Journal of health services research & policy
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J Health Serv Res Policy · Oct 2004
Do different types of nurses give different triage decisions in NHS Direct? A mixed methods study.
To determine whether nurses with different clinical backgrounds make different triage decisions in NHS Direct, the 24-hour telephone helpline staffed by nurses. ⋯ There is no likely benefit in narrowing nurse recruitment to particular clinical backgrounds. The appropriateness of triage decisions still needs to be evaluated.
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J Health Serv Res Policy · Oct 2004
Pricing of general practice in Australia: some recent proposals to reform Medicare.
In the Australian Medicare system, general practitioners (GPs) are paid on a fee-for-service basis. A practitioner can choose to bill the government directly (termed bulk billing) and receive 85% of a regulated fee as full payment. Bulk billed consultations are free to the patient. ⋯ A key feature of the proposal involved changes to the way that GPs are reimbursed. Following political opposition that would have prevented it passing both houses of the federal parliament, a revised version, MedicarePlus, was released in November 2003. This paper describes the factors influencing a GP's choice to bulk bill and examines the two proposals, in this context.
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J Health Serv Res Policy · Oct 2004
Health services research in Australia: an investigation of its current status.
The objectives of this audit were to document the current status of health services research (HSR) in Australia in terms of inputs and outputs. Inputs were defined as the number of organised centres or groups undertaking HSR, the extent to which HSR was being developed and the funding available for HSR. Outputs were measured as the number of peer-reviewed papers. ⋯ Although HSR is widespread in Australia, no specific training appears to be available to build capacity. Overall, HSR is not well-funded especially by organisations outside the NHMRC or Australian Research Council. Thus, it is not surprising that the output of Australian HSR, in terms of peer-reviewed articles, is slight.
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J Health Serv Res Policy · Apr 2004
Comparative StudyCounting in-hospital deaths in England: a comparison of hospital computer systems and mortuary registers.
In-hospital death counts derived from hospital computer systems have been used in England by an independent company, 'Dr Foster', to rank the quality of care of hospitals, but the validity of the underlying data remains unclear. This study compares counts of in-hospital deaths using two different sources - the hospital computer system and the mortuary register - to determine: whether the counts of in-hospital deaths from these two sources differed; qualitative explanations for possible sources of discrepancy; the direction and magnitude of any differences; and the possible impact of any differences on the Dr Foster rankings. ⋯ The differences between the two sources of in-hospital death counts were not large enough to influence the Dr Foster ranks but were sufficient to raise concern about the validity and completeness of mortality data in the NHS.
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J Health Serv Res Policy · Apr 2004
Modelling in the economic evaluation of health care: selecting the appropriate approach.
To provide an overview of alternative approaches to modelling in economic evaluation, and to highlight situations where each of the alternative modelling techniques should be employed. ⋯ The paper highlights the crucial question to be answered when selecting the approach to modelling: can the individuals being simulated in the model be regarded as independent? This issue is very commonly not recognised by analysts but is fundamental to the appropriate application of modelling in economic evaluation.