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.
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Journal of public health · Mar 2006
Legislation on smoking in enclosed public places in Scotland: how will we evaluate the impact?
From 26 March 2006, smoking will be prohibited in wholly and substantially enclosed public places in Scotland, and it will be an offence to permit smoking or to smoke in no-smoking premises. We anticipate that implementation of the smoke-free legislation will result in significant health gains associated with reductions in exposure to both environmental tobacco smoke (ETS) and personal tobacco consumption as well as other social and economic impacts. ⋯ The findings from this evaluation will make a significant contribution to the international understanding of the health effects of exposure to ETS and the broader social, cultural and economic impacts of smoke-free legislation.
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Journal of public health · Mar 2006
Socioeconomic deprivation, coronary heart disease prevalence and quality of care: a practice-level analysis in Rotherham using data from the new UK general practitioner Quality and Outcomes Framework.
The provision of coronary heart disease (CHD) health care has been shown to be inequitous, with those most in need having the least access to high-quality care. The new UK general practitioner (GP) Quality and Outcomes Framework (QOF) contract offers substantial financial rewards to general practices that combine maximal CHD case finding with high-quality CHD care. ⋯ Practice-level CHD prevalence is associated with deprivation, but we found no evidence of socioeconomic inequality in CHD care. This finding is in contrast to that from previous studies and the widely reported inverse care law.
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Journal of public health · Dec 2005
Were less disabled patients the most affected by 2003 heat wave in nursing homes in Paris, France?
To analyse the change of mortality rates (MRs) and their contributing medical factors among nursing home patients during the 2003 heat wave in France. ⋯ These results suggest that medical care during heat wave has been directed towards more fragile patients, helping to limit deaths in this group. Less frail patients made the largest contribution to excess mortality during the heat wave. During extreme weather conditions, specific attention should be paid not only to frail persons, but to all the elderly community.