117 research outputs found
Association between patient and general practice characteristics and unplanned first-time admissions for cancer: observational study.
No full textBACKGROUND: To identify patient and general practice (GP) characteristics associated with emergency (unplanned) first admissions for cancer in secondary care. METHODS: Patients who had a first-time admission with a primary diagnosis of cancer during 2007/08 to 2009/10 were identified from administrative hospital data. We modelled the associations between the odds of these admissions being unplanned and various patient and GP practice characteristics using national data sets, including the Quality and Outcomes Framework (QOF). RESULTS: There were 639,064 patients with a first-time admission for cancer, with 139,351 unplanned, from 7957 GP practices. The unplanned proportion ranged from 13.9% (patients aged 15-44 years) to 44.9% (patients aged 85 years and older, P<0.0001), with large variation by ethnicity (highest in Asians), deprivation, rurality and cancer type. In unadjusted analyses, all included patient and practice-level variables were statistically significant predictors of the admissions being unplanned. After adjustment, patient area-level deprivation was a key factor (most deprived compared with least deprived quintile OR 1.36, 95% CI 1.32-1.40). Higher total QOF performance protected against unplanned admission (OR 0.94 per 100 points; 95% CI 0.91-0.97); having no GPs with a UK primary medical qualification (OR 1.08, 95% CI 1.04-1.11) and being less able to offer appointments within 48 h were associated with higher odds. CONCLUSION: We have identified some patient and practice characteristics associated with a first-time admission for cancer being unplanned. The former could be used to help identify patients at high risk, while the latter raise questions about the role of practice organisation and staff training
Associations between postoperative rehabilitation of hip fracture and outcomes: national database analysis (vol 19, 211, 2018)
No full textFollowing publication of the original article [1], the author reported an error in the Title. The original article has been corrected
NHS health checks: an update on the debate and program implementation in England.
No full textCardiovascular disease is the leading cause of mortality and morbidity worldwide. In England, the government has adopted a population-wide prevention program for cardiovascular disease, the NHS Health Check program. The program has sparked controversies over the evidence base and feasibility of implementation. We aim to provide an update on the debate and program implementation. In conclusion, the evidence base for the NHS Health Check program has a number of uncertainties and program delivery has been suboptimal. It is important to continue monitoring and evaluating the program to provide the evidence base for future policy direction
The nationwide systematic prevention of cardiovascular disease: the UK's health check programme.
No full textHigh-income countries have witnessed marked reductions in cardiovascular disease (CVD) in recent years. Aging populations, however, maintain CVD as a major threat to public health and health system's financial stability. England has commenced on a population-wide screening and prevention program for CVD, the NHS Health Check program, the first national program of its type. We outline the program, its implications for public health and primary care, potential threats to the program, and its implications for the US health system. We conclude that the universal approach adopted contains a number of risks and uncertainties. The program's ongoing evaluation is vital and will provide internationally valuable data
Associations between post-operative rehabilitation of hip fracture and outcomes: national database analysis (90 characters)
No full textRehabilitation programmes are used to improve hip fracture outcomes. There is little published trial clinical trial or population-based data on the effects of the type or provider of rehabilitation treatments on hip fracture outcomes. We evaluated the associations of rehabilitation interventions with post-operative hip fracture outcomes
Is there an association between deprivation and pre-operative disease severity? A cross-sectional study of patient-reported health status
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