BMJ : British medical journal
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Multicenter Study
Retention in the British National Health Service of medical graduates trained in Britain: cohort studies.
To report the percentage of graduates from British medical schools who eventually practise medicine in the British NHS. ⋯ The majority of British medical graduates from British medical schools practise in the NHS in both the short and long term. Differences between men and women in this respect are negligible. A majority of doctors from overseas homes remain in Britain for their years as junior doctors, but eventually about half leave the NHS.
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Multicenter Study
Reliability of patient responses in pay for performance schemes: analysis of national General Practitioner Patient Survey data in England.
To assess the robustness of patient responses to a new national survey of patient experience as a basis for providing financial incentives to doctors. ⋯ There is little evidence to support the concern of some general practitioners that low response rates and selective non-response bias have led to systematic unfairness in payments attached to questionnaire scores. The study raises issues relating to the validity and reliability of payments based on patient surveys and provides lessons for the UK and for other countries considering the use of patient experience as part of pay for performance schemes.
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Multicenter Study
Preserving professional credibility: grounded theory study of medical trainees' requests for clinical support.
To develop a conceptual framework of the influences on medical trainees' decisions regarding requests for clinical support from a supervisor. ⋯ Trainees consider not only clinical implications but also professional credibility when requesting support from clinical supervisors. Exposing the complexity of this process provides the opportunity to make changes to training programmes to promote timely supervision and provides a framework for further exploration of the impact of clinical training on quality of care of patients.
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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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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.