Journal of evaluation in clinical practice
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As the prescribing of drugs in secondary care is known to influence prescribing in primary care and because an understanding of prescribers' reasoning is essential for evaluating prescribing appropriateness, the aim of this study was to investigate secondary care doctors' views of appropriate prescribing, using qualitative individual interviews. ⋯ The hospital doctors brought up continuous review as a necessary part of appropriate prescribing. Thus, from the prescribers' point of view, this time perspective should be explicitly incorporated in definitions of appropriate prescribing, in addition to individualization of treatment and cost considerations.
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Falls in older people are associated with increased mortality, physical injury, loss of function and independence. The extent to which trusts had met the requirements to implement an integrated falls service for older people by April 2005 was assessed by the performance of a national organizational audit. ⋯ The results of a national audit, especially when linked to a scoring system, can help local services benchmark themselves which, in association with action planning workshops and commitment from trusts, can achieve changes in practice.
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Age-related effects on health service utilization are not well understood. Most previous studies have examined only a single specific health care service or disease condition or have focused exclusively on economic variables. We aim to measure age-related change in health care utilization among the elderly. ⋯ At the population level, overall health care utilization would appear to increase significantly with age. It is unclear whether increasing health care utilization prevents morbidity, decreases mortality, or improves quality of life.
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This study used the discrete-events computer simulation methodology to model a large hospital surgical centre (SC), in order to analyse the impact of increases in the number of post-anaesthetic beds (PABs), of changes in surgical room scheduling strategies and of increases in surgery numbers. ⋯ It was observed that the introduction of a flexible scheduling/increase in PABs would lead to a significant improvement in the SC productivity.
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The Clinical Global Impression Scale (CGI) is established as a core metric in psychiatric research. This study aims to test the validity of CGI as a clinical outcome measure suitable for routine use in a private inpatient setting. ⋯ The CGI is a valid clinical outcome measure suitable for routine use in an inpatient setting. It offers a number of advantages, including its established utility in psychiatric research, sensitivity to change, quick and simple administration, utility across diagnostic groupings, and reliability in the hands of skilled clinicians.