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Appointment as a staff grade doctor: success or failure? 任命为职级医生:成功还是失败?
Health trends Pub Date : 1993-01-01
P Hill, L Donaldson
{"title":"Appointment as a staff grade doctor: success or failure?","authors":"P Hill,&nbsp;L Donaldson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper describes the characteristics of applicants for the first cohort of staff grade posts in an English health Region based on extraction of data from the curricula vitae and application forms of all doctors who applied for such posts over a two year period. 374 doctors applied for 34 staff grade posts in the 16 health Districts of the Northern Region from 1 January 1989 to 31 December 1990. The mean number of applicants for each post was 11, with a mean age of 43 years and a mean time since qualification of 18 years. One-third of the applicants had a higher qualification; about a quarter had passed the first part of an examination for such a qualification or had a Diploma, and nearly one-fifth of applicants did not possess any higher qualification. Between specialties there was wide variation in the time spent by applicants in each grade of their previous posts. Applying the criteria to identify 'stuck doctors' as set out in the national medical manpower plan Hospital Medical Staffing: Achieving a Balance: Plan for Action revealed wide variations within and between specialties. The criteria proposed in Achieving a Balance may not be adequate to identify 'stuck doctors', a finding which has clear implications for national medical manpower policy.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 3","pages":"109-11"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21002951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluation of Communication Aid Centres in England and Wales. 对英格兰和威尔士通讯援助中心的评价。
Health trends Pub Date : 1993-01-01
A Chamberlain, C Rowley, J Stowe, S Hennessy, B Leese, K Tolley, K Wright
{"title":"Evaluation of Communication Aid Centres in England and Wales.","authors":"A Chamberlain,&nbsp;C Rowley,&nbsp;J Stowe,&nbsp;S Hennessy,&nbsp;B Leese,&nbsp;K Tolley,&nbsp;K Wright","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper reports the findings of an evaluation (funded by the Department of Health) of six Communication Aid Centres established in 1983. The evaluation was undertaken to assess the effectiveness of these Centres in meeting their set objectives, and to examine service costs and client satisfaction. The findings show that the work of each Centre was effective in meeting its stated objectives, but that the work of individual Centres reflected its own specialised interests. Two problems with current funding arrangements were highlighted. First, the need to replace the original funding by locally based finance, and second, the funding of communication aids for clients. The findings also show that the specialist service provided by these Centres can be managed at costs per person assessed at, or below, non-specialist services in health districts. Client satisfaction with the services provided by the Centres was high.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 2","pages":"75-9"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21003649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
The last resort? Bed and breakfast accommodation for mentally ill people in a seaside town. 最后的手段?海滨小镇为精神病患者提供的住宿和早餐。
Health trends Pub Date : 1993-01-01
J Barnes, G Thornicroft
{"title":"The last resort? Bed and breakfast accommodation for mentally ill people in a seaside town.","authors":"J Barnes,&nbsp;G Thornicroft","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>There have been few studies about the seaside hotel accommodation provided for mentally ill people in the United Kingdom, despite its extensive use. This paper reports the findings of a survey in Southend, which compared living conditions and residents in bed and breakfast accommodation with those in sheltered accommodation for mentally ill adults. The results show that the mentally ill residents of bed and breakfast accommodation were living in less attractive and less well maintained surroundings. They were not only more likely to have been recently discharged from a psychiatric unit, but also had less contact with the range of community mental health services. Residents in bed and breakfast accommodation were, however, closer to local amenities, such as day centres and parks, than the control group. Staff practices were less restrictive in bed and breakfast accommodation than in the majority of sheltered homes; homes employing psychiatric nurses allowed residents the most freedom. These findings support the need for more accommodation of an acceptable standard for those people discharged from psychiatric units. Local liaison schemes between health workers responsible for the continuing care of mentally ill people and the landlords of bed and breakfast accommodation could improve the quality of life for these residents.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 3","pages":"87-90"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21002769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Purchasing services for end stage renal failure: the potential and limitations of existing information sources. 终末期肾衰竭的购买服务:现有信息来源的潜力和局限性。
Health trends Pub Date : 1993-01-01
R Beech, S Mandalia, J Melia, N Mays, A Swan
{"title":"Purchasing services for end stage renal failure: the potential and limitations of existing information sources.","authors":"R Beech,&nbsp;S Mandalia,&nbsp;J Melia,&nbsp;N Mays,&nbsp;A Swan","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Renal replacement therapy services already consume considerable health service resources and, as patient stock levels rise and unmet need continues to be identified, the pressure to spend more on renal services will increase. Purchasers of services must decide how to respond to these pressures, and a clear assessment of need and the effectiveness and efficiency of services are key issues when contracts are being developed for such services. This paper reports an examination of the quality and potential of information currently available from routine data sources to support the contracting process. The results expose gaps in current knowledge and identify areas for future research. Locally, purchasers should consider surveying their population to identify the incidence of renal disease, including the reasons for any unmet need. Nationally, research is required to investigate the following: the relationship between ethnicity and the development of renal disease; the criteria for allocating patients to the alternative treatment modalities; and the treatments in terms of their costs and cost-effectiveness.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 2","pages":"60-4"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21003645","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Pulmonary embolus and maternal mortality in the antenatal period--evidence of a trend? 产前期肺栓塞和孕产妇死亡率——一种趋势的证据?
Health trends Pub Date : 1993-01-01
J Kurinczuk, M Clarke
{"title":"Pulmonary embolus and maternal mortality in the antenatal period--evidence of a trend?","authors":"J Kurinczuk,&nbsp;M Clarke","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>An analysis of pulmonary embolus mortality data was undertaken to investigate a putative change in maternal mortality due to pulmonary embolism in the antenatal period of pregnancy. A comparison was made of mortality due to pulmonary embolus for pregnant and non-pregnant women of reproductive age in England and Wales in the four triennia from 1976. During this period the antenatal pulmonary embolus mortality rate remained unchanged, whereas a statistically significant decline in non-pregnancy related pulmonary embolus mortality was observed. A comparison of the mortality trends between the two groups found the difference to be statistically highly significant. These findings strongly suggest that, over the twelve years investigated, women in the antenatal period of pregnancy have not benefited from the reduced risk of death from pulmonary embolus enjoyed by their non-pregnant counterparts.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 1","pages":"23-5"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20995794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Demand for hospital services following admission with suspected myocardial infarction in 1983 and 1989. 1983年和1989年疑似心肌梗死入院后的医院服务需求。
Health trends Pub Date : 1993-01-01
P Hampton, L Harrison, D Gray
{"title":"Demand for hospital services following admission with suspected myocardial infarction in 1983 and 1989.","authors":"P Hampton,&nbsp;L Harrison,&nbsp;D Gray","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Formulation of business plans by National Health hospitals requires information on likely demands for the services they provide. Two cohorts of patients admitted to the Nottingham hospitals in 1983 and 1989 with suspected myocardial infarction were sampled to determine the workload implications due to initial in-hospital tests, subsequent readmission and outpatient investigations. The results show that attendance in the first year after discharge related principally to cardiac problems, while in subsequent years non-cardiac problems predominated. An estimation of the total workload, based upon 1,000 patients admitted in 1989, suggests that demands for hospital services in the following year include over 4,000 electrocardiographs, 1,400 chest X-rays and 18,000 laboratory tests, and only 118 exercise tests and 37 cardiac catheterisations. Admission with suspected myocardial infarction makes great demand on hospital services in the year after discharge. Any change in practice, which increases the potential demand for cardiac investigations, could have important financial implications for Nottingham hospitals.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 3","pages":"91-4"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21002770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Alzheimer's disease: the burden of the illness in England. 阿尔茨海默病:英国的疾病负担。
Health trends Pub Date : 1993-01-01
A Gray, P Fenn
{"title":"Alzheimer's disease: the burden of the illness in England.","authors":"A Gray,&nbsp;P Fenn","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This paper reports the findings of a study that estimated the socioeconomic costs, both direct and indirect, of Alzheimer's Disease in England by using a 'burden of illness' framework. The burden of illness was calculated for all main areas of provision: hospital and residential care, general practice, day care, home care and informal care, including the calculations of costs by age-group and by service provider. The results show that the cost of this care amounted to around 1,039m pounds in 1990/91, establishing that spending associated with Alzheimer's Disease is a major area of care expenditure. Such burden of illness data should help those involved with health care decision-making, planning and priority setting, especially for health districts and social services establishing base plans for care in the community.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 1","pages":"31-7"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21043023","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Is cost-awareness really improving? 成本意识真的在提高吗?
Health trends Pub Date : 1993-01-01
G Mills, A Chaffe
{"title":"Is cost-awareness really improving?","authors":"G Mills,&nbsp;A Chaffe","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The findings of a comparative study of cost awareness amongst particular groups of health service staff are reported. The study is a repeat of that undertaken in 1987 by Fairbrass and Chaffe. The findings are compared to assess how awareness of the cost of anaesthetic drugs, fluids and disposables has changed as a result of the publicity since 1987. Without prior warning, the study group were asked to estimate the cost of twenty-eight items. The results show that their degree of accuracy remains poor. Overall the tendency was to overestimate costs, whilst a small number of expensive items such as volatile agents were consistently underpriced. The results show that, over the last three years, there has been no significant change in the knowledge of cost awareness. At a time when the effective use of scarce resources is being emphasised, a staff programme of continuing cost awareness training is recommended.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 1","pages":"38-40"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20998796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Coronary thrombolysis: still too little too late? 冠状动脉溶栓:还是太少太晚?
Health trends Pub Date : 1993-01-01
J Pinkney, S Catnach, A Woods, P Fairclough
{"title":"Coronary thrombolysis: still too little too late?","authors":"J Pinkney,&nbsp;S Catnach,&nbsp;A Woods,&nbsp;P Fairclough","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We reviewed the case records of 109 consecutive patients with a definite diagnosis of myocardial infarction, admitted through the accident and emergency department of an inner-city general hospital to identify delays in referral to hospital, admission to the coronary care unit, and start of thrombolysis. Of the 109 patients, only 28 (26%) received streptokinase (the only thrombolytic drug used at this hospital), and at least 47 (58%) of the remaining 81 who should have benefited from it did not. However, the proportion of patients given streptokinase improved significantly after publication of the Second International Study of Infarct Survival (ISIS 2) study results. The average delay from onset of symptoms to presentation at the accident department was over 3 hours, with a further 1 hour in-hospital delay before administration of streptokinase. This study revealed considerable underuse of thrombolytic therapy in cases where treatment was clearly indicated, but this picture improved substantially during the period of audit.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 4","pages":"132-4"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"21006808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Medical and dental staffing prospects in the NHS in England and Wales 1991. 1991年英格兰和威尔士国民保健制度的医疗和牙科人员配置前景。
Health trends Pub Date : 1993-01-01
P Allen
{"title":"Medical and dental staffing prospects in the NHS in England and Wales 1991.","authors":"P Allen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>This article offers some background information to help junior doctors, and those who advise them, to make decisions about their future careers. Further information can be obtained from the Regional tables, which the Department of Health circulate to Regional Postgraduate Deans, Health Authorities and clinical tutors. All the information presented here is retrospective. Comparing this with the previous annual articles in this series may help you to assess the likely future prospects in your particular specialty.</p>","PeriodicalId":79616,"journal":{"name":"Health trends","volume":"25 1","pages":"4-12"},"PeriodicalIF":0.0,"publicationDate":"1993-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20998797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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