BMJ : British medical journal
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Multicenter Study
Has payment by results affected the way that English hospitals provide care? Difference-in-differences analysis.
To examine whether the introduction of payment by results (a fixed tariff case mix based payment system) was associated with changes in key outcome variables measuring volume, cost, and quality of care between 2003/4 and 2005/6. ⋯ Reductions in unit costs may have been achieved without detrimental impact on the quality of care, at least in as far as these are measured by the proxy variables used in this study.
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Multicenter Study
Evaluation of modernisation of adult critical care services in England: time series and cost effectiveness analysis.
To evaluate the impact and cost effectiveness of a programme to transform adult critical care throughout England initiated in late 2000. ⋯ Substantial improvements in NHS critical care have occurred in England since 2000. While it is unclear which factors were responsible, collectively the interventions represented a highly cost effective use of NHS resources.
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Comparative Study
Reliability of self reported smoking status by pregnant women for estimating smoking prevalence: a retrospective, cross sectional study.
To determine what impact reliance on self reported smoking status during pregnancy has on both the accuracy of smoking prevalence figures and access to smoking cessation services for pregnant women in Scotland. ⋯ Reliance on self reporting to identify pregnant smokers significantly underestimates the number of pregnant smokers in Scotland and results in a failure to detect over 2400 smokers each year who are therefore not offered smoking cessation services.
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Multicenter Study
Meeting information needs of patients with incurable progressive disease and their families in South Africa and Uganda: multicentre qualitative study.
To explore the information needs of patients with progressive, life limiting disease and their family caregivers in South Africa and Uganda and to inform clinical practice and policy in this emerging field. ⋯ Lack of information was a major theme for both patients and carers, who had important unanswered questions relating to living with a progressive incurable disease. Evidence based recommendations for clinicians are presented, including the proactive provision of information tailored to individual patients and families.
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Multicenter Study
Exploring preferences for place of death with terminally ill patients: qualitative study of experiences of general practitioners and community nurses in England.
To explore the experiences and perceptions of general practitioners and community nurses in discussing preferences for place of death with terminally ill patients. ⋯ Further research is needed to enable development of appropriate training and support for primary care professionals. Better understanding of the importance of place of death to patients and their carers is also needed.