Journal of Health Services Research and Policy via MedWorm.com MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Health Services Research and Policy' source. Sun, 14 Mar 2010 15:49:43 +0100 Population health: data, trends and indicators http://www.medworm.com/index.php?rid=3170468&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F62%3Frss%3D1 Several websites provide information about the health of the population including health indicators at regional and district levels. These allow health services researchers to access comparable statistics for different countries. This edition of ‘What's on the web’ lists some of the websites that provide easy access to reliable population health data and statistics. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to: Kath Wright Information Service Manager Centre for Reviews and Dissemination University of York, York YO10 5DD UK (Email: kew5@york.ac.uk) (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170468 Wed, 13 Jan 2010 17:42:59 +0100 3170468 The appropriation of complexity theory in health care http://www.medworm.com/index.php?rid=3170467&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F59%3Frss%3D1 The way in which complexity is usually interpreted in the health care literature misses the whole point of complexity theory, thanks to an influential but misleading series of articles in the BMJ. Complexity provides an explanation of patterns and structures in certain systems by modelling known outcomes at the global level in terms of stimulus–response rules governing the unilateral, non-intentional behaviour of individual units comprising the system. The BMJ articles overlook the explanatory function of complex systems, restore the link between order and design which complexity thinking disrupts, and interpret purely mathematical concepts in psychological terms. As a consequence, the health care literature typically regards complexity as a variation on democratic, collaborative, &l... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170467 Wed, 13 Jan 2010 17:42:59 +0100 3170467 America's troubled search for universal health care http://www.medworm.com/index.php?rid=3170466&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F56%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170466 Wed, 13 Jan 2010 17:42:59 +0100 3170466 Community professionals' management of client care: a mixed-methods systematic review http://www.medworm.com/index.php?rid=3170465&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F47%3Frss%3D1 Conclusions Although there is a considerable literature on caseload management, it is not possible to make summative conclusions. Policy-makers and professional bodies should encourage and support development of research evidence about the ways to achieve effective, efficient and equitable caseload management. Health and social care services considering implementing caseload management tools or models of practice should critically appraise their basis, and consider their potential advantages as well as disadvantages. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170465 Wed, 13 Jan 2010 17:42:59 +0100 3170465 Disentangling the impact of multiple innovations to reduce delayed hospital discharges http://www.medworm.com/index.php?rid=3170464&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F41%3Frss%3D1 Delayed hospital discharges are often blamed for interrupting the smooth operation of hospitals. In England, the Community Care Act in 2003 introduced fines to social services departments to resolve this issue. Evaluations of this policy reported success in the reduction of delays. However, this policy was an amalgam of several innovations, not just the introduction of fines. This simultaneity makes attribution of impact of fines a difficult task because of the potential impact of those other measures. All the other designed organizational changes contain as much mechanisms of change as the more advertised fines. The exploration of how all these elements are connected unravels the inner workings of the programme as a whole, and by default, of the fines. This theoretical analysis also demon... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170464 Wed, 13 Jan 2010 17:42:59 +0100 3170464 Municipal governments' role in averting access problems associated with market reform http://www.medworm.com/index.php?rid=3170463&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F36%3Frss%3D1 Conclusion Health insurance legislation based on the principle of individual responsbility requires a policy to support social security recipients in society. Such a policy may imply restrictions to individual responsibility. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170463 Wed, 13 Jan 2010 17:42:59 +0100 3170463 Where did all the GPs go? Increasing supply and geographical equity in England and Scotland http://www.medworm.com/index.php?rid=3170462&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F28%3Frss%3D1 Conclusions Reducing geographical inequity in the provision of GPs requires targeted area level policies. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170462 Wed, 13 Jan 2010 17:42:59 +0100 3170462 Do telephones overcome geographical barriers to general practice out-of-hours services? Mixed-methods study of parents with young children http://www.medworm.com/index.php?rid=3170461&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F21%3Frss%3D1 Conclusions People already disadvantaged by their distance from facilities or socioeconomic circumstances may continue to be at a disadvantage when services are provided by telephone. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170461 Wed, 13 Jan 2010 17:42:59 +0100 3170461 The desirability of being open about health care rationing decisions: findings from a qualitative study of patients and clinical professionals http://www.medworm.com/index.php?rid=3170460&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F14%3Frss%3D1 Conclusions The results suggest that moves in the UK and elsewhere to undertake rationing more explicitly are in line with the preferences of the majority of patients and professionals. However, the potential for distress caused through rationing openly means that further research is needed to understand whether explicitness is always the best approach at the consultation level, and professionals need further training and support to deal with the stressful nature of making rationing decisions openly. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170460 Wed, 13 Jan 2010 17:42:59 +0100 3170460 Evaluation of workforce and organizational issues in establishing primary angioplasty in England http://www.medworm.com/index.php?rid=3170459&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F6%3Frss%3D1 Conclusions Primary angioplasty was feasible in varied settings and generally supported by staff. However, the participating hospitals were selected enthusiasts, only some implemented a 24-hour service and activity levels were relatively low. Organizational and workforce issues need to be addressed to achieve an efficient and sustainable service. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170459 Wed, 13 Jan 2010 17:42:59 +0100 3170459 Audit of submissions: July 2008 to June 2009 http://www.medworm.com/index.php?rid=3170458&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F5%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170458 Wed, 13 Jan 2010 17:42:59 +0100 3170458 Purchasing health care in a cold climate http://www.medworm.com/index.php?rid=3170457&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F3%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170457 Wed, 13 Jan 2010 17:42:59 +0100 3170457 Measuring productivity in health services http://www.medworm.com/index.php?rid=3170456&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F15%2F1%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=3170456 Wed, 13 Jan 2010 17:42:59 +0100 3170456 How to review a paper http://www.medworm.com/index.php?rid=2809198&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F255%3Frss%3D1 Peer review is integral to assuring the quality of papers that are published in the scientific literature. Many health professionals at some point in their career will be invited by a journal editor to review a manuscript that has been submitted for publication. What resources are available on the web to support reviewers in this task? This edition of ‘What's on the web’ pulls together some of the essential websites that provide guidance, tips, background information and current debates about the process of peer review. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to: Kath Wright Information Service Manager Centre for Reviews and Dissemination University of York, York YO10 5DD UK (Email: kew5@york.ac.uk) (Source: ... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809198 Thu, 17 Sep 2009 23:00:00 +0100 2809198 Images in health care: potential and problems http://www.medworm.com/index.php?rid=2809197&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F251%3Frss%3D1 Although communication issues within health care have received greater research and policy attention in recent years, one growing aspect of such communication has been largely overlooked. In this paper we suggest that visual forms of communication, at both the individual and population level, are increasingly used and relied upon. This seems appropriate given a general shift towards a more visual and visually literate society, and the potential of images to convey complex information and influence both beliefs and emotion. However, we also argue that the widespread use of such a potentially powerful tool necessitates a solid evidence base that is currently lacking. Such a lack leaves image-based interventions at best potentially ineffective and at worst harmful. We examine the reasons for ... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809197 Thu, 17 Sep 2009 23:00:00 +0100 2809197 Assessment and accountability http://www.medworm.com/index.php?rid=2809196&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F249%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809196 Thu, 17 Sep 2009 23:00:00 +0100 2809196 Equity in the distribution of community pharmacies in England: impact of regulatory reform http://www.medworm.com/index.php?rid=2809195&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F243%3Frss%3D1 Conclusion Deregulation was associated with more community pharmacies per capita and a small increase in geographic equity of community pharmacy distribution at PCT level. Future research should continue to monitor how pharmacy distribution changes over time and assess the extent to which the new regulatory framework has allowed clustering of pharmacies which could result in increased inequity below PCT level. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809195 Thu, 17 Sep 2009 23:00:00 +0100 2809195 Evaluation of the impact of program budgeting and marginal analysis in Vancouver Island Health Authority http://www.medworm.com/index.php?rid=2809194&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F234%3Frss%3D1 Conclusion Faced with claims that typically outstrip available resources, health care decision-makers need a process to guide allocation decisions. PBMA has demonstrated at VIHA an ability to handle some of the key issues associated with this challenge. Our analysis has produced lessons that should facilitate future implementation but has also shown that resource allocation criteria selection and the extent of executive discretion are likely to be ongoing challenges. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809194 Thu, 17 Sep 2009 23:00:00 +0100 2809194 A Bayesian method for the synthesis of evidence from qualitative and quantitative reports: the example of antiretroviral medication adherence http://www.medworm.com/index.php?rid=2809193&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F226%3Frss%3D1 Conclusions The utility of Bayesian methods for synthesizing qualitative and quantitative research findings at the participant level may depend on the nature of the relationship being synthesized and on how well the findings are represented in the individual reports. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809193 Thu, 17 Sep 2009 23:00:00 +0100 2809193 Commentary: Motes, beams and evidence-based practice http://www.medworm.com/index.php?rid=2809192&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F224%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809192 Thu, 17 Sep 2009 23:00:00 +0100 2809192 Evidence-based practice in British complementary and alternative medicine: double standards? http://www.medworm.com/index.php?rid=2809191&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F219%3Frss%3D1 Conclusions This discloses double standards in UK health care which may compromise patient safety. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809191 Thu, 17 Sep 2009 23:00:00 +0100 2809191 'There are too many of us to fix.' Patients' views of acceptable waiting times for hip and knee replacement http://www.medworm.com/index.php?rid=2809190&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F212%3Frss%3D1 Conclusions Patients' views of acceptable waiting times are important for a fair process of establishing waiting time benchmarks for joint replacement. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809190 Thu, 17 Sep 2009 23:00:00 +0100 2809190 Bringing genetics into primary care: findings from a national evaluation of pilots in England http://www.medworm.com/index.php?rid=2809189&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F204%3Frss%3D1 Conclusions More wide-ranging policy and organizational support is required if the aim of entrenching genetics knowledge and practice across the Health Service is to be realized. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809189 Thu, 17 Sep 2009 23:00:00 +0100 2809189 What medical specialists like and dislike about health technology assessment reports http://www.medworm.com/index.php?rid=2809188&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F197%3Frss%3D1 Conclusions HTA producers cannot afford to overlook medical specialists who play a key role in the adoption of health technologies. Establishing a transparent dialogue between producers and users of HTA reports could enrich policy recommendations. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809188 Thu, 17 Sep 2009 23:00:00 +0100 2809188 Evidence-based design of health care facilities http://www.medworm.com/index.php?rid=2809187&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F194%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809187 Thu, 17 Sep 2009 23:00:00 +0100 2809187 The theory and practice of markets in health care http://www.medworm.com/index.php?rid=2809186&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F4%2F193%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2809186 Thu, 17 Sep 2009 23:00:00 +0100 2809186 National clinical guidance http://www.medworm.com/index.php?rid=2500882&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F190%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500882 Wed, 17 Jun 2009 23:00:00 +0100 2500882 In praise of chiropractic http://www.medworm.com/index.php?rid=2500881&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F188%3Frss%3D1 The rationales used in chiropractic are largely in keeping with current evidence-based guidance. When listening to debates for and against the scientific basis of chiropractic, it is important to be aware of the selective use of evidence on both sides and of the limitations of logical positivistic arguments when it comes to health care areas that have a substantial psychosocial component. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500881 Wed, 17 Jun 2009 23:00:00 +0100 2500881 UK chiropractic: regulated but unruly http://www.medworm.com/index.php?rid=2500880&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F186%3Frss%3D1 Since 1994 chiropractic has been regulated by statute in the UK. Despite this air of respectability, a range of important problems continue to bedevil this profession. Professional organizations of chiropractic and their members make numerous claims which are not supported by sound evidence. Many chiropractors adhere to concepts which fly in the face of science and most seem to regularly violate important principles of ethical behaviour. The advice chiropractors give to their clients is often dangerously misleading. If chiropractic in the UK is to grow into an established health care profession, the General Chiropractic Council and its members should comply with the accepted standards of today's health care. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500880 Wed, 17 Jun 2009 23:00:00 +0100 2500880 Measuring the quality of medical care http://www.medworm.com/index.php?rid=2500879&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F183%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500879 Wed, 17 Jun 2009 23:00:00 +0100 2500879 What is the relationship between patients' and clinicians' reports of the outcomes of elective surgery? http://www.medworm.com/index.php?rid=2500878&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F174%3Frss%3D1 Conclusions Patients' views of their level of disability reflect clinicians' views and can be relied upon to assess this dimension of health status. In addition, patients are the ‘gold standard’ judges of symptoms and quality of life. Given these findings, clinicians, provider managers, commissioners and politicians can be confident that patients' reports provide an accurate indication of the outcome of elective surgery. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500878 Wed, 17 Jun 2009 23:00:00 +0100 2500878 Reducing waiting times for hospital treatment: lessons from the English NHS http://www.medworm.com/index.php?rid=2500877&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F168%3Frss%3D1 In recent years, the English NHS has achieved substantial reductions in waiting times for hospital treatment. This paper considers first whether the data used by the Government provide an accurate description of changes in waiting times and identifies some of the limitations of the measures used. It then attempts to identify how reductions have been achieved. It argues that some features of central government policy have been important – such as the use of targets – others, such as the introduction of new private sector capacity have not. It also shows that changes at local level have been critical to achieving the recorded improvements, but the precise impact of these is hard to identify. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500877 Wed, 17 Jun 2009 23:00:00 +0100 2500877 Tackling climate change close to home: mobile breast screening as a model http://www.medworm.com/index.php?rid=2500876&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F165%3Frss%3D1 Conclusions Decentralizing health care delivery can potentially provide substantial reductions in emissions at the same time as improving the patient experience. Thus, the ‘care close to home’ agenda can simultaneously improve health outcomes and the environment. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500876 Wed, 17 Jun 2009 23:00:00 +0100 2500876 Developing a framework for transferring knowledge into action: a thematic analysis of the literature http://www.medworm.com/index.php?rid=2500875&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F156%3Frss%3D1 Conclusion Our framework provides a foundation for gathering evidence from case studies of knowledge transfer interventions. We propose that future empirical work is designed to test and refine the relevance, importance and applicability of each of the components in order to build a more useful model of knowledge transfer which can serve as a practical checklist for planning or evaluating knowledge transfer activities. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500875 Wed, 17 Jun 2009 23:00:00 +0100 2500875 Patient and hospital characteristics associated with claims and compensations for patient injuries in coronary artery bypass grafting in Finland http://www.medworm.com/index.php?rid=2500874&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F150%3Frss%3D1 Conclusions Although high-risk patients file a claim more frequently than low-risk patients, the latter have a higher probability of getting their claims accepted and receiving compensation. This risk pattern is probably a reflection of compensation practices related to patient injuries involving an infection. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500874 Wed, 17 Jun 2009 23:00:00 +0100 2500874 Delivering health care through community pharmacies: are working conditions deterring female pharmacists' participation? http://www.medworm.com/index.php?rid=2500873&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F141%3Frss%3D1 Conclusions Family-friendly flexible work environments, adequate staffing levels and improved management support, might be more effective in increasing workforce participation than enhanced salary levels in this group of workers. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500873 Wed, 17 Jun 2009 23:00:00 +0100 2500873 Sources of variation in the costs of health care for asthma patients in Australia http://www.medworm.com/index.php?rid=2500872&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F133%3Frss%3D1 Conclusions Those with poorly-controlled asthma and the elderly require more carefully targeted strategies to improve their health and ensure appropriate use of resources. Access to appropriate services for those living outside of major cities should be improved. Co-payments for the middle-income groups and those living outside major cities should be reduced to improve equity in the use of services. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500872 Wed, 17 Jun 2009 23:00:00 +0100 2500872 Paying for better outcomes - the English way http://www.medworm.com/index.php?rid=2500871&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F131%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500871 Wed, 17 Jun 2009 23:00:00 +0100 2500871 Opportunity value http://www.medworm.com/index.php?rid=2500870&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F3%2F129%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2500870 Wed, 17 Jun 2009 23:00:00 +0100 2500870 Health policy websites http://www.medworm.com/index.php?rid=2281656&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F126%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281656 Wed, 18 Mar 2009 04:00:00 +0100 2281656 Myth: In health care, more is always better http://www.medworm.com/index.php?rid=2281655&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F124%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281655 Wed, 18 Mar 2009 04:00:00 +0100 2281655 Health services research: the gradual encroachment of ideas http://www.medworm.com/index.php?rid=2281654&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F120%3Frss%3D1 There is increasing pressure on researchers and research funding bodies to demonstrate the value of research. Simple approaches, consistent with the biomedical paradigm, based on relating the cost of research to its supposed impact are being investigated and adopted in laboratory and clinical research. While this may be appropriate in such research areas, it should not be applied to health services research which aims to alter the ways policy-makers and managers think about health, disease and health care or, as John Maynard Keynes put it, ‘the gradual encroachment of ideas’. By considering six fundamental assumptions about health care that have been successfully challenged and overturned over the past few decades, the profound and sustained impact of health services research c... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281654 Wed, 18 Mar 2009 04:00:00 +0100 2281654 Author's response http://www.medworm.com/index.php?rid=2281653&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F119%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281653 Wed, 18 Mar 2009 04:00:00 +0100 2281653 Commentary on 'What is a priority?' by Paul Spicker http://www.medworm.com/index.php?rid=2281652&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F117%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281652 Wed, 18 Mar 2009 04:00:00 +0100 2281652 What is a priority? http://www.medworm.com/index.php?rid=2281651&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F112%3Frss%3D1 What does it mean to say that something is a ‘priority’? Priority setting is used to balance competing claims for resources, but the nature of the exercise is ambiguous. The priorities which are claimed might be for time, resources, process, rights or service. The setting of priorities might refer to importance, relative value, precedence, special status or lexical ordering. And there are different ways of ranking priorities including simple ordering, optimization, triage and satisficing. There is a fundamental distinction between preference rankings and precedence rankings, which can lead to strongly different conclusions from the same initial information. Because there is no definitive understanding of what a priority is, there can be no authoritative formula for deciding bet... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281651 Wed, 18 Mar 2009 04:00:00 +0100 2281651 Partnerships for knowledge exchange in health services research, policy and practice http://www.medworm.com/index.php?rid=2281650&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F104%3Frss%3D1 Within the health services research community there is a growing strength of feeling that ongoing partnerships between researchers and decision-makers are critically important to effective transfer and exchange of knowledge generated from health services research. A body of literature is emerging around this idea that favours a particular model of partnership based on decision-maker involvement in research. This model is also gaining favour among health research funding bodies internationally. We argue that it is premature for the health services community to privilege any particular model of partnership between researchers and decision-makers. Rather a diversity of models should be conceptualized, explored in theory and practice, and evaluated. We identify seven dimensions that could be u... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281650 Wed, 18 Mar 2009 04:00:00 +0100 2281650 Does the culture of a medical practice affect the clinical management of diabetes by primary care providers? http://www.medworm.com/index.php?rid=2281649&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F96%3Frss%3D1 Conclusions Attention is beginning to focus on physician behavior in the context of different organizational environments. This study provides additional support for the suggestion that organization-level interventions (especially focused on practice culture) may offer an opportunity to reduce health care disparities and improve the quality of care. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281649 Wed, 18 Mar 2009 04:00:00 +0100 2281649 Impacts of case management for frail elderly people: a qualitative study http://www.medworm.com/index.php?rid=2281648&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F88%3Frss%3D1 Conclusion Case management was highly valued by patients and their carers, but there were few major differences in outcomes between Evercare and other models. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281648 Wed, 18 Mar 2009 04:00:00 +0100 2281648 Experience of continuity of care of patients with multiple long-term conditions in England http://www.medworm.com/index.php?rid=2281647&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F82%3Frss%3D1 Conclusions Across a range of long-term conditions, patients' experiences of health care can be understood in terms of nuanced understandings of relational and management continuity. Continuity experiences, meanings and expectations, as well as barriers and facilitators, are influenced by the model of care rather than type of condition. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281647 Wed, 18 Mar 2009 04:00:00 +0100 2281647 Feasibility and cost of obtaining informed consent for essential review of medical records in large-scale health services research http://www.medworm.com/index.php?rid=2281646&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F77%3Frss%3D1 Conclusions A high consent rate for review of medical notes is achievable but at a cost. There needs to be renewed debate about the automatic need for consent to review medical records where the chance of personal harm is negligible and the purpose of the review is to provide robust evidence to save lives, prevent needless suffering, and improve the effectiveness and efficiency of health care delivery. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281646 Wed, 18 Mar 2009 04:00:00 +0100 2281646 Tight budgetary control: a study of clinical department managers' perceptions in Swedish hospitals http://www.medworm.com/index.php?rid=2281645&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F70%3Frss%3D1 Conclusions Perception of tight budgetary control by managers depends on both their personal characteristics and the financial situation of their departments. Differences between men and women, and doctors and non-doctors call for additional research about the possible impact of changes in the composition of clinical department managers on how budgetary responsibility is exercised. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281645 Wed, 18 Mar 2009 04:00:00 +0100 2281645 Unhealthy markets: financial crisis, fiscal crisis ... health care crisis? http://www.medworm.com/index.php?rid=2281644&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F68%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281644 Wed, 18 Mar 2009 04:00:00 +0100 2281644 Clinically integrated health care in the English NHS http://www.medworm.com/index.php?rid=2281643&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F2%2F65%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2281643 Wed, 18 Mar 2009 04:00:00 +0100 2281643 How to find research before publication http://www.medworm.com/index.php?rid=2062655&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F62%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062655 Mon, 22 Dec 2008 05:00:00 +0100 2062655 Non-adherence to medicines: not solved but solvable http://www.medworm.com/index.php?rid=2062654&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F58%3Frss%3D1 Non-adherence to medicines is common, with convincing evidence for adverse effects on patient health and costs to health systems. At least half of reported non-adherence is intentional. An extensive body of research suggests that, while patient characteristics may contribute to this behaviour, key influences are linked to beliefs and experiences of an illness and its medicines. Characteristics of the health system such as patient–practitioner relationships and access are also significant drivers. Inadvertent effects of some policies, such as co-payments, reduce adherence. Interventions to improve adherence have not utilized available research evidence fully and are not integrated into service delivery, so have been disappointing in producing sustained behaviour change. Policies relyi... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062654 Mon, 22 Dec 2008 05:00:00 +0100 2062654 Reconstructing continuity of care in mental health services: a multilevel conceptual framework http://www.medworm.com/index.php?rid=2062653&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F52%3Frss%3D1 Continuity of mental health care is a key issue in the organization and evaluation of services for patients with disabling chronic conditions. Over many years, health services researchers have been exploring the conceptual boundaries between continuity of care and other service characteristics. On the basis of papers published over the past decade, we argue that while conceptual consensus is growing, there is room to improve continuity measures, and the development of practical interventions is still at an early stage. There is growing consensus that continuity of care is a multidimensional concept. We identified four core elements: continuous care; care of an individual patient; cross-boundary care; and care recorded objectively. These elements help clarify conceptual boundaries, and inco... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062653 Mon, 22 Dec 2008 05:00:00 +0100 2062653 From quasi-market to market in the National Health Service in England: what does this mean for the purchasing of health services? http://www.medworm.com/index.php?rid=2062652&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F44%3Frss%3D1 The purchasing function was first developed within the British National Health Service as part of a quasi-market introduced by a Conservative government in 1990 and retained by the Labour government on coming to power in 1997. Since 2002 further reforms in England have begun to transform the quasi-market into a ‘real’ market with greater diversity of supplier, including from the private sector, a payment regime designed to reward additional hospital activity and new rights for patients to choose their provider. Evidence from the quasi-market era suggests that the purchasing function made little significant impact on services for patients or shifts in the pattern of hospital provision. The new market reforms, in theory, provide an opportunity to overcome prior weaknesses in the ... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062652 Mon, 22 Dec 2008 05:00:00 +0100 2062652 Are home sampling kits for sexually transmitted infections acceptable among men who have sex with men? http://www.medworm.com/index.php?rid=2062651&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F35%3Frss%3D1 Conclusion The widespread acceptability of using HSKs for the diagnosis of STIs could have important public health impacts in terms of earlier diagnosis of asymptomatic infections and thus a decrease in the rate of onward transmission. In addition, HSKs could potentially optimize the use of genitourinary medicine services and facilitate patient choice. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062651 Mon, 22 Dec 2008 05:00:00 +0100 2062651 Is it feasible to pool funds for local children's services in England? Evidence from the national evaluation of children's trust pathfinders http://www.medworm.com/index.php?rid=2062650&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F27%3Frss%3D1 Conclusions Sharing money for local children's services requires shared objectives, trust, and legal and accounting expertise. Several different mechanisms are permitted and many are feasible but programme budgeting for children's services could make them more effective. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062650 Mon, 22 Dec 2008 05:00:00 +0100 2062650 'We can't get anything done because...': making sense of 'barriers' to Practice-based Commissioning http://www.medworm.com/index.php?rid=2062649&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F20%3Frss%3D1 Conclusion Weick's concept of ‘organizational sensemaking’ provides a useful framework within which to explore the problems encountered when implementing policy. Observational methods are a powerful tool in understanding sensemaking. The variations in sensemaking that we observed suggest that the use of ‘barrier’ metaphors in descriptions of implementation problems risks homogenizing the portrayal of situations that differ greatly in reality. This implies that top-down or centrally driven solutions to such situations will often be inappropriate. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062649 Mon, 22 Dec 2008 05:00:00 +0100 2062649 Public attitudes to the storage of blood left over from routine general practice tests and its use in research http://www.medworm.com/index.php?rid=2062648&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F13%3Frss%3D1 Conclusion Despite its limitations, this first survey of a general practice population suggests that the majority would be willing to consider giving open-ended consent for the use of blood left over from routine clinical tests in general practice to be stored and used later for medical research. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062648 Mon, 22 Dec 2008 05:00:00 +0100 2062648 The influence of professional values on the implementation of Aboriginal health policy http://www.medworm.com/index.php?rid=2062647&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F6%3Frss%3D1 Conclusion The findings highlight the role that a myriad of values play in influencing which aspects of a policy are implemented by organizations and their agents. Comprehensive and equitable implementation of policy requires an investigation and awareness of different professional values, and an examination of whose voices will be privileged in the decision-making process. If the advances in developing evidence-based, culturally-appropriate and inclusive policy are to be translated into practice, then care needs to be taken to monitor and influence whose values are being included at what point in the policy implementation process. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062647 Mon, 22 Dec 2008 05:00:00 +0100 2062647 Audit of submissions: July 2007 to June 2008 http://www.medworm.com/index.php?rid=2062646&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F4%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062646 Mon, 22 Dec 2008 05:00:00 +0100 2062646 Health services and climate change: what can be done? http://www.medworm.com/index.php?rid=2062645&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F2%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062645 Mon, 22 Dec 2008 05:00:00 +0100 2062645 Can financial carrots improve health? http://www.medworm.com/index.php?rid=2062644&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F14%2F1%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062644 Mon, 22 Dec 2008 05:00:00 +0100 2062644 Patient preferences for treatment for angina: an overview of findings from three studies http://www.medworm.com/index.php?rid=2062670&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F104%3Frss%3D1 Conclusions The research resulted in a psychometrically sound Patients' Preferences Questionnaire. There was some evidence to support the view that older people's weaker preferences for CABG may contribute slightly to variations in the provision of re-vascularization. There was also variation in preferences within age groups, cautioning against the assumption that all or most older people are more reluctant than younger people to undergo invasive procedures. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062670 Fri, 19 Sep 2008 04:00:00 +0100 2062670 Trust relations in a changing health service http://www.medworm.com/index.php?rid=2062669&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F97%3Frss%3D1 Conclusion Trust is still important for effective therapeutic and working relationships. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062669 Fri, 19 Sep 2008 04:00:00 +0100 2062669 Using qualitative research methods to improve recruitment to randomized controlled trials: the Quartet study http://www.medworm.com/index.php?rid=2062668&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F92%3Frss%3D1 Conclusion Straightforward replication of the ProtecT complex intervention was more complicated than expected. However, the study has increased understanding of RCT recruitment and identified ways to overcome barriers to collaboration. Such research is more easily undertaken in the feasibility stage of an RCT, and greater success will be achieved if the research is integrated into the everyday conduct of RCTs. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062668 Fri, 19 Sep 2008 04:00:00 +0100 2062668 Reducing the burden of chronic wounds: prevention and management of the diabetic foot in the context of clinical guidelines http://www.medworm.com/index.php?rid=2062667&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F82%3Frss%3D1 Conclusion Patient and practitioner factors may contribute to the effective implementation of clinical guidelines regarding education, partnership building and shared decision-making. These findings are discussed in relation to patient education, partnership building and shared decision-making as recommended in NICE guidelines. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062667 Fri, 19 Sep 2008 04:00:00 +0100 2062667 Consumer involvement in setting the health services research agenda: persistent questions of value http://www.medworm.com/index.php?rid=2062666&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F76%3Frss%3D1 Interest in consumer involvement in health services research started to gain momentum at around the same time that the MRC Health Services Research Collaboration (HSRC) was established. Consumer involvement was not the focus of a formal research programme within the HSRC, but HSRC members took opportunities to conduct three projects relating to consumer involvement in research agenda-setting activities. These were: (1) a comparison of the focus of published research relating to the management of osteoarthritis of the knee with clinicians' and patients' ideas about research priorities; (2) a survey that examined the consumer involvement policies of public- and voluntary-sector organizations that fund health services research in the UK; and (3) a citizens' jury that was convened to develop p... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062666 Fri, 19 Sep 2008 04:00:00 +0100 2062666 Measuring and valuing mental health for use in economic evaluation http://www.medworm.com/index.php?rid=2062665&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F70%3Frss%3D1 This article presents research undertaken as part of a wider programme of work concerned with measuring and health and wellbeing for economic evaluation. The focus is on developing quality adjusted life years (QALYs) in mental health, but the issues are common across all areas of health care. The article begins by reviewing the issues of what should be valued (health or broader notions of wellbeing), how mental health and wellbeing should be described, how mental health states should be valued and who should do the valuing. The article presents four pieces of work. The first is a re-analysis of the ONS Psychiatric Morbidity 2000 Survey to provide evidence on the relevance of generic measures across different mental health disorders. It found that common mental health problems, such as anxi... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062665 Fri, 19 Sep 2008 04:00:00 +0100 2062665 Designing and implementing behaviour change interventions to improve population health http://www.medworm.com/index.php?rid=2062664&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F64%3Frss%3D1 Improved population health depends on changing behaviour: of those who are healthy (e.g. stopping smoking), those who are ill (e.g. adhering to health advice) and those delivering health care. To design more effective behaviour change interventions, we need more investment in developing the scientific methods for studying behaviour change. Behavioural science is relevant to all phases of the process of implementing evidence-based health care: developing evidence through primary studies, synthesizing the findings in systematic reviews, translating evidence into guidelines and practice recommendations, and implementing these in practice. ‘Behaviour change: Implementation and Health’, the last research programme to be funded within the MRC HSRC, aimed to develop innovative ways of... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062664 Fri, 19 Sep 2008 04:00:00 +0100 2062664 Evidence-based diagnosis http://www.medworm.com/index.php?rid=2062663&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F57%3Frss%3D1 Making an accurate diagnosis is essential to ensure that a patient receives appropriate treatment and correct information regarding their prognosis. Characteristics of diagnostic tests are quantified in test accuracy studies, but many such studies have methodological flaws. The HSRC evidence-based diagnosis programme has focused on methods for systematic reviews of test accuracy studies, and the wider context in which tests are ordered and interpreted. We carried out a range of projects relating to literature searching, quality assessment, meta-analysis, presentation of results, and interactions between doctors and patients during the diagnostic process. We have shown that systematic reviews of test accuracy studies should search a range of databases and that current diagnostic filters do ... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062663 Fri, 19 Sep 2008 04:00:00 +0100 2062663 MOBILE and the provision of total joint replacement http://www.medworm.com/index.php?rid=2062662&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F47%3Frss%3D1 Modern joint replacements have been available for 45 years, but we still do not have clear indications for these interventions, and we do not know how to optimize the outcome for patients who agree to have them done. The MOBILE programme has been investigating these issues in relation to primary total hip and knee joint replacements, using mixed methods research. There have been five main strands:Epidemiological investigations to find out who is receiving total hip and knee replacements in the National Health Service (NHS). This has shown that there are extensive variations in different regions of the UK, with inequalities and probable inequities in the provision of these operations; Epidemiological work to ascertain the population-based needs for the operations, showing under-provision o... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062662 Fri, 19 Sep 2008 04:00:00 +0100 2062662 Locomotor disability: meaning, causes and effects of interventions http://www.medworm.com/index.php?rid=2062661&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F38%3Frss%3D1 This paper provides a synopsis of a long-term programme of MRC-funded work on locomotor disability in older people. Specifically it describes the meaning and experience of disability, examines the risk factors for disability and systematically reviews the evidence from randomized trials of complex interventions for disability. We undertook a national prospective study of a representative sample of 999 people aged 65 years or more plus in-depth interviews with a small subsample and a selected sample obtained from hospital sources. Secondary analysis of several large prospective studies was carried out and a systematic review and meta-analysis of published randomized controlled trials of the effects of complex interventions for disability. Very few participants subscribed to the constructs o... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062661 Fri, 19 Sep 2008 04:00:00 +0100 2062661 Investigating Choice Experiments for Preferences of Older People (ICEPOP): evaluative spaces in health economics http://www.medworm.com/index.php?rid=2062660&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F31%3Frss%3D1 This paper deals with three concerns about the evaluative framework that is currently dominant within health economics. These concerns are: that the evaluative framework is concerned entirely with health; that the evaluative framework has an individualistic focus on patients alone; and that the methods used to estimate ‘health’ within the current evaluative framework could be improved both in terms of the generation of descriptive systems and in using valuation methods that rely less on people's ability to express their preferences on a cardinal scale. In exploring these issues the Investigating Choice Experiments for Preferences of Older People (ICEPOP) programme has explicitly focused on both the topic of older people and the methods of discrete choice experiments. A capabili... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062660 Fri, 19 Sep 2008 04:00:00 +0100 2062660 Decision analysis for resource allocation in health care http://www.medworm.com/index.php?rid=2062659&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F23%3Frss%3D1 This paper addresses the use of economic evaluation to inform resource allocation decisions within health care systems about which interventions to reimburse and whether additional research should be funded. A social decision-making view of economic evaluation, that is to maximize health gains subject to an exogenous budget constraint, is adopted. A brief overview of the components of an economic evaluation is presented. Particular attention is paid to how uncertainty is inherent to decisions about resource allocation, the consequences of that uncertainty and how it can be incorporated informatively into economic evaluation. A Bayesian approach to uncertainty is used as it meets the needs of social decision-making, allowing analysts to quantify the probability that an intervention is cost-... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062659 Fri, 19 Sep 2008 04:00:00 +0100 2062659 Multiparameter evidence synthesis in epidemiology and medical decision-making http://www.medworm.com/index.php?rid=2062658&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F12%3Frss%3D1 Meta-analysis has been well-established for many years, but has been largely confined to pooling evidence on pair-wise contrasts. Broader forms of synthesis have also been described, apparently re-invented in disparate fields, each time taking different computational approaches. The potential value of Bayesian estimation of a joint posterior parameter distribution and simultaneously sampling from it for decision analysis has also been appreciated. However, applications have been relatively few in number, sometimes stylized, and presented mainly to a statistical methods audience. As a result, the potential for multiparameter evidence synthesis in both epidemiology and health technology assessment has remained largely unrecognized. The advent of flexible software for Bayesian Markov chain Mo... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062658 Fri, 19 Sep 2008 04:00:00 +0100 2062658 Research capacity development and training http://www.medworm.com/index.php?rid=2062657&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F6%3Frss%3D1 The HSRC was awarded a large core grant specifically for research capacity development and training, with the aim of facilitating future high quality HSR in the UK. This was used to pursue three main areas of activity. First, the provision of small grants to facilitate the development of new work, help create new, multidisciplinary groupings and support junior researchers. Of the various schemes discussed, the research initiation grants (max £6000) and workshop awards (max £3000) appear to have been particularly valuable. Second, appoint cohorts of PhD students to pursue four-year training programmes (rather than the traditional three years), during which they received individualized research training and development opportunities with an emphasis on both multidisciplinary HSR ... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062657 Fri, 19 Sep 2008 04:00:00 +0100 2062657 Why does health services research seem so hard to fund? http://www.medworm.com/index.php?rid=2062656&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_3%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=2062656 Fri, 19 Sep 2008 04:00:00 +0100 2062656 Unsafe science http://www.medworm.com/index.php?rid=1810274&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F255%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810274 Fri, 19 Sep 2008 04:00:00 +0100 1810274 What leads to better health care innovation? Arguments for an integrated policy-oriented research agenda http://www.medworm.com/index.php?rid=1810273&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F251%3Frss%3D1 This essay is based on the recognition that the current ‘downstream’ health services research and policy approach to innovation misses the mark on one crucial point. It has not addressed how to promote the design of innovations that are likely to be more valuable than others. Re-visiting the ways in which health services research could inform innovation processes, this paper suggests that three attributes make innovations especially compelling from a health care system perspective: relevance; usability; and sustainability. These could be used as a starting point for outlining a policy-oriented research agenda that could bridge upstream design processes, and downstream needs and priorities. Given the pace at which innovations come about and the complexity of health care systems,... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810273 Fri, 19 Sep 2008 04:00:00 +0100 1810273 Everything you wanted to know about anxiety but were afraid to ask http://www.medworm.com/index.php?rid=1810272&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F249%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810272 Fri, 19 Sep 2008 04:00:00 +0100 1810272 Factors contributing to nursing leadership: a systematic review http://www.medworm.com/index.php?rid=1810271&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F240%3Frss%3D1 Conclusion These findings suggest that leadership can be developed through specific educational activities, and by modelling and practising leadership competencies. However, the relatively weak study designs provide limited evidence for specific factors that could increase the effectiveness of current nursing leadership or guide the identification of future nurse leaders. Robust theory and research on interventions to develop and promote viable nursing leadership for the future are needed to achieve the goal of developing healthy work environments for health care providers and optimizing care for patients. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810271 Fri, 19 Sep 2008 04:00:00 +0100 1810271 Moving specialist care into the community: an initial evaluation http://www.medworm.com/index.php?rid=1810270&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F233%3Frss%3D1 Conclusions Moving specialist care into the community can improve patient access, particularly when new services are added to existing hospital services. Wider impacts on health care quality, capacity and cost merit closer scrutiny before rollout. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810270 Fri, 19 Sep 2008 04:00:00 +0100 1810270 Health care professionals' views of implementing a policy of open disclosure of errors http://www.medworm.com/index.php?rid=1810269&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F227%3Frss%3D1 Conclusion Health services must develop organizing capabilities if open disclosure is to be implemented as intended. Activities should identify and address factors that impede implementation and enable workforce and system competencies to develop. These activities will allow health services to adapt central open disclosure policy to local conditions and to embed its principles and practices organization-wide. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810269 Fri, 19 Sep 2008 04:00:00 +0100 1810269 The impact of income on private patients' access to GP services in Ireland http://www.medworm.com/index.php?rid=1810268&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F222%3Frss%3D1 Conclusions While recent commentary has focused on the plight of individuals just above the income threshold for free GP care, these results suggest that the key difference in GP visiting is between those with, and without, eligibility for free care. If private patients are prevented from accessing GP care due to cost, this is as much an issue for those at the top of the income distribution as for those at the bottom. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810268 Fri, 19 Sep 2008 04:00:00 +0100 1810268 Stakeholders' views of UK nurse and pharmacist supplementary prescribing http://www.medworm.com/index.php?rid=1810267&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F215%3Frss%3D1 Conclusion SP appeared to be broadly welcomed by stakeholders and was perceived to offer patient benefits. Several years after its introduction in the UK, stakeholders still perceived several implementation barriers and challenges and these, together with various tensions identified, might affect the success of supplementary and other forms of non-medical prescribing. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810267 Fri, 19 Sep 2008 04:00:00 +0100 1810267 Policy-makers' attitudes to decision support models for coronary heart disease: a qualitative study http://www.medworm.com/index.php?rid=1810266&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F209%3Frss%3D1 Conclusion Policy-makers and planners were generally enthusiastic about the use of models to support decision-making, illustrating the potential uses for models and the factors that improve confidence in them. However, existing models are often not being used in practice. So new models that are fit for practice need to be developed. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810266 Fri, 19 Sep 2008 04:00:00 +0100 1810266 Increasing appropriateness of hospital admissions in the Emilia-Romagna region of Italy http://www.medworm.com/index.php?rid=1810265&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F202%3Frss%3D1 Conclusions The Emilia-Romagna region has succeeded in reducing the use of acute hospital beds for patients in selected diagnosis related groups. However, there are still substantial numbers of admissions that could potentially be treated in less costly settings. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810265 Fri, 19 Sep 2008 04:00:00 +0100 1810265 'They're more like ordinary stroppy British women': attitudes and expectations of maternity care professionals to UK-born ethnic minority women http://www.medworm.com/index.php?rid=1810264&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F195%3Frss%3D1 Conclusions Professionals appeared to equate the needs of UK-born ethnic minority women with those of white English women. Overall, this has positive implications for care provision. Despite this, specific behavioural expectations and unconscious stereotypical views were evident and have the potential to affect clinical practice. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810264 Fri, 19 Sep 2008 04:00:00 +0100 1810264 Fundamental similarities between tort and administrative systems for managing health care accidents http://www.medworm.com/index.php?rid=1810263&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F4%2F193%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1810263 Fri, 19 Sep 2008 04:00:00 +0100 1810263 Open access training material http://www.medworm.com/index.php?rid=1568391&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F191%3Frss%3D1 One of the main challenges of providing training is producing the content. Even if the subject is the trainer's own area of expertise, distilling years of knowledge and experience into an effective training package is often a daunting and time consuming task. Sourcing content from the Internet can be fraught with difficulties relating to copyright. Luckily there are now many sites that provide open access training materials. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to: Kate Light Information Officer Centre for Reviews and Dissemination University of York, York, YO10 5DD, UK Email: KL9@york.ac.uk (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568391 Fri, 20 Jun 2008 04:00:00 +0100 1568391 Why 'knowledge transfer' is misconceived for applied social research http://www.medworm.com/index.php?rid=1568390&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F188%3Frss%3D1 ‘Knowledge transfer’ has become established as shorthand for a wide variety of activities linking the production of academic knowledge to the potential use of such knowledge in non-academic environments. While welcoming the attention now being paid to non-academic applications of social research, we contend that terms such as knowledge transfer (and its subordinate sibling, knowledge translation) misrepresent the tasks that they seek to support. By articulating the complex and contested nature of applied social research, and then highlighting the social and contextual complexities of its use, we can see that other terms may serve us better. Following from this analysis, we suggest that ‘knowledge interaction’ might more appropriately describe the messy engagement of... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568390 Fri, 20 Jun 2008 04:00:00 +0100 1568390 The central role of nursing in health care http://www.medworm.com/index.php?rid=1568389&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F185%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568389 Fri, 20 Jun 2008 04:00:00 +0100 1568389 What benefits will choice bring to patients? Literature review and assessment of implications http://www.medworm.com/index.php?rid=1568388&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F178%3Frss%3D1 Conclusion Although patients may themselves make limited use of choices, the existence of choice may, in theory, stimulate providers to improve quality of care. Patients do, however, want to be more involved in individual decisions about their own treatment, and generally participate much less in these decisions than they would wish. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568388 Fri, 20 Jun 2008 04:00:00 +0100 1568388 Pay for performance in Australia: Queensland's new Clinical Practice Improvement Payment http://www.medworm.com/index.php?rid=1568387&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F174%3Frss%3D1 Following a high profile scandal relating to quality and safety of care, the health authority in the Australian state of Queensland introduced a pay for performance (P4P) component into its new hospital prospective payment system. The Clinical Practice Improvement Payment system pays hospitals for achievement of clinical process indicators. Initially the focus is on the quality of clinical processes and outcomes. Using a consensus approach involving consultation with clinicians, seven clinical indicators were adopted for 2007–2008. The first payments using pay for performance were made for work carried out up until June 2008. Although no data exist yet as to the impact of the new system, pay for performance appears to be gaining widespread, if somewhat reluctant, acceptance. (Source:... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568387 Fri, 20 Jun 2008 04:00:00 +0100 1568387 Evidence-informed evidence-making http://www.medworm.com/index.php?rid=1568386&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F167%3Frss%3D1 We describe the early experience of NICE and the National Institute for Health Research (NIHR) working together to articulate and commission research to inform best practice recommendations. We propose ways in which NICE can collaborate more effectively with research funders to improve the evidence base upon which it bases its recommendations. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568386 Fri, 20 Jun 2008 04:00:00 +0100 1568386 Influence of body mass index on prescribing costs and potential cost savings of a weight management programme in primary care http://www.medworm.com/index.php?rid=1568385&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F158%3Frss%3D1 Conclusion Drug prescriptions rise from a minimum at BMI of 20 kg/m2 and steeply above BMI 30 kg/m2. An effective weight management programme in primary care could potentially reduce prescription costs and lead to substantial cost avoidance, such that at least 8% of the programme delivery cost would be recouped from prescribing savings alone in the first year. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568385 Fri, 20 Jun 2008 04:00:00 +0100 1568385 Impact of critical care outreach services on the delivery and organization of hospital care http://www.medworm.com/index.php?rid=1568384&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F152%3Frss%3D1 Conclusion Critical care outreach services have had a positive impact on the delivery and organization of hospital care. In attempting to share critical care skills, however, these services can experience a tension between the aims of service delivery and education – a tension which is partly resolved by sharing skills in the clinical and organizational context of direct patient care. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568384 Fri, 20 Jun 2008 04:00:00 +0100 1568384 Improving the appropriateness of referrals and waiting times for endoscopic procedures http://www.medworm.com/index.php?rid=1568383&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F146%3Frss%3D1 Conclusions There is value in liaison between GPs and specialists for achieving timely referrals and avoiding delayed diagnosis though higher levels of agreement need to be achieved. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568383 Fri, 20 Jun 2008 04:00:00 +0100 1568383 Whose interest? British newspaper reporting of use of medical records for research http://www.medworm.com/index.php?rid=1568382&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F140%3Frss%3D1 Conclusions Use of medical records for research raises important ethical questions, in particular regarding the balance between the rights and interests of the individual and the public interest benefits of the research. Understanding how these positions are represented within the mass media is important because the media can inform and influence the public's views and public policy. Empirical research into patient views is needed. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568382 Fri, 20 Jun 2008 04:00:00 +0100 1568382 Effects of payment for performance in primary care: qualitative interview study http://www.medworm.com/index.php?rid=1568381&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F133%3Frss%3D1 Conclusions Payment for performance is driving major changes in the roles and organization of English primary health care teams. Non-incentivized activities and patients' concerns may receive less clinical attention. Practitioners would benefit from improved dissemination of the evidence justifying the inclusion of new performance indicators in the QOF. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568381 Fri, 20 Jun 2008 04:00:00 +0100 1568381 US health care reform and the Presidential candidates http://www.medworm.com/index.php?rid=1568380&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F131%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568380 Fri, 20 Jun 2008 04:00:00 +0100 1568380 Tracking disability disparities: the data dilemma http://www.medworm.com/index.php?rid=1568379&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F3%2F129%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568379 Fri, 20 Jun 2008 04:00:00 +0100 1568379 Learning from other countries: an on-call facility for health care policy http://www.medworm.com/index.php?rid=1568416&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_2%2F58%3Frss%3D1 Recognizing that robust information on health systems in other countries can provide valuable lessons for the English National Health Service, the Department of Health commissioned an academic team to provide an ‘On-call Facility for International Healthcare Comparisons’ in 2005. This paper describes the work of this novel approach to informing policy and reviews the experience of the first two years. It illustrates the well-documented challenges of comparative analysis of health systems. One important issue is understanding the health system context so as to interpret phenomena and draw appropriate policy conclusions. Other challenges include the potential tension between academic interest and rigour, and the need for timely analysis to inform the Department of Health's rapidl... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568416 Tue, 01 Apr 2008 04:00:00 +0100 1568416 The local adaptation of national recommendations for preventing early-onset neonatal Group B Streptococcal disease in UK maternity units http://www.medworm.com/index.php?rid=1568415&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_2%2F52%3Frss%3D1 Conclusions There are considerable differences in the GBS protocols used in maternity units in the UK despite the availability of a national guideline. Consequently, some high-risk women may not receive IAP while some women without risk factors are treated needlessly. While local adaptation may be for legitimate reasons, the processes used in some units seem to require improvement. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568415 Tue, 01 Apr 2008 04:00:00 +0100 1568415 Career intentions of pharmacy students http://www.medworm.com/index.php?rid=1568414&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_2%2F45%3Frss%3D1 Conclusions A sizeable proportion of pharmacy students do not intend entering the profession for which they have trained, a proportion which is much larger than estimated by other studies. This has significant implications for workforce planning. Existing gender and ethnic segregation in the profession may have occurred as a result of personal choice rather than being a function of constraints operating within the pharmacy labour market. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568414 Tue, 01 Apr 2008 04:00:00 +0100 1568414 The increasing burden of alcoholic liver disease on United Kingdom critical care units: secondary analysis of a high quality clinical database http://www.medworm.com/index.php?rid=1568413&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_2%2F40%3Frss%3D1 Conclusions Admissions to ICUs in England and Wales with alcoholic liver disease tripled over the 10-year period from 1996 to 2005. The continuing increase in alcohol consumption means that this trend is likely to continue. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568413 Tue, 01 Apr 2008 04:00:00 +0100 1568413 Part of a global workforce: migration of British-trained pharmacists http://www.medworm.com/index.php?rid=1568412&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_2%2F32%3Frss%3D1 Conclusions Great Britain is both a source and destination country for migrating pharmacists. Emigration currently exceeds immigration. Pharmacists are not migrating to developing countries, so the profession may want to consider ways of contributing to the health care systems in developing countries which are the source of some of the immigrant pharmacists to Great Britain. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568412 Tue, 01 Apr 2008 04:00:00 +0100 1568412 Equity and service innovation: the implementation of a bibliotherapy scheme in Wales http://www.medworm.com/index.php?rid=1568411&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_2%2F26%3Frss%3D1 Conclusion Variation in usage of bibliotherapy raises questions about equity; it is unlikely to reflect the distribution of people who could potentially benefit. Factors influencing variation existed all along the implementation chain. It is not always possibly to separate demand-side and supply-side factors when considering equity and service innovation in health care. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568411 Tue, 01 Apr 2008 04:00:00 +0100 1568411 Characteristics of the emergency and urgent care system important to patients: a qualitative study http://www.medworm.com/index.php?rid=1568410&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_2%2F19%3Frss%3D1 Conclusions Questionnaires designed to assess patients' views and experiences of emergency and urgent care should address system-level as well as service-specific issues in order to address the full range of patient concerns. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568410 Tue, 01 Apr 2008 04:00:00 +0100 1568410 Legitimacy of hospital reconfiguration: the controversial downsizing of Kidderminster hospital http://www.medworm.com/index.php?rid=1568409&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_2%2F11%3Frss%3D1 Conclusions Stakeholders value hospitals in different ways and argue for diverse accounts of legitimacy. Broader discourses of medical science and democratic participation were drawn into rhetorical texts concerning regionalization to render them more powerful. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568409 Tue, 01 Apr 2008 04:00:00 +0100 1568409 Is fast access to general practice all that should matter? A discrete choice experiment of patients' preferences http://www.medworm.com/index.php?rid=1568408&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_2%2F3%3Frss%3D1 Conclusions Patients hold strong preferences for the way general practice appointment systems are managed. Contrary to current policy on improving access to primary care patients value a more complex mix of factors than fast access at all costs. It is important that policy-makers and practices take note of these preferences. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568408 Tue, 01 Apr 2008 04:00:00 +0100 1568408 UK Health Services Research Network makes steady progress http://www.medworm.com/index.php?rid=1568407&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2Fsuppl_2%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568407 Tue, 01 Apr 2008 04:00:00 +0100 1568407 How to write a good research paper http://www.medworm.com/index.php?rid=1568406&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F127%3Frss%3D1 There are numerous websites that aim to help students write research papers but it is necessary to look a little further to find websites that are relevant to researchers wishing to publish in peer-reviewed journals. Here we review sites that address scientific writing style, present guidelines for reporting trials and other studies, and provide access to submission requirements for individual journals. Additionally, we list some other relevant sites. If you would like to alert readers to useful web pages or suggest topics for this column, please send details to: Kate Light Information Officer Centre for Reviews and Dissemination University of York, York YO10 5DD UK (Email: KL9@york.ac.uk) (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568406 Tue, 01 Apr 2008 04:00:00 +0100 1568406 Doctors, lies and the addiction bureaucracy http://www.medworm.com/index.php?rid=1568405&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F124%3Frss%3D1 Almost everything you know about heroin addiction is wrong. Not only is it wrong, but it is obviously wrong. Heroin is not highly addictive; withdrawal from it is not medically serious; addicts do not become criminals to feed their habit; addicts do not need any medical assistance to stop taking heroin; and contrary to received wisdom, heroin addiction most certainly is a moral or spiritual problem. A literary tradition dating back to De Quincey and Coleridge, and continuing up to the deeply sociopathic William Burroughs and beyond, has misled all Western societies for generations about the nature of heroin addiction. These writers' self-dramatizing and dishonest accounts of their own addiction have been accepted uncritically, and have been more influential by far in forming public at... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568405 Tue, 01 Apr 2008 04:00:00 +0100 1568405 Understanding determinants of health service use from a systems perspective http://www.medworm.com/index.php?rid=1568404&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F122%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568404 Tue, 01 Apr 2008 04:00:00 +0100 1568404 World class commissioning: a health policy chimera? http://www.medworm.com/index.php?rid=1568403&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F116%3Frss%3D1 The health reforms in England have entered a phase in which greater emphasis is being placed on market-like mechanisms. The ability of the commissioners of care to negotiate on equal terms with providers will be of critical importance in the emerging market. The government has set out plans to develop ‘world class commissioning’ and this essay reviews experience in Europe, New Zealand and the United States to understand what is involved in working towards this goal. The evidence reviewed shows that in no system is commissioning done consistently well and highlights the obstacles to the development of world class commissioning. The reasons for this centre on the complexity of health care and the inherent difficulty of commissioning health services in publicly financed systems. C... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568403 Tue, 01 Apr 2008 04:00:00 +0100 1568403 Decentralizing resource allocation: early experiences with District Health Boards in New Zealand http://www.medworm.com/index.php?rid=1568402&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F109%3Frss%3D1 Conclusions Decentralized decision-making is starting to make some inroads towards achieving some of the government's objectives with respect to resource allocation and purchasing. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568402 Tue, 01 Apr 2008 04:00:00 +0100 1568402 Evidence-based medicine and patient choice: the case of heart failure care http://www.medworm.com/index.php?rid=1568401&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F103%3Frss%3D1 Conclusion Evidence-based medicine was used to buttress professional authority and seemed to provide an additional barrier to the adoption of patient-centred clinical practice. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568401 Tue, 01 Apr 2008 04:00:00 +0100 1568401 Can cheap generic statins achieve national cholesterol lowering targets? http://www.medworm.com/index.php?rid=1568400&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F99%3Frss%3D1 Conclusions PCTs that had a high proportion of simvastatin and pravastatin use were just as successful achieving cholesterol targets for patients with coronary heart disease, diabetes and stroke as those that used more atorvastatin, rosuvastatin or fluvastatin. This supports the policy to use the less expensive generic statins. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568400 Tue, 01 Apr 2008 04:00:00 +0100 1568400 The quality of mixed methods studies in health services research http://www.medworm.com/index.php?rid=1568399&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F92%3Frss%3D1 Conclusions The HSR community could improve mixed methods studies by giving more consideration to describing and justifying the design, being transparent about the qualitative component, and attempting to integrate data and findings from the individual components. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568399 Tue, 01 Apr 2008 04:00:00 +0100 1568399 Modelling the expected net benefits of interventions to reduce the burden of medication errors http://www.medworm.com/index.php?rid=1568398&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F85%3Frss%3D1 Conclusions The results identify the potential cost-effectiveness of interventions aimed at medication errors, as well as identifying key drivers of cost-effectiveness that should be specifically addressed in the design of primary evaluations of medication error interventions. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568398 Tue, 01 Apr 2008 04:00:00 +0100 1568398 Competing norms: Canadian rural family physicians' perceptions of clinical practice guidelines and shared decision-making http://www.medworm.com/index.php?rid=1568397&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F79%3Frss%3D1 Conclusion In circumstances where physicians judge patient participation in decision-making to be important, physicians perceive a tension between the need to respect patients' preferences and the pressure to apply guidelines. CPGs should include information that supports shared decision-making, besides their current focus on influencing prescription patterns, costs and health outcomes. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568397 Tue, 01 Apr 2008 04:00:00 +0100 1568397 Hospital clinicians' attitudes towards a statutory advocacy service for patients lacking mental capacity: implications for implementation http://www.medworm.com/index.php?rid=1568396&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F73%3Frss%3D1 Conclusions Clinicians held ambivalent attitudes towards the involvement of a statutory IMCA service in medical decisions, reflecting beliefs that the service was largely impractical and unnecessary given current procedures for making medical decisions in patients' ‘best interests’. Conversely, clinicians were more likely to support advocacy in discharge decisions because they believed that non-medically qualified advocates could make a valuable contribution to decisions that were seen as predominantly social and where practice was frequently considered deficient. By holding these beliefs, clinicians are failing to have due regard for the IMCA service as a statutory measure for safeguarding patients' interests. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568396 Tue, 01 Apr 2008 04:00:00 +0100 1568396 Patient choice in general practice: the implications of patient satisfaction surveys http://www.medworm.com/index.php?rid=1568395&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F67%3Frss%3D1 Conclusions Patients value the quality of their relationship with their doctor more than the appearance of the surgery, accessibility of appointments and their experience in the waiting room. This suggests that, if current restrictions on choice of GP were removed, we would in theory expect a patient's choice to be driven by the quality of the doctor–patient relationship. Once a patient establishes a good relationship with a GP, however, we might expect them to be loyal and therefore unlikely to change practice unless the relationship with the doctor breaks down. Although relationship factors are important to the satisfaction of patients, it is not clear that they will lead large numbers of people to change their GP. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568395 Tue, 01 Apr 2008 04:00:00 +0100 1568395 Do clinicians always maximize patient outcomes? A conjoint analysis of preferences for carotid artery testing http://www.medworm.com/index.php?rid=1568394&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F61%3Frss%3D1 Conclusions Clinicians attached substantially more importance to the PPV of carotid artery tests than would be justified by ther impact on patient outcomes. Cognitive errors and attitudes to risk are likely to play an important role in explaining this finding. This study casts doubts on the validity of common assumptions made in the evaluation of health interventions, and in clinical and policy decisions. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568394 Tue, 01 Apr 2008 04:00:00 +0100 1568394 Are networks the answer to achieving integrated care? http://www.medworm.com/index.php?rid=1568393&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F59%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568393 Tue, 01 Apr 2008 04:00:00 +0100 1568393 Barriers to eliminating waste in US health care http://www.medworm.com/index.php?rid=1568392&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F2%2F57%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568392 Tue, 01 Apr 2008 04:00:00 +0100 1568392 Correction http://www.medworm.com/index.php?rid=1568430&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F56%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568430 Tue, 01 Jan 2008 05:00:00 +0100 1568430 Does a citation rating tell you whether an article is useful? http://www.medworm.com/index.php?rid=1568429&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F55%3Frss%3D1 The aim of this section is for you to identify and try to answer puzzles, especially methodological ones, in health services research and policy. Readers are invited both to submit questions, which they think will be of general interest or which are particularly topical, and to offer answers to questions. Questions can be ones that you feel have not been satisfactorily answered in the existing literature, ones that relate to ‘self-evident’ definitions which need to be made problematic, or paradoxes. Please send your questions to: Gillian Parker, SPRU, University of York, Alcuin College, Heslington, York YO10 5DD, UK. Email: gmp501@york.ac.uk. Fax: +44 (0)1904 321953. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568429 Tue, 01 Jan 2008 05:00:00 +0100 1568429 Incidence and prevalence of diseases http://www.medworm.com/index.php?rid=1568428&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F53%3Frss%3D1 Finding statistics on the incidence and prevalence of disease can be daunting. Although many resources, both free and commercial, exist, there are gaps in the collection of data and the material may be summarized in a manner that makes it hard to access specific information. If you would like to alert readers to useful web pages or suggest topics for this column please send details to: Kate Light Information Officer Centre for Reviews and Dissemination University of York, York YO10 5DD, UK (Email: kl9@york.ac.uk) (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568428 Tue, 01 Jan 2008 05:00:00 +0100 1568428 Will reputational incentives stimulate a reversal of the physician brain drain? http://www.medworm.com/index.php?rid=1568427&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F50%3Frss%3D1 An increased supply of physicians in high income countries both from domestic production and from immigration from low and middle income countries has made medical employment increasingly competitive. This has been heightened by the introduction of reputational incentives, such as public reporting of physicians' outcomes, and the use of other health care professionals, such as nurses. An unanticipated consequence might be a reversal of the ‘brain drain’, with physicians migrating to low and middle income countries. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568427 Tue, 01 Jan 2008 05:00:00 +0100 1568427 Asylums: the social situation of mental patients and other inmates http://www.medworm.com/index.php?rid=1568426&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F47%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568426 Tue, 01 Jan 2008 05:00:00 +0100 1568426 Recognizing rhetoric in health care policy analysis http://www.medworm.com/index.php?rid=1568425&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F40%3Frss%3D1 Critiques of the ‘naïve rationalist’ model of policy-making abound in the sociological and political science literature. Yet academic debate on health care policy-making continues to be couched in the dominant discourse of evidence-based medicine, whose underlying assumptions – that policies are driven by facts rather than values and these can be clearly separated; that ‘evidence’ is context-free, can be objectively weighed up and placed unproblematically in a ‘hierarchy’; and that policy-making is essentially an exercise in decision science – have constrained both thinking and practice. In this paper, drawing on theoretical work from political science and philosophy, and innovative empirical work in the health care sector, we argue that... Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568425 Tue, 01 Jan 2008 05:00:00 +0100 1568425 Improving access to primary care: eight case studies of introducing Advanced Access in England http://www.medworm.com/index.php?rid=1568424&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F33%3Frss%3D1 Conclusion Advanced Access was diluted because it became confused with same-day appointment systems and other incentives and targets. Its guiding philosophy of ‘manageable demand’ appeared counter-intuitive to staff in the context of general practice, which made its implementation problematic. As a result, the system was adapted and modified. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568424 Tue, 01 Jan 2008 05:00:00 +0100 1568424 The effect of age and procedure on resource use for patients with cerebrovascular disease http://www.medworm.com/index.php?rid=1568423&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F26%3Frss%3D1 Conclusions Ageing has no significant impact on total charge. Instead policy-makers should acknowledge the effect of procedures on health care costs, conduct economic evaluations and monitor use of procedures. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568423 Tue, 01 Jan 2008 05:00:00 +0100 1568423 Citizen and staff involvement in health service decision-making: have National Health Service foundation trusts in England given stakeholders a louder voice? http://www.medworm.com/index.php?rid=1568422&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F19%3Frss%3D1 Conclusions Government plans to decentralize accountability of public hospitals to local communities appear problematic, at least in the short term. Unless the effectiveness of the new local governance arrangements is addressed, an accountability ‘gap’ may emerge as prior mechanisms for public accountability to the centre are dismantled. In these circumstances, decentralization may lead in practice to a loss of public accountability. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568422 Tue, 01 Jan 2008 05:00:00 +0100 1568422 'Nurse entrepreneurs' a case of government rhetoric? http://www.medworm.com/index.php?rid=1568421&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F13%3Frss%3D1 Conclusion Policy-makers have to make their policies acceptable to those whom they expect to implement them. In this case, organizational efficiency, chiefly in terms of broader access to NHS services, as well as role substitution, is aligned with government policy promoting social enterprise and ‘sold’ to the nursing profession as enhancing its status compared with medicine. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568421 Tue, 01 Jan 2008 05:00:00 +0100 1568421 Loss of doctor-to-doctor communication: lessons from the reconfiguration of mental health services in England http://www.medworm.com/index.php?rid=1568420&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F6%3Frss%3D1 Conclusions Development of intermediate or ‘Tier 2’ services beyond the mental health services, where the GP refers to a team rather than to a specialist (hospital consultant) could benefit from reflecting on experiences with mental health services. There is a danger that new community services for the physically ill will engender the same level of confusion and discontent described by GPs and other health professionals in this study who are concerned with mental health care. Flexibility is needed within care pathways, including the provision of direct doctor-to-doctor communication together with approaches to minimize the marginalization of non-medical professionals. (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568420 Tue, 01 Jan 2008 05:00:00 +0100 1568420 Audit of submissions: July 2006 to June 2007 http://www.medworm.com/index.php?rid=1568419&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F5%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568419 Tue, 01 Jan 2008 05:00:00 +0100 1568419 Academic health centres: what is the agenda for research? http://www.medworm.com/index.php?rid=1568418&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F3%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568418 Tue, 01 Jan 2008 05:00:00 +0100 1568418 Medical autonomy: peeling the onion http://www.medworm.com/index.php?rid=1568417&cid=s_37245_51_f&fid=37245&url=http%3A%2F%2Fjhsrp.rsmjournals.com%2Fcgi%2Fcontent%2Fshort%2F13%2F1%2F1%3Frss%3D1 (Source: Journal of Health Services Research and Policy) Journal of Health Services Research and Policy journals http://www.medworm.com/rss/comments.php?id=1568417 Tue, 01 Jan 2008 05:00:00 +0100 1568417