Journal of epidemiology and community health
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J Epidemiol Community Health · Jun 1997
Effect of labour market conditions on reporting of limiting long-term illness and permanent sickness in England and Wales.
To identify any bias in the reporting of limiting long term illness and permanent sickness due to labour market conditions, and show the absence of the effect in mortality rates. ⋯ Limiting long term illness and permanent sickness measures may reflect a tendency for higher positive response in difficult labour market conditions. For average social deprivation conditions, standardised limiting long term illness for people aged 0-64 years was 20% higher in travel to work areas where employment prospects were relatively poor compared with areas with relatively good employment prospects. This casts doubt on the use of limiting long term illness as an indicator of objective health care needs for resource allocation purposes at national level.
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J Epidemiol Community Health · Apr 1997
Predicting the outcome in elderly patients of hospital admission for acute care in Paris, France: construction and initial validation of a simplex index.
To develop a simple index able to identify at an early stage those elderly patients at high risk of requiring discharge to a residential or nursing home after admission to hospital for acute care. For these patients, early discharge planning might lead to a more effective management and reduce the length of hospitalisation. ⋯ The simple index, using data available very early in the course of hospitalisation, provides an accurate prediction of the hospitalisation outcome. The performance of the index should be tested in other populations and the practical benefits of risk screening should be assessed in a controlled trial to evaluate whether the intervention is useful and without any adverse effects.
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J Epidemiol Community Health · Feb 1997
Evaluation of specialists' outreach clinics in general practice in England: process and acceptability to patients, specialists, and general practitioners.
The wider study aimed to evaluate specialists' outreach clinics in relation to their costs, processes, and effectiveness, including patients' and professionals' attitudes. The data on processes and attitudes are presented here. ⋯ The processes of care (waiting times, patient satisfaction, convenience to patients, follow up attendances) were better in outreach than in outpatients' clinics. However, waiting lists were only significantly reduced for gynaecology patients, despite both GPs and consultants reporting reduced waiting lists for patients as one of the main advantages of outreach. Whether these improvements merit the increased cost to the specialists (in terms of their increased travelling times and time spent away from their hospital base) and whether the development of what is, in effect, two standards of care between practices with and without outreach can be stemmed and the standard of care raised in all practices (eg, by sharing outreach clinics between GPs in an area) remain the subject of debate. As the data were based on the pilot study, the results should be viewed with some caution, although statistical power was adequate for comparisons of sites if not specialties.
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J Epidemiol Community Health · Dec 1996
The sociodemographic pattern of tobacco cessation in the 1980s: results from a panel study of living condition surveys in Sweden.
To analyse the factors that determined whether or not people were successful in quitting tobacco during the 1980s in Sweden. ⋯ One in four smokers had quit during the 1980s and a few started smoking (5%). Some men quit smoking and started using snuff instead. For both sexes, the daily consumption of cigarettes, years spent smoking, and age were the most important determinants of successful quitting. In men, being married/ cohabiting was an important factor as was higher education in women.