Journal of the Royal Society of Medicine
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Multicenter Study
Is multidisciplinary teamwork the key? A qualitative study of the development of respiratory services in the UK.
Using frameworks, such as the long-term conditions pyramid of healthcare, primary care organizations (PCOs) in England and Wales are exploring ways of developing services for people with long-term respiratory disease. We aimed to explore the current and planned respiratory services and the roles of people responsible for change. ⋯ While the majority of PCOs are developing clinical services for people with complex needs (principally in order to reduce admissions), relatively few are addressing the broader strategic issues and providing for local educational needs. The presence of multidisciplinary teams, which integrated primary and secondary care clinicians with PCO management, was associated with more comprehensive service provision addressing the needs of all respiratory patients. Future research needs to provide insight into the structures, processes and inter-professional relationships that facilitate development of clinical, educational and policy initiatives which aim to enhance local delivery of respiratory care.
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Multicenter Study Comparative Study
Pay for perfomance and the quality of diabetes management in individuals with and without co-morbid medical conditions.
To examine the impact of the Quality and Outcomes Framework, a major pay-for-performance incentive introduced in the UK during 2004, on diabetes management in patients with and without co-morbidity. ⋯ Diabetes patients with co-morbid conditions appear to have benefited more from this pay-for-performance program than those without co-morbidity.
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Biography Historical Article
John Hunter: learning from natural experiments, 'placebos', and the state of mind of a patient in the 18th century.