Journal of public health
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Journal of public health · Jun 2006
The effects of surgical volumes and training centre status on outcomes following total joint replacement: analysis of the Hospital Episode Statistics for England.
Previous work from other countries has shown a significant inverse relationship between the number of some surgical procedures undertaken in a hospital and in an adverse outcomes. In the light of the changing nature of the provision of joint replacements in the United Kingdom, we have examined the effects of surgical volumes and the presence/absence of training centre status, on outcomes following total joint replacement (TJR) in England. ⋯ In England, there are fewer adverse events following TJR in high volume centres and in orthopaedic training centres. Standardization of procedures may account for this finding. The data have implications for private practice in the United Kingdom and for the current move to undertake TJRs in Independent Sector Treatment Centres.
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Journal of public health · Jun 2006
Emergency call work-load, deprivation and population density: an investigation into ambulance services across England.
Demand for emergency ambulance services has risen steeply over the recent years. This study examined differences in work-load of ambulance services across England and investigated factors linked to high demand. The number of emergency calls received by each ambulance service in 1997 and 2002 and population and area data were used to calculate call rates and population density for each of 27 service areas. ⋯ We conclude that areas with higher population density have higher call rates, which is not explained by deprivation. Deprivation is associated with higher usage, but its effect is partly due to population density. There is no evidence that these relationships are confounded by age.