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 secondary care. METHODS:Fifty general practices (177 practitioners) from the NHS Trent region and the West of Scotland were cluster-randomised either to a control group (n = 12) or to one of three intervention groups (training video (n = 16), checklist (n = 11), or both (n = 11)). Data on all paediatric ear, nose and throat (ENT) referrals and diagnostic results at ENT clinics were collected for a one-year period pre- and post-intervention. Referral rates for OME and for closely related conditions were calculated for children aged 0-15 years, based on each practice's list size. PPV was defined as the proportion of referrals resulting in bilateral hearing loss > or = 20 dB at the ENT outpatient department. RESULTS:There was a significant improvement in the PPV, adjusted for patients' waiting time between general practitioner (GP) referral and being seen at the ENT department. The improvement in PPV pre- and post-intervention was 15% (95% confidence interval, CI: -12.1% to 41.7%) for the practices receiving both interventions, compared with a degradation of 20% pre- and post-intervention (95% CI: -32.9% to -6.4%) for practices receiving only one intervention and a degradation of 34% for those receiving no intervention. CONCLUSIONS:Disseminating a risk factor checklist and training video on glue ear to GPs using a multi-channel approach can improve the quality of referrals to ENT.
journal_name
J Health Serv Res Policyjournal_title
Journal of health services research & policyauthors
Bennett K,Haggard M,Churchill R,Wood Sdoi
10.1258/1355819011927387subject
Has Abstractpub_date
2001-07-01 00:00:00pages
139-44issue
3eissn
1355-8196issn
1758-1060journal_volume
6pub_type
临床试验,杂志文章,随机对照试验abstract：:This essay considers some limitations of programme theory evaluation in relation to healthcare policies. This approach, which seeks to surface 'programme theories' or construct 'logic models', is often unable to account for empirical observations of policy implementation in real-world contexts. I argue that this failu...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1177/1355819618779614
更新日期：2018-10-01 00:00:00
abstract：BACKGROUND AND PURPOSE:The assessment of any health care intervention should consider both risks and benefits and take patients' preferences about these into account. The study reported in this paper aimed to elicit patient valuations of health states relevant to assessment of the prevention of stroke by warfarin antic...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/1355819011927288
更新日期：2001-04-01 00:00:00
abstract：:Evidence-based medicine (EBM) and evidence-based decision-making (EBDM) were intended to revolutionize health care and health policy. Thus far they have not. A great deal of research has demonstrated the persistent ubiquity of error in health care, wide and unjustifiable variations in practice and the minimal impact o...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/135581907781543094
更新日期：2007-07-01 00:00:00
abstract：:The purpose of this paper is to expand understanding of academic-practitioner knowledge-sharing in the service of enhanced knowledge creation in health care. To this end, we describe the tacit and explicit knowledge of academics and practitioners and how this knowledge exists within their communities of practice. We a...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/135581903322405199
更新日期：2003-10-01 00:00:00
abstract：OBJECTIVES:To test the effects of adding text messages to weekly email communications on recipients' total physical activity (leisure-time; workplace; domestic and garden; and active transportation) in employees of universities and colleges in the UK. METHODS:A randomised trial with two study groups (email only or ema...
journal_title：Journal of health services research & policy
pub_type： 杂志文章,随机对照试验
doi：10.1177/1355819613478001
更新日期：2013-04-01 00:00:00
abstract：:The economic evaluation of health care technologies has a key role within the new National Health Service health technology assessment process. There has, however, been little discussion of the best way of combining economic and clinical research. Economic evaluation should be iterative, generating progressively firme...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1177/135581969700200107
更新日期：1997-01-01 00:00:00
abstract：OBJECTIVES:To estimate the costs and potential efficiency gains of changing the frequency of clinic appointments and drug dispensing arrangements for stable HIV patients compared to the costs of hospital pharmacy dispensing and home delivery. METHODS:We estimated the annual costs per patient (HIV clinic visits and eit...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1177/1355819613508176
更新日期：2014-07-01 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：:Though the science of medicine subscribes to learning from best practices and the transmission of superior treatment regimens across national boundaries, the same ethos does not inform political debates surrounding health system reform. The Canadian and English health systems have been used - and, more frequently - ab...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/jhsrp.2010.010141
更新日期：2011-07-01 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：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：OBJECTIVES:Successful partnership working has theoretically been linked to improvements in service delivery and is dependent on the strength of the partnership, trust, communication, professional roles and resource sharing. Empirical evidence to confirm the relationships between these factors and improved service provi...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1177/1355819612473584
更新日期：2013-07-01 00:00:00
abstract：:Research can contribute to resolving some of the workforce challenges that all heath care systems face. In an attempt to identify the research agenda, key stakeholders in the UK were brought together and background papers were presented by academics with expertise in seven related but distinct areas: global issues; pr...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/135581904322724158
更新日期：2004-01-01 00:00:00
abstract：OBJECTIVES:To investigate the organisational factors that impede or facilitate transition of young people from child and adolescent (CAMHS) to adult mental health services (AMHS). METHODS:Thirty-four semi-structured interviews were conducted with health and social care professionals working in child and adult services...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1177/1355819614527439
更新日期：2014-07-01 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：: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：OBJECTIVES:To demonstrate the benefits of applying meta ethnography to the synthesis of qualitative research, by means of a worked example. METHODS:Four papers about lay meanings of medicines were arbitrarily chosen. Noblit and Hare's seven-step process for conducting a meta ethnography was employed: getting started; ...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/135581902320432732
更新日期：2002-10-01 00:00:00
abstract：OBJECTIVES:In developed countries, community pharmacists are increasingly involved in clinical care. This study aimed to explore the acceptability to users of pharmaceutical care (drug therapy monitoring and management) provided in Portuguese community pharmacies, thereby informing future practice, policy and research....
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/jhsrp.2010.009121
更新日期：2010-10-01 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：:This article raises the concern that biobanks are failing to realize the expected research and health service outcomes. Rather than biobanking, we have been engaging in 'biohoarding', where building a quantifiable collection of tissue samples is the primary basis of the bio-resource. The root cause of 'biohoarding' is...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1177/1355819615599014
更新日期：2016-04-01 00:00:00
abstract：OBJECTIVE:The effects of demographic, locational and socio-economic disadvantage, and the influence of private health care on five-year mortality rates in patients with lung cancer or after breast cancer surgery in Western Australia were examined. METHODS:The Western Australian Record Linkage Project was used to extra...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/1355819042248116
更新日期：2004-10-01 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：OBJECTIVE:To explore some of the impacts of star performance ratings in acute hospital trusts in England. METHODS:A multiple case study design was used which incorporated purposeful sampling of 'low' and 'high' performing trusts using the star rating system. In each case study site, data collection comprised semi-stru...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1177/135581960501000106
更新日期：2005-01-01 00:00:00
abstract：OBJECTIVES:To assess whether it is feasible to elicit patients' preferences for treatments and then to proceed with randomisation which may allocate those with preferences to their less preferred treatment; and to describe which prognostic variables were associated with such preferences within the context of a randomis...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1177/135581969600100403
更新日期：1996-10-01 00:00:00
abstract：OBJECTIVE:Poor people receive shorter consultations in general practice than more affluent people. Our aim was to study the two reasons generally advanced for this for patients consulting with mental health problems: people of low socioeconomic status (SES) demand shorter consultations or they tend to match with practi...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/jhsrp.2009.009034
更新日期：2010-04-01 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：:Almost everything you know about heroin addiction is wrong. Not only is it wrong, but it is obviously wrong. Heroin is not highly addictive; withdrawal from it is not medically serious; addicts do not become criminals to feed their habit; addicts do not need any medical assistance to stop taking heroin; and contrary t...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/jhsrp.2008.008022
更新日期：2008-04-01 00:00:00
abstract：AIMS:To evaluate the extent to which structural variation between English general practices is accounted for at higher organisational levels in the National Health Service (NHS). METHODS:We analysed data for 11 structural characteristics of all general practices in England. These included characteristics of general pr...
journal_title：Journal of health services research & policy
pub_type： 杂志文章
doi：10.1258/135581903321466058
更新日期：2003-04-01 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
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
