Articles

Does the Patient Clinical Complexity Level (PCCL) reflect nursing acuity?

Authors: John Bayliss-McCulloch

P4P in Australia

Authors: Stephen Duckett

Performance indicators in Swedish Health Care

Authors: Mona Heurgren, Anders Åberg, Max Köster and Rickad Ljung

Evaluating case-mix and predictive modeling measures within the British Primary care sector

Authors: Karen Kinder Siemens, Ipek Gurol-Urganci, Rifat Atun and Jonathan Weiner

From a Belgian Nursing minimum dataset to a nursing cost-weight per DRG

Authors: Walter Sermeus, D Gillain, P Gillet, J Grietens, N Laport, D Michiels, O Thonon, G Vandenboer and P Van Herck

Developing casemix classifications for rehabilitation in the UK

Authors: Lynne Turner-Stokes

Widening access to cardiovascular healthcare: community screening among ethnic minorities in inner-city Britain – the Healthy Hearts Project

The burden of cardiovascular disease (CVD) in Britain is concentrated in inner-city areas such as Sandwell, which is home to a diverse multi-ethnic population. Current guidance for CVD risk screening is not es...

Authors: Jeetesh V Patel, Ashan Gunarathne, Deidre Lane, Hoong S Lim, Inessa Tracey, Nimai C Panja, Gregory YH Lip and Elizabeth A Hughes

Comparison of international guideline programs to evaluate and update the Dutch program for clinical guideline development in physical therapy

Clinical guidelines are considered important instruments to improve quality in health care. Since 1998 the Royal Dutch Society for Physical Therapy (KNGF) produced evidence-based clinical guidelines, based on ...

Authors: Philip J Van der Wees, Erik JM Hendriks, Jan WH Custers, Jako S Burgers, Joost Dekker and Rob A de Bie

The care of patients with subthreshold depression in primary care: Is it all that bad? A qualitative study on the views of general practitioners and patients

Studies show that subthreshold depression is highly prevalent in primary care, has impact on the quality of life and causes immense health care costs. Although this points to the clinical relevance of subthres...

Authors: Matthias Backenstrass, Katharina Joest, Thomas Rosemann and Joachim Szecsenyi

Cost of diabetes care in out-patient clinics of Karachi, Pakistan

Diabetes Mellitus (DM) is a growing epidemic and the cost of treating diabetes is largely increasing. The objective of this study was to estimate the cost-of-illness of DM among attendees of out-patient clinic...

Authors: Liaquat A Khowaja, Ali K Khuwaja and Peter Cosgrove

Using hospital discharge data for determining neonatal morbidity and mortality: a validation study

Despite widespread use of neonatal hospital discharge data, there are few published reports on the accuracy of population health data with neonatal diagnostic or procedure codes. The aim of this study was to a...

Authors: Jane B Ford, Christine L Roberts, Charles S Algert, Jennifer R Bowen, Barbara Bajuk and David J Henderson-Smart

Factors associated with the appropriate use of preoperatory hospital stays: historical cohort study

To ensure the highest efficiency, health services should be provided with the least possible complexity. The aim of this study is to quantify the degree of appropriateness in preoperatory hospital stays and to...

Authors: Sonia Tamames, Alberto Perez Rubio, Javier Castrodeza Sanz, Maria Belen Canton Alvarez, Francisco J Luquero, Sara Santos Sanz, Placido Lopez Encinar, Maria Paz de la Torre Pardo and Juan Manuel Gil Gonzalez

Public involvement in the priority setting activities of a wait time management initiative: a qualitative case study

As no health system can afford to provide all possible services and treatments for the people it serves, each system must set priorities. Priority setting decision makers are increasingly involving the public ...

Authors: Rebecca A Bruni, Andreas Laupacis, Wendy Levinson and Douglas K Martin

The most dangerous hospital or the most dangerous equation?

Hospital mortality rates are one of the most frequently selected indicators for measuring the performance of NHS Trusts. A recent article in a national newspaper named the hospital with the highest or lowest m...

Authors: Yu-Kang Tu and Mark S Gilthorpe

Dental practice satisfaction with preferred provider organizations

Despite their increasing share of the dental insurance market, little is known about dental practices' satisfaction with preferred provider organizations (PPOs). This analysis examined practice satisfaction wi...

Authors: Robert H Aseltine Jr, Susan Reisine, Elizabeth A Schilling and James Kennedy

Evaluating an educational intervention to improve the accuracy of death certification among trainees from various specialties

The inaccuracy of death certification can lead to the misallocation of resources in health care programs and research. We evaluated the rate of errors in the completion of death certificates among medical resi...

Authors: Jesús Villar and Lina Pérez-Méndez

Adoption of an innovation to repair aortic aneurysms at a Canadian hospital: a qualitative case study and evaluation

Priority setting in health care is a challenge because demand for services exceeds available resources. The increasing demand for less invasive surgical procedures by patients, health care institutions and ind...

Authors: Nathalie M Danjoux, Douglas K Martin, Pascale N Lehoux, Julie L Harnish, Randi Zlotnik Shaul, Mark Bernstein and David R Urbach

The costs of preventing the spread of respiratory infection in family physician offices: a threshold analysis

Influenza poses concerns about epidemic respiratory infection. Interventions designed to prevent the spread of respiratory infection within family physician (FP) offices could potentially have a significant po...

Authors: William Hogg, David Gray, Patricia Huston and Wei Zhang

What do District Health Planners in Tanzania think about improving priority setting using 'Accountability for Reasonableness'?

Priority setting in every health system is complex and difficult. In less wealthy countries the dominant approach to priority setting has been Burden of Disease (BOD) and cost-effectiveness analysis (CEA), whi...

Authors: Simon Mshana, Haji Shemilu, Benedict Ndawi, Roman Momburi, Oystein Evjen Olsen, Jens Byskov and Douglas K Martin

A cluster randomized controlled trial of a clinical pathway for hospital treatment of heart failure: study design and population

The hospital treatment of heart failure frequently does not follow published guidelines, potentially contributing to the high morbidity, mortality and economic cost of this disorder. Consequently the developme...

Authors: Massimiliano Panella, Sara Marchisio, Andrea Gardini and Francesco Di Stanislao

Critical views on postpartum care expressed by new mothers

Women's evaluation of hospital postpartum care has consistently been more negative than their assessment of other types of maternity care. The need to further explore what is wrong with postpartum care, in ord...

Authors: Ann Rudman and Ulla Waldenström

Effectiveness and costs of implementation strategies to reduce acid suppressive drug prescriptions: a systematic review

Evaluation of evidence for the effectiveness of implementation strategies aimed at reducing prescriptions for the use of acid suppressive drugs (ASD).

Authors: Hugo M Smeets, Arno W Hoes and Niek J de Wit

Training pediatric health care providers in prevention of dental decay: results from a randomized controlled trial

Physicians report willingness to provide preventive dental care, but optimal methods for their training and support in such procedures are not known. This study aimed to evaluate the effect of three forms of c...

Authors: Gary D Slade, R Gary Rozier, Leslie P Zeldin and Peter A Margolis

Impact of prescription size on statin adherence and cholesterol levels

Therapy with 3-Hydroxy-3-methylglutaryl Co-enzyme A reductase inhibitors (statins) improve outcomes in a broad spectrum of patients with hyperlipidemia. However, effective therapy requires ongoing medication a...

Authors: Holly A Batal, Mori J Krantz, Rita A Dale, Phillip S Mehler and John F Steiner

The perception of healthcare quality of elderly in the city of Bari, South Italy

In recent decades in Italy, as in all the industrialized nations, the proportion of elderly subjects in the total population is constantly on the increase. However the increased life expectancy is not always p...

Authors: Rosa Prato, Domenico Martinelli, Annarita Fusco, Annarita Panebianco, Pietro Luigi Lopalco, Cinzia Annatea Germinario and Michele Quarto

The implementation of the Medical Regulation Office and Mobile Emergency Attendance System and its impact on the gravity profile of non-traumatic afflictions treated in a University Hospital: a research study

The public health system of Brazil is structured by a network of increasing complexity, but the low resolution of emergency care at pre-hospital units and the lack of organization of patient flow overloaded th...

Authors: Sérgio LB Lopes, José Sebastião dos Santos and Sandro Scarpelini

Cost-effectiveness analysis of guidelines for antihypertensive care in Finland

Hypertension is one of the major causes of disease burden affecting the Finnish population. Over the last decade, evidence-based care has emerged to complement other approaches to antihypertensive care, often ...

Authors: Neill Booth, Antti Jula, Pasi Aronen, Minna Kaila, Timo Klaukka, Katriina Kukkonen-Harjula, Antti Reunanen, Pekka Rissanen, Harri Sintonen and Marjukka Mäkelä

A five-year review of burn injuries in Irrua

The management of burns remains a challenge in developing countries. Few data exist to document the extent of the problem. This study provides data from a suburban setting by documenting the epidemiology of bu...

Authors: Andrew E Dongo, Eshobo E Irekpita, Lilian O Oseghale, Charles E Ogbebor, Christopher E Iyamu and John E Onuminya Sr

Team climate, intention to leave and turnover among hospital employees: Prospective cohort study

In hospitals, the costs of employee turnover are substantial and intentions to leave among staff may manifest as lowered performance. We examined whether team climate, as indicated by clear and shared goals, p...

Authors: Mika Kivimäki, Anna Vanhala, Jaana Pentti, Hannakaisa Länsisalmi, Marianna Virtanen, Marko Elovainio and Jussi Vahtera

Health service utilization patterns of primary care patients with osteoarthritis

To assess factors associated with visits to GPs, orthopaedists, and non-physician practitioners of complementary medicine (alternative practitioners) by primary care patients with osteoarthritis (OA).

Authors: Thomas Rosemann, Stefanie Joos, Joachim Szecsenyi, Gunter Laux and Michel Wensing

Microfinance investments in quality at private clinics in Uganda: a case-control study

Small private-sector health care providers can play an important role in meeting the developing country health care needs, but a lack of credit can prove major constraint to small-provider expansion. This stud...

Authors: Eric E Seiber and Amara L Robinson

Diffusion of good practices of care and decline of the association with case volume: the example of breast conserving surgery

Several previous studies conducted on cancer registry data and hospital discharge records (HDR) have found an association between hospital volume and the recourse to breast conserving surgery (BCS) for breast ...

Authors: Ugo Fedeli, Natalia Alba, Elena Schievano, Cristiana Visentin, Rosalba Rosato, Manuel Zorzi, Giancarlo Ruscitti and Paolo Spolaore

Do the UK government's new Quality and Outcomes Framework (QOF) scores adequately measure primary care performance? A cross-sectional survey of routine healthcare data

General practitioners' remuneration is now linked directly to the scores attained in the Quality and Outcomes Framework (QOF). The success of this approach depends in part on designing a robust and clinically ...

Authors: Amy Downing, Gavin Rudge, Yaping Cheng, Yu-Kang Tu, Justin Keen and Mark S Gilthorpe

Evaluating compulsory minimum volume standards in Germany: how many hospitals were compliant in 2004?

Minimum hospital procedure volumes are discussed as an instrument for quality assurance. In 2004 Germany introduced such annual minimum volumes nationwide on five surgical procedures: kidney, liver, stem cell ...

Authors: Werner de Cruppé, Christian Ohmann, Karl Blum and Max Geraedts

A novel emergency department based prevention intervention program for people living with HIV: evaluation of early experiences

HIV prevention is increasingly focused on people living with HIV (PLWH) and the role of healthcare settings in prevention. Emergency Departments (EDs) frequently care for PLWH, but do not typically endorse a p...

Authors: Michael S Lyons, Dana L Raab, Christopher J Lindsell, Alexander T Trott and Carl J Fichtenbaum

Integrated obesity care management system -implementation and research protocol

Nearly 50% of Canadians are overweight and their number is increasing rapidly. The majority of obese subjects are treated by primary care physicians (PCPs) who often feel uncomfortable with the management of o...

Authors: Jean-Patrice Baillargeon, André Carpentier, Denise Donovan, Martin Fortin, Andrew Grant, Judith Simoneau-Roy, Denise St-Cyr-Tribble, Mariane Xhignesse and Marie-France Langlois

Patient-provider interaction from the perspectives of type 2 diabetes patients in Muscat, Oman: a qualitative study

Patients' expectations and perceptions of the medical encounter and interactions are important tools in diabetes management. Some problems regarding the interaction during encounters may be related to a lack o...

Authors: Nadia Abdulhadi, Mohammed Al Shafaee, Solveig Freudenthal, Claes-Göran Östenson and Rolf Wahlström

Patients' satisfaction and opinions of their experiences during admission in a tertiary care hospital in Pakistan – a cross sectional study

It is often felt that developing countries need to improve their quality of healthcare provision. This study hopes to generate data that can help managers and doctors to improve the standard of care they provi...

Authors: Sardar Zakariya Imam, Khezar Shahzada Syed, Syed Ahad Ali, Syed Umer Ali, Kiran Fatima, Marium Gill, Muhammad Ovais Hassan, Saad Hasan Hashmi, Maham T Siddiqi, Hadi Muhammad Khan and Omar Farooq Jameel

A study of the efficacy and cost-effectiveness of MRSA screening and monitoring on surgical wards using a new, rapid molecular test (EMMS)

MRSA is a significant contributor to prolonged hospital stay, poor clinical outcome and increased healthcare costs amongst surgical patients. A PCR test has been developed for rapid detection of MRSA in nasal ...

Authors: Katherine J Hardy, Ala Szczepura, Ruth Davies, Andrew Bradbury, Nigel Stallard, Savita Gossain, Paul Walley and Peter M Hawkey

Validation of ICD-9-CM/ICD-10 coding algorithms for the identification of patients with acetaminophen overdose and hepatotoxicity using administrative data

Acetaminophen overdose is the most common cause of acute liver failure (ALF). Our objective was to develop coding algorithms using administrative data for identifying patients with acetaminophen overdose and h...

Authors: Robert P Myers, Yvette Leung, Abdel Aziz M Shaheen and Bing Li

Randomised controlled trials for evaluating the prescribing impact of information meetings led by pharmacists and of new information formats, in General Practice in Italy

Suboptimal translation of valid and relevant information in clinical practice is a problem for all health systems. Lack of information independent from commercial influences, limited efforts to actively implem...

Authors: Nicola Magrini, Giulio Formoso, Anna Maria Marata, Oreste Capelli, Emilio Maestri, Claudio Voci, Francesco Nonino, Massimo Brunetti, Barbara Paltrinieri, Susanna Maltoni, Lucia Magnano, Maria Isabella Bonacini, Lisa Daya and Nilla Viani

Hospital quality reports in Germany: patient and physician opinion of the reported quality indicators

Starting in 2005, Germany's health law required hospital quality reports to be published every two years by all acute care hospitals. The reports were intended to help patients and physicians make informed cho...

Authors: Max Geraedts, David Schwartze and Tanja Molzahn

Feasibility of a cognitive behavioural group intervention to reduce fear of falling and associated avoidance of activity in community-living older people: a process evaluation

Fear of falling and associated avoidance of activity are common among older people and may have negative consequences in terms of functional decline, quality of life and institutionalisation. We evaluated the ...

Authors: Jolanda CM van Haastregt, GA Rixt Zijlstra, Erik van Rossum, Jacques ThM van Eijk, Luc P de Witte and Gertrudis IJM Kempen

Hospital characteristics and patient populations served by physician owned and non physician owned orthopedic specialty hospitals

The emergence of physician owned specialty hospitals focusing on high margin procedures has generated significant controversy. Yet, it is unclear whether physician owned specialty hospitals differ significantl...

Authors: Peter Cram, Mary S Vaughan-Sarrazin and Gary E Rosenthal

Event-based record linkage in health and aged care services data: a methodological innovation

The interface between acute hospital care and residential aged care has long been recognised as an important issue in aged care services research in Australia. However, existing national data provide very poor...

Authors: Rosemary Karmel and Diane Gibson

Distributing questionnaires about smoking to patients: impact on general practitioners' recording of smoking advice

Little is known about the impact of questionnaire-based data collection methods on the consulting behaviour of general practitioners (family physicians) who participate in research. Here data collected during ...

Authors: Tim Coleman, Andrew Wilson, Steve Barrett, Alison Wynne and Sarah Lewis

Combining evidence and values in priority setting: testing the balance sheet method in a low-income country

Procedures for priority setting need to incorporate both scientific evidence and public values. The aim of this study was to test out a model for priority setting which incorporates both scientific evidence an...

Authors: Emmanuel Makundi, Lydia Kapiriri and Ole Frithjof Norheim

Self-reported social class in adolescents: validity and relationship with gradients in self-reported health

Analyzing social differences in the health of adolescents is a challenge. The accuracy of adolescent's report on familial socio-economic position is unknown. The aims of the study were to examine the validity ...

Authors: María-Jesús Pueyo, Vicky Serra-Sutton, Jordi Alonso, Barbara Starfield and Luis Rajmil

Are physical symptoms among survivors of a disaster presented to the general practitioner? A comparison between self-reports and GP data

Most studies examining medically unexplained symptoms (MUS) have been performed in primary or secondary care and have examined symptoms for which patients sought medical attention. Disasters are often describe...

Authors: Bellis van den Berg, C Joris Yzermans, Peter G van der Velden, Rebecca K Stellato, Erik Lebret and Linda Grievink

Collecting data for sexually transmitted infections (STI) surveillance: what do patients prefer in Flanders?

STI surveillance systems are subject to qualitative and quantitative underreporting. General practitioners (GPs), who are key subjects in case reporting, explain their underreporting partly by their observatio...

Authors: Veronique Verhoeven, Annelies Colliers, Ann Verster, Dirk Avonts, Lieve Peremans and Paul Van Royen