Abstract:
STUDY OBJECTIVE:To assess the potential for substituting alternative forms of care for admission to an acute hospital in particular groups of patients. DESIGN:A screening tool, the intensity-severity-discharge review system with adult criteria (ISD-A), developed for hospital utilisation review in the USA, was used in a cohort of hospital admissions to identify a group of patients who could potentially have been treated outside the acute hospital. These patients were further assessed by a panel of general practitioners (GPs) to determine the most appropriate alternative form of care. A cost analysis was performed on the results obtained. SETTING:General medicine and geriatric specialties in one acute hospital in the south western region. PATIENTS:Patients comprised a sample of 701 admitted to general medical and geriatric specialties. MAIN RESULTS:The screening tool identified 19.7% of admissions for whom there was potential for treatment outside the acute hospital. Assessment by the GP panel reduced this potential to between 9.8% and 15.0% of emergency admissions. The alternatives most frequently identified as "most appropriate" were the community hospital/GP bed and the urgent outpatient assessment (within either 24 or 48 hours). Potential resource savings based on the average cost were relatively small. This potential seemed to be greater for the alternative of the urgent outpatient assessment. CONCLUSIONS:Potential exists for treating a proportion of patients in lower intensity alternatives to the acute hospital. If this potential were exploited few resource savings would occur.
journal_name
J Epidemiol Community Healthjournal_title
Journal of epidemiology and community healthauthors
Coast J,Inglis A,Morgan K,Gray S,Kammerling M,Frankel Sdoi
10.1136/jech.49.2.194subject
Has Abstractpub_date
1995-04-01 00:00:00pages
194-9issue
2eissn
0143-005Xissn
1470-2738journal_volume
49pub_type
杂志文章abstract:BACKGROUND:Active ageing is a key to healthy ageing; shopping behaviour is an economically relevant activity of the elderly. METHODS:Analysis was based on the NAHSIT 1999-2000 dataset. A total of 1841 representative free-living elderly Taiwanese people were selected and information included demographics, socioeconomic...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2010.126698
更新日期:2012-07-01 00:00:00
abstract::Environmental pollutants and nutrients may be present in the same foodstuffs or dietary patterns; share internal mechanisms of transport, metabolism and cellular uptake; or target the same molecular signalling pathways and biological functions. Lipophilic pollutants and nutrients, like dioxins and polyunsaturated fatt...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2020-213789
更新日期:2021-02-01 00:00:00
abstract:BACKGROUND:Several models have been proposed to explain the association between ethnicity and health. It was investigated whether the association between Roma ethnicity and health is fully mediated by socioeconomic status in Hungary. METHODS:Comparative health interview surveys were performed in 2003-04 on representat...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2008.079715
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Earlier investigations have shown mortality effects of community socio-economic resources. However, the sex differences have not been clear, and the estimates may well have been biased because of inadequate control for community factors affecting both the socio-economic resources and mortality. The objective...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2008.081034
更新日期:2010-12-01 00:00:00
abstract:STUDY OBJECTIVE:This paper addresses the environmental justice implications of children's health by exploring racial/ethnic disparities in potential exposure to air pollution, based on both school and home locations of children and three different types of pollution sources, in Orange County, Florida, USA. METHODS:Usi...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2006.054130
更新日期:2007-12-01 00:00:00
abstract:BACKGROUND:Although working smoke alarms halve deaths in residential fires, many households do not keep alarms operational. We tested whether theory-based education increases alarm operability. METHODS:Randomised multiarm trial, with a single arm randomly selected for use each day, in low-income neighbourhoods in Mary...
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pub_type: 杂志文章,随机对照试验
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更新日期:2014-12-01 00:00:00
abstract:BACKGROUND:Socioeconomic status (SES) is an important determinant of health, but SES measures are frequently unavailable in commonly used datasets. Area-level SES measures are used as proxy measures of individual SES when the individual measures are lacking. Little is known about the agreement between individual-level ...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2012-201742
更新日期:2013-04-01 00:00:00
abstract:BACKGROUND:We investigated the influence of sleeplessness and number of insomnia symptoms on the probability of recovery from chronic low back pain (LBP), and the possible interplay between sleeplessness and co-occurring musculoskeletal pain on this association. METHODS:The study comprised data on 3712 women and 2488 ...
journal_title:Journal of epidemiology and community health
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更新日期:2020-03-01 00:00:00
abstract::In a study of selenium status in 391 apparently healthy subjects resident in the south of England statistical examination of the data showed a significant effect with regard to age, smoking, alcohol, and oral contraceptives. The most important of these factors seems to be a combination of alcohol and smoking habits in...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.37.3.213
更新日期:1983-09-01 00:00:00
abstract:STUDY OBJECTIVES:Sociodemographic differentials in cancer survival have occasionally been studied by using a relative survival approach, where all cause mortality among persons with a cancer diagnosis is compared with that among similar persons without such a diagnosis ("normal" mortality). One should ideally take into...
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pub_type: 杂志文章
doi:10.1136/jech.56.4.309
更新日期:2002-04-01 00:00:00
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journal_title:Journal of epidemiology and community health
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doi:10.1136/jech.53.6.343
更新日期:1999-06-01 00:00:00
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doi:10.1136/jech.49.2.139
更新日期:1995-04-01 00:00:00
abstract:STUDY OBJECTIVE:The aim was to estimate health and economic consequences of interventions aimed at reducing the daily intake of salt (sodium chloride) by 6 g per person in the Norwegian population. Health promotion (information campaigns), development of new industry food recipes, declaration of salt content in food an...
journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.54.9.697
更新日期:2000-09-01 00:00:00
abstract:STUDY OBJECTIVE:To explore risk factors for symptomatic knee osteoarthritis (OAK) in women, which included wearing high heeled shoes. DESIGN:Matched case-control study. Exposure information obtained by interview, included details about past footwear. Self reported weight and height data obtained representing when wome...
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doi:10.1136/jech.57.10.823
更新日期:2003-10-01 00:00:00
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更新日期:2016-06-01 00:00:00
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更新日期:2013-09-01 00:00:00
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更新日期:2021-02-01 00:00:00
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pub_type: 杂志文章
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更新日期:1996-12-01 00:00:00
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更新日期:2012-10-01 00:00:00
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更新日期:2009-09-01 00:00:00
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更新日期:1998-07-01 00:00:00
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更新日期:1991-03-01 00:00:00
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更新日期:2004-04-01 00:00:00
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更新日期:2016-12-01 00:00:00
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更新日期:2016-06-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2017-209453
更新日期:2018-03-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2005.040881
更新日期:2006-10-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech.2008.078873
更新日期:2009-05-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
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更新日期:1982-12-01 00:00:00
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journal_title:Journal of epidemiology and community health
pub_type: 杂志文章
doi:10.1136/jech-2019-213462
更新日期:2020-04-01 00:00:00