Abstract:
OBJECTIVES:To assess the role of economics, in combination with clinical judgement, for setting research priorities, using osteoporosis prevention (and, as a result, hip fracture prevention) as an example. METHODS:Modelling the cost and effectiveness of each of six potential interventions to prevent hip fractures over the 5-year length of a randomized trial (vitamin D injection; thiazide diuretics; hormone replacement therapy; oral calcium and vitamin D; calcium alone; calcitonin). Drug costs were derived from the Monthly Index of Medical Specialties (MIMS); averted fracture costs and estimates of effectiveness were derived from published sources. RESULTS:Vitamin D injection proved to be the most potentially cost-effective treatment with a cost-effectiveness ratio of 584 Pounds. If averted costs are included, this leads to a saving of 9,176,496 Pounds per 100,000 women treated. By contrast, the most expensive therapy was calcitonin (marginal cost-effectiveness ratio of 433,548 Pounds). This suggests that priority should be given to trials assessing the effectiveness of vitamin D injections. CONCLUSIONS:Relatively simple economic modelling exercises can inform research priorities and could help optimize the use of scarce research resources.
journal_name
J Health Serv Res Policyjournal_title
Journal of health services research & policyauthors
Torgerson D,Donaldson C,Reid Ddoi
10.1177/135581969600100305subject
Has Abstractpub_date
1996-07-01 00:00:00pages
141-6issue
3eissn
1355-8196issn
1758-1060journal_volume
1pub_type
杂志文章abstract:BACKGROUND:Improvements in health service provision need not be costly and indeed may save money. Administration of radio iodine ((131)I) to patients with thyrotoxicosis in the UK is often delayed because few endocrinologists have appropriate Administration of Radioactive Substances Advisory Committee (ARSAC) certifica...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581907782101534
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVES:to determine the extent and nature of the decisions individuals are asked to make as in-patients, and whether doctors, nurses, other health care practitioners, and housekeepers engaged in routine (non-emergency) medical assessments, investigations and treatments, or acts of personal care observe the Referenc...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.009148
更新日期:2011-01-01 00:00:00
abstract::Policy-makers and managers have always used a wide range of sources of evidence in making decisions about policy and the organization of services. However, they are under increasing pressure to adopt a more systematic approach to the utilization of the complex evidence base. Decision-makers must address complicated qu...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/1355819054308576
更新日期:2005-07-01 00:00:00
abstract:OBJECTIVE:Physician gender may be a source of differences in communication between physicians and their patients, which may in turn contribute to patient satisfaction and other outcomes. Our aim was to review systematically research on gender differences in the length, style and content of communication with patients. ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,meta分析,评审
doi:10.1177/1355819613486465
更新日期:2013-10-01 00:00:00
abstract:OBJECTIVES:The National Service Framework (NSF) for Coronary Heart Disease--published by the English Department of Health in 2000--sets out how those within the health service should seek to prevent and treat coronary heart disease and care for people with the disease. Its prescriptions are partly based on what is know...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581906776318956
更新日期:2006-04-01 00:00:00
abstract:OBJECTIVE:the nature of care delivered in emergency departments has changed due to increased demand. In response, one relatively new change is the introduction of a physiotherapy service. There have been anecdotal reports that this may reduce patient waiting times and lead to more effective use of other health care sta...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/jhsrp.2010.009129
更新日期:2011-01-01 00:00:00
abstract:INTRODUCTION:Levels of management staffing in the UK National Health Service (NHS) have received considerable political and media attention in the last four years or so. Both the previous and current governments committed themselves to reducing management expenditure in the health service, and significant cuts appear t...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969900400104
更新日期:1999-01-01 00:00:00
abstract::It has previously been suggested that the English Department of Health seems, wittingly or not, to have drawn on the experiences of Stalinist Russia in devising policies for the National Health Service. The development of general practitioner fundholding during the 1990s could be compared to the Soviet support for the...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960000500311
更新日期:2000-07-01 00:00:00
abstract:OBJECTIVES:To evaluate whether the Clinical Priority Assessment Criteria (CPAC), used to prioritise access to elective surgery, was associated with: (a) patients' access to surgery in practice; (b) patients' level of need; and (c) patients' ability to benefit from surgery. Patients' perceptions of the 'booking system' ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581902320176322
更新日期:2002-07-01 00:00:00
abstract::Health services research must continually address the question: Under what conditions may data not collected specifically for research, such as primary medical data, be re-used for research without compromising the privacy of the data-subjects? For secondary use of data in research there are basically three options. O...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581903766468800
更新日期:2003-07-01 00:00:00
abstract:OBJECTIVES:This paper focuses upon health status, need for care, and use of health care from 1994/95 to 2000/01 in the Canadian foreign-born population. METHODS:Using Statistics Canada's longitudinal National Population Health Survey, descriptive and survival analyses are used to explore immigrant health status and he...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/1355819053559074
更新日期:2005-04-01 00:00:00
abstract::An important component of the reforms of the British National Health Service (NHS) has been devolution of a previously highly centralised pay bargaining system to the local provider level. As the wage bill is by far the single largest item of health care expenditure, the implications of this change may be far-reaching...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969800300210
更新日期:1998-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Automated pharmacy data have been used to develop a measure of chronic disease status in the general population. The objectives of this project were to refine and apply a model of chronic disease identification using Italian automated pharmacy data; to describe how this model may identify patt...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581905774414259
更新日期:2005-10-01 00:00:00
abstract:OBJECTIVES:To critically evaluate the quality of hospital medical care at the beginning, during and shortly after regionalization of health boards in Newfoundland and Labrador, and aggregation of hospitals in the St John's region. METHODS:Retrospective chart audits for the years 1995/96, 1998/99 and 2000/01 (at the be...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/135581905774424465
更新日期:2005-10-01 00:00:00
abstract::The National Health Service (NHS) in England is not only a commissioner and provider of health care to the sick, but also offers certainty and peace of mind to all citizens--even those who do not use the health service in any year. However, due to the recent dominance of cost-effectiveness and cost-utility analysis as...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2009.009024
更新日期:2010-07-01 00:00:00
abstract:OBJECTIVE:Cost-utility analysis is gaining importance as a tool for setting priorities in health care. The approach requires quality-of-life weights on a scale from 0.00 (corresponding to death) to 1.00 (corresponding to perfect health). Different methods and perspectives of the evaluators tend to give different result...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1258/135581904322716111
更新日期:2004-01-01 00:00:00
abstract:OBJECTIVES:English primary care organisations (primary care groups and trusts - PCGs, PCTs) were, and are, responsible for the quality of general practice but lack hierarchical structures and, frequently, contractual relationships through which to influence it. The theory of soft governance describes how managers can i...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/1355819041403295
更新日期:2004-07-01 00:00:00
abstract::This paper analyses likely implications of two recent European Court rulings on the provision of health care across borders within the European Union. We argue that the two cases have fundamental implications for the provision of health services as free access to care across borders conflicts with the principle of sub...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581960000500408
更新日期:2000-10-01 00:00:00
abstract:OBJECTIVES:To illustrate the complexity of setting up evaluative research when it is perceived to threaten professional and financial interests. METHODS:A case study based on participatory observation of attempts to study the delivery and health consequences of in vitro fertilization (IVF). Two research projects were ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/1355819021927610
更新日期:2002-01-01 00:00:00
abstract:OBJECTIVES:To identify the barriers to shifting services from secondary to primary care perceived by the involved stakeholders. METHODS:Forty-five semi-structured interviews with stakeholders from primary care, acute and community hospitals, purchasers (health authorities) and other agencies involved in two contrastin...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969900400306
更新日期:1999-07-01 00:00:00
abstract::The rationales used in chiropractic are largely in keeping with current evidence-based guidance. When listening to debates for and against the scientific basis of chiropractic, it is important to be aware of the selective use of evidence on both sides and of the limitations of logical positivistic arguments when it co...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2009.009025
更新日期:2009-07-01 00:00:00
abstract:OBJECTIVE:To evaluate the effectiveness and cost of obtaining consent for review of medical records within the passively observed non-intervention arm of a cluster randomized controlled trial, 'Comparison Arm for ProtecT'. METHODS:Two hundred and thirty men, who had been notified to the trial by cancer registries as h...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2008.008085
更新日期:2009-04-01 00:00:00
abstract::Patients are increasingly using the internet to access information on health care and services, as well as writing reviews of their own experiences. With patient choice increasing in many health systems, payers, purchasers and providers are attempting to take control of this trend by designing and managing their own p...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2010.010010
更新日期:2011-04-01 00:00:00
abstract::This paper takes an overview of the organizational and managerial literature on recent large-scale change efforts within health care organizations. Such literature refers to issues of enhanced policy significance, as a succession of such changes has swept through health care, at an international level. Interpretive an...
journal_title:Journal of health services research & policy
pub_type: 杂志文章,评审
doi:10.1177/135581969700200310
更新日期:1997-07-01 00:00:00
abstract:OBJECTIVES:The introduction of an internal market in the British National Health Service (NHS) has highlighted the importance of developing appropriate, valid and timely measures of hospital activity, both for the purposes of specifying and monitoring contracts and for evaluating the success of the NHS reforms in gener...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969600100104
更新日期:1996-01-01 00:00:00
abstract::The incorporation of genetics into health services research has largely floundered, despite the rapidly accelerating availability of, and access to, such data. This is expected given the ethical questions involved. However, using these new resources robustly to examine population choices when it comes to health insure...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819616664374
更新日期:2017-01-01 00:00:00
abstract::In most jurisdictions, public policy regarding assisted death has not advanced beyond simple prohibition. However, this issue is increasingly likely to reach the policy agenda. Policy-makers may be tempted to turn for guidance to the three places in the world with developed policy or legislation: the Netherlands; the ...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/135581969900400409
更新日期:1999-10-01 00:00:00
abstract::Hospitals are awash with patient experience data, much of it collected with the ostensible purpose of improving the quality of patient care. However, there has been comparatively little consideration of the nature and capacities of data itself. Using insights from actor-network theory, we propose that paying attention...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1177/1355819616685349
更新日期:2017-04-01 00:00:00
abstract:OBJECTIVES:To evaluate the effect of a risk factor checklist and training video for general practitioners in reducing inter-practice variation and improving the appropriateness of referrals (assessed by their positive predictive value or PPV) of patients with suspected otitis media with effusion (OME or 'glue ear') to ...
journal_title:Journal of health services research & policy
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1258/1355819011927387
更新日期:2001-07-01 00:00:00
abstract:OBJECTIVES:To understand the challenges and opportunities associated with the introduction of assistant practitioner (AP) roles supporting the work of ward-based registered nurses (RNs) in National Health Service (NHS) acute hospital trusts in England. METHODS:Three case studies of NHS acute hospital trusts. This pape...
journal_title:Journal of health services research & policy
pub_type: 杂志文章
doi:10.1258/jhsrp.2011.010106
更新日期:2011-04-01 00:00:00