Public health
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Road traffic accidents cause several thousand deaths each year in England and Wales. One approach to reducing this toll is to ensure that services are planned to achieve early response of ambulances to accident victims and their rapid conveyance to a hospital with good accident and emergency facilities. In order to undertake medical care of the highest quality, there has been a policy of concentrating such facilities in large units. ⋯ Regression analysis was used to analyse the factors affecting the odds of death versus serious injury for each individual. An elevated probability of death was found among the old, pedestrians, casualties involved in multiple accidents, and casualties on roads with higher speed limits. However, no relationship was found between outcome and the estimated time taken to reach victims and to convey them to hospital, either before or after adjustment for other factors.(ABSTRACT TRUNCATED AT 250 WORDS)
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The National Health Service reforms revitalized the national emphasis on the public's health and health needs assessment. In Scotland, in contrast with England, there was no central investment in the development of methods and programmes for needs assessment in the context of the new NHS. To achieve a concerted effort, therefore, a self-help network--the Scottish Needs Assessment Programme (SNAP)--was created by the Scottish Forum for Public Health Medicine. This paper describes its evolution to the point where it is now supported as part of a national network of information for purchasing.