Journal of health services research & policy
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J Health Serv Res Policy · Jul 2002
Multiple sclerosis and quality of life: a qualitative investigation.
Many people who live with long-term illness experience a decline in their quality of life. The primary aim of this qualitative study was to identify aspects of life that contributed to the quality of the lives of people who had one particular chronic illness, namely multiple sclerosis (MS). A secondary aim was to use this information to highlight areas where there was potential for effective intervention by health or social services. ⋯ Many aspects of living with chronic illness are unavoidable, but health or social intervention can affect others. Inappropriate personal assistance may result in dependency, which detracts from personal control and worsens quality of life. When appropriate, however, support may have beneficial consequences. By recognising the specific factors that link personal control and the illness trajectory, appropriate and timely support can be negotiated.
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J Health Serv Res Policy · Jul 2002
Variations in practice admission rates: the policy relevance of regression standardisation.
To explore variations in general practice admission rates, comparing standardisation by regression with direct standardisation of the data to identify explained and unexplained variation. ⋯ Given the increasing importance of systematic performance assessment to support quality improvement, care must be taken when interpreting variations in health care activity even after conventional standardisation of the data. If significant variations are detected, regression analysis can assist in explaining some of it, which is the starting point in informing discussions about whether variations are justified or unjustified.
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J Health Serv Res Policy · Jul 2002
ReviewSystematic review of outreach clinics in primary care in the UK.
To determine the benefits of holding specialist outreach clinics in primary care settings by means of a systematic literature review of UK studies. ⋯ Health care purchasers and providers must decide whether the advantages in terms of patients' experience of outreach clinics are worth the additional costs. They also need to consider issues of equity, which have not been addressed in research to date.
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J Health Serv Res Policy · Jul 2002
'Inappropriate' attendance at an accident and emergency department by adults registered in local general practices: how is it related to their use of primary care?
To identify the relationship between 'inappropriate' attendance at an accident and emergency department (AED) by adults registered with local general practices and their use of primary care. ⋯ GP-registered, 'inappropriate' attendees at AEDs utilise primary care services more than matched controls; this pattern of service utilisation appears to be unrelated to chronic physical illness. Thus, simply providing new, directly accessible primary health care services may not significantly reduce AED use.