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Total 55 results found since Jan 2013.

Adverse outcomes after total and unicompartmental knee replacement in 101 330 matched patients: a study of data from the National Joint Registry for England and Wales
Publication date: 18–24 October 2014 Source:The Lancet, Volume 384, Issue 9952 Author(s): Alexander D Liddle , Andrew Judge , Hemant Pandit , David W Murray Background Total knee replacement (TKR) or unicompartmental knee replacement (UKR) are options for end-stage osteoarthritis. However, comparisons between the two procedures are confounded by differences in baseline characteristics of patients undergoing either procedure and by insufficient reporting of endpoints other than revision. We aimed to compare adverse outcomes for each procedure in matched patients. Methods With propensity score techniques, we compared ma...
Source: The Lancet - October 17, 2014 Category: Journals (General) Source Type: research

Electronic patient information systems and care pathways: The organisational challenges of implementation and integration
We report on the development and implementation of four such pathways within two National Health Service primary care trusts in England: (a) frail elderly care, (b) stroke care, (c) diabetic retinopathy screening and (d) intermediate care. The pathways were selected because each represents a different type of information and data ‘couplings’, in terms of task interdependency with some pathways/systems reflecting more complex coordinating patterns than others. Our aim here is identify and explain how health professionals and information specialists in two organisational National Health Service primary care trust...
Source: Health Informatics Journal - September 2, 2014 Category: Information Technology Authors: Dent, M., Tutt, D. Tags: Special Issue Articles Source Type: research

The DARS (Dopamine Augmented Rehabilitation in Stroke) trial: protocol for a randomised controlled trial of Co-careldopa treatment in addition to routine NHS occupational and physical therapy after stroke
DiscussionThe DARS trial will provide evidence as to whether Co-careldopa, in addition to routine NHS occupational and physical therapy, leads to a greater recovery of motor function, a reduction in carer dependency and advance rehabilitation treatments for people with stroke.Trial registration: ISRCTN99643613 assigned on 4 December 2009.
Source: Trials - August 8, 2014 Category: Journals (General) Authors: Bipin BhaktaSuzanne HartleyIvana HollowayJ CouzensGary FordDavid MeadsCatherine SackleyMarion WalkerSharon RuddockAmanda Farrin Source Type: research

Quality and the curate's egg
A famous cartoon in the satirical magazine Punch from the 1890s shows a meek curate assuring his dinner host that his egg is not spoiled. "Parts of it are exceptional", he suggests. We, the knowing reader, appreciate the humour. An egg cannot be good in parts. For those who think about quality, the question of whether care can be good in parts is a tricky one. That a hospital might deliver better care for one clinical service—top notch cardiac surgery, say, but below average stroke care—would not surprise anyone. But, the idea that quality itself, even within a given clinical domain, like cardiac surgery or str...
Source: Quality and Safety in Health Care - June 12, 2014 Category: Health Management Authors: Greaves, F., Jha, A. K. Tags: Editor's choice Editorials Source Type: research

The Shortfall in Long-term Survival of Patients with Repaired Thoracic or Abdominal Aortic Aneurysms: Retrospective Case–Control Analysis of Hospital Episode Statistics
Objective: To report the contemporary life expectancy of patients undergoing abdominal (AAA) or thoracic aortic aneurysm (TAA) repair in England, relative to a healthy control population.Methods: A retrospective observational case–control study was carried out of Hospital Episode Statistics (HES) data, an administrative dataset covering the entire English National Health Service. Patients undergoing elective repair of an abdominal or thoracic aortic aneurysm in an English NHS hospital between April 2006 and March 2011 were included. Outcome measures were 5-year all-cause mortality (in- and out-of-hospital) and adverse ca...
Source: European Journal of Vascular and Endovascular Surgery - October 2, 2013 Category: Surgery Authors: A. Karthikesalingam, S.S. Bahia, B.O. Patterson, G. Peach, A. Vidal-Diez, K.K. Ray, R. Sharma, R.J. Hinchliffe, P.J. Holt, M.M. Thompson Tags: Aneurysms Source Type: research

‘Finding a Balance’ in Involving Patients in Goal Setting Early After Stroke: A Physiotherapy Perspective
DiscussionPhysiotherapists perceived that collaborating with patients in goal setting was important but challenging. Goal setting interactions with other professionals, patients and families were perceived as complex, difficult and requiring significant effort. The importance of individuality and temporality were recognized suggesting that the goal setting approach needs to be adapted to the context and the individuals involved. Copyright © 2013 John Wiley & Sons, Ltd.
Source: Physiotherapy Research International - September 1, 2013 Category: Physiotherapy Authors: A. Lloyd, A. R. Roberts, J. A. Freeman Tags: Research Article Source Type: research

Reimbursement systems and quality of hospital care: An empirical analysis for Italy
Abstract: There is an ongoing debate about the effect of different reimbursement systems on hospital performance and quality of care. The present paper aims at contributing to this literature by analysing the impact of different hospital payment schemes on patients’ outcomes in Italy.The Italian National Health Service is, indeed, a particularly interesting case since it has been subject to a considerable decentralization process with wider responsibilities devolved to regional governments. Therefore, great variability exists in the way tariffs are used, as Regions have settled them in accordance with the characteristics...
Source: Health Policy - July 8, 2013 Category: Health Management Authors: Marina Cavalieri, Lara Gitto, Calogero Guccio Tags: Health Care Quality Source Type: research

Approaches to economic evaluations of stroke rehabilitation
This study highlights that complex interventions such as stroke rehabilitation have widespread effects, which may not be represented by the changes on a single outcome. This study recommends the adoption of a wider cost and benefit perspective in the economic evaluations of complex interventions. It supports a move away from conventional economic evaluation and decision making, based purely on cost‐effectiveness, toward multicriteria decision analysis frameworks for complex interventions, where a broader range of criteria may be assessed by policy makers.
Source: International Journal of Stroke - March 21, 2013 Category: Neurology Authors: Louise E Craig, Olivia Wu, Julie Bernhardt, Peter Langhorne Tags: Review Source Type: research

Innovations in major system reconfiguration in England: a study of the effectiveness, acceptability and processes of implementation of two models of stroke care
This study will analyse processes involved in making significant changes to stroke care services over a short time period, and the factors influencing these processes. We will examine whether the changes have delivered improvements in quality of care and patient outcomes; and, in light of this, whether the significant extra financial investment represented good value for money. Methods: This study brings together quantitative data on 'what works and at what cost?' with qualitative data on 'understanding implementation and sustainability' to understand major system change in two large conurbations in England. Data on proces...
Source: BioMed Central - January 5, 2013 Category: Journals (General) Authors: Naomi FulopRuth BoadenRachael HunterChristopher McKevittSteve MorrisNanik PursaniAngus IG RamsayAnthony G RuddPippa J TyrrellCharles Wolfe Source Type: research