Journal of public health medicine
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This review aims to document and analyse aspects of death certification that are relevant to public health. ⋯ The traditional perspective on improving the quality of death certification has not worked. There is a need for reorientated thinking rather than just urging more education. Evidence-based educational interventions are needed. The flaws in the theoretical framework of cause of death and the routine nature of death certification are unavoidable, but require consideration. Certifiers need practical feedback mechanisms, integral to continuing quality assurance at all levels and fostering an understanding of the construction of mortality data. Continued development should be a core public health medicine role.
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J Public Health Med · Mar 1996
Comparative StudyThe costs and benefits of helicopter emergency ambulance services in England and Wales.
Following the introduction of Helicopter Emergency Ambulance Services (HEAS) in the United Kingdom in the last ten years this paper examines the costs and benefits of three contrasting services in Cornwall, London and Sussex. ⋯ The analysis suggests that Helicopter Emergency Ambulance Services are costly, the health benefits are small, and there are limited circumstances in which the pre-hospital performance of an ambulance service in England and Wales can be improved.
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J Public Health Med · Mar 1996
Access to health care in England: continuing inequalities in the distribution of GPs.
One of the successes of the National Health Service is that the distribution of general practitioners (GPs) corresponds much more closely to the size of the local communities than it did before 1948. However, more should be done to reflect the fact that different populations have variable needs for GPs. The aim of this paper is to estimate the relative need for GPs by linking evidence from individual utilization data to the characteristics of small areas. ⋯ The findings in this paper suggest that there are still considerable inequalities in access to GP services in England in relation to need.