like to be treated in this way, we cannot come to this conclusion.

A high percentage may result from a real drive on the part of a hospital to get patients in and out on the same day regardless (with an eye on the financial savings), even if that means some patients being sent home inappropriately; patients who because of age, general poor health or poor domestic circumstances would be much better served by at least an overnight stay.

I have no objection to performance tables in principle, but health care is an enormously complex subject and unless complete data on all the variables that might influence such a final percentage figure are made available, permitting that figure to be judged in its proper context, it would be better to have no figure at all.

Yours sincerely,

C. J. BARBER

Harlow, Essex

1 July