Improving patient services by alternative prescribing: experience with radioiodine treatment.

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) certification. Hence referral must be made to an oncologist. We tried to reduce the time to treatment by acquiring an appropriate licence for an endocrinologist and hence eliminating need for further referral. METHODS:An observational study of 414 doses of (131)I administered to 353 patients for benign thyroid disorders at a district general hospital by either endocrinologist or oncologist. After decision to treat had been made, the time taken for treatment to be given was compared between the groups. RESULTS:An endocrinologist licensed to prescribe (131)I reduced the time taken from referral to administration of (131)I from 28 to 12 days (P<0.001) compared with oncologists. A further group seen by another endocrinologist and then referred to the licensed endocrinologist also had their delay reduced to 19 days. Treatment was administered within three weeks in 88% of treatments by the endocrinologist, 62% by the non-licensed endocrinologist and only 28% by oncologists. CONCLUSIONS:Improving treatment times for patients were achieved at no extra cost and indeed freed up time for oncologists. Encouraging alternative means of delivering services can result in not only better services but also in cost savings. As certification is simple, endocrinologists should be encouraged to deliver (131)I themselves rather than devolving care to other practitioners.

authors

Singh R,Aitken M

doi

10.1258/135581907782101534

subject

Has Abstract

pub_date

2007-10-01 00:00:00

pages

202-4

issue

4

eissn

1355-8196

issn

1758-1060

journal_volume

12

pub_type

杂志文章
  • Variations in the persistence of health expenditures and the implications for the design of capitation payments in Taiwan.

    abstract:OBJECTIVES:The National Health Insurance (NHI) system in Taiwan launched a trial capitation provider payment programme in 2011, with the capitation formula based on patients' average NHI expenditure in the previous year. This study seeks to examine the concentration and persistence of health care expenditure among the ...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章

    doi:10.1177/1355819615577711

    authors: Ku LJ,Chiou MJ,Liu LF

    更新日期:2015-07-01 00:00:00

  • Pay in the British NHS: a local solution for a national service?

    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

    authors: Gray A,Buchan J

    更新日期:1998-04-01 00:00:00

  • Toward a general theory of indifference to research-based evidence.

    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

    authors: Lewis S

    更新日期:2007-07-01 00:00:00

  • The new frontier in health services research: a behavioural paradigm guided by genetics.

    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

    authors: Fluegge K

    更新日期:2017-01-01 00:00:00

  • Learning to lead: a review and synthesis of literature examining health care managers' use of knowledge.

    abstract:BACKGROUND:Scholarship cites health care managers (HCMs) as not using research evidence in their management practice. The purpose of this review was to evaluate the effectiveness of interventions to enhance HCMs use of research evidence in practice. METHODS:We carried out a systematic review and focus groups to valida...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章,评审

    doi:10.1177/1355819618786764

    authors: Tate K,Hewko S,McLane P,Baxter P,Perry K,Armijo-Olivo S,Estabrooks C,Gordon D,Cummings G

    更新日期:2019-01-01 00:00:00

  • Ethnicity, socioeconomic deprivation and consultation rates in New Zealand general practice.

    abstract:OBJECTIVES:To explore the relationship between ethnicity, socioeconomic deprivation and utilization of general practice. METHODS:Data routinely collected by New Zealand general practices in 2001 were analysed using generalized linear regression. RESULTS:The mean number of doctor consultations for registered individua...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章

    doi:10.1258/135581906777641721

    authors: Health Utilisation Research Alliance (HURA).

    更新日期:2006-07-01 00:00:00

  • Challenges and opportunities associated with the introduction of assistant practitioners supporting the work of registered nurses in NHS acute hospital trusts in England.

    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

    authors: Spilsbury K,Adamson J,Atkin K,Bloor K,Carr-Hill R,McCaughan D,McKenna H,Wakefield A

    更新日期:2011-04-01 00:00:00

  • Why we need to move beyond diagnosis-related groups and how we might do so.

    abstract::Diagnosis-related groups are widespread across Europe and they are meant to be a central instrument to improve the activity and efficiency of hospitals. However, there are many examples of diagnosis-related groups having adverse effects which are difficult to control and which endanger the goals of health care systems...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章

    doi:10.1177/1355819615586444

    authors: Sørensen ML,Burau V

    更新日期:2016-01-01 00:00:00

  • Presentational approaches used in the UK for reporting evidence synthesis using indirect and mixed treatment comparisons.

    abstract:OBJECTIVES:To establish current guidance and practice in UK on presentation of indirect comparison and mixed treatment comparison analyses; to provide recommendations to improve indirect comparison/mixed treatment comparison reporting and to identify research priorities for improved presentation. METHODS:Existing inst...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章

    doi:10.1177/1355819613498379

    authors: Tan SH,Bujkiewicz S,Sutton A,Dequen P,Cooper N

    更新日期:2013-10-01 00:00:00

  • Investigating Choice Experiments for Preferences of Older People (ICEPOP): evaluative spaces in health economics.

    abstract::This paper deals with three concerns about the evaluative framework that is currently dominant within health economics. These concerns are: that the evaluative framework is concerned entirely with health; that the evaluative framework has an individualistic focus on patients alone; and that the methods used to estimat...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章

    doi:10.1258/jhsrp.2008.008024

    authors: Coast J,Flynn T,Sutton E,Al-Janabi H,Vosper J,Lavender S,Louviere J,Peters T

    更新日期:2008-10-01 00:00:00

  • Roughly right or precisely wrong? Systematic review of quality-of-life weights elicited with the time trade-off method.

    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

    authors: Arnesen T,Trommald M

    更新日期:2004-01-01 00:00:00

  • Large-scale organizational and managerial change in health care: a review of the literature.

    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

    authors: Ferlie E

    更新日期:1997-07-01 00:00:00

  • Patient choice in general practice: the implications of patient satisfaction surveys.

    abstract:OBJECTIVES:To identify factors that explain patient satisfaction with general practice physicians and hence that may drive patients' choice of practice. METHODS:Logistic regression analysis of English National Health Service national patient survey data is used to identify the aspects of general practice care that are...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章

    doi:10.1258/jhsrp.2007.007055

    authors: Robertson R,Dixon A,Le Grand J

    更新日期:2008-04-01 00:00:00

  • Values underlying the National Service Framework for coronary heart disease in England: a discourse analysis.

    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

    authors: Rayner M,Scarborough P,Allender S

    更新日期:2006-04-01 00:00:00

  • An economic evaluation comparing two schedules of antenatal visits.

    abstract:OBJECTIVES:To conduct an economic evaluation comparing a traditional antenatal visiting schedule (traditional care) with a reduced schedule of visits (new style care) for women at low risk of complications. METHODS:Economic evaluation using the results of a randomised controlled trial, the Antenatal Care Project. This...

    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:10.1177/135581960000500203

    authors: Henderson J,Roberts T,Sikorski J,Wilson J,Clement S

    更新日期:2000-04-01 00:00:00

  • Collectivising the Kulaks? General practitioners and primary care groups in England.

    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

    authors: Clegg K

    更新日期:2000-07-01 00:00:00

  • Using pharmacy data to identify those with chronic conditions in Emilia Romagna, Italy.

    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

    authors: Maio V,Yuen E,Rabinowitz C,Louis D,Jimbo M,Donatini A,Mall S,Taroni F

    更新日期:2005-10-01 00:00:00

  • Case mix measurement in English hospitals: an evaluation of five methods for predicting resource use.

    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

    authors: Söderlund N,Gray A,Milne R,Raftery J

    更新日期:1996-01-01 00:00:00

  • Using economics to prioritize research: a case study of randomized trials for the prevention of hip fractures due to osteoporosis.

    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...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章

    doi:10.1177/135581969600100305

    authors: Torgerson D,Donaldson C,Reid D

    更新日期:1996-07-01 00:00:00

  • Integrated care: theory to practice.

    abstract::'Integrated care' is pitched as the solution to current health system challenges. In the literature, what integrated care actually involves is complex and contested. Multi-disciplinary team case management is frequently the primary focus of integrated care when implemented internationally. We examine the practical app...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章

    doi:10.1177/1355819616660581

    authors: Stokes J,Checkland K,Kristensen SR

    更新日期:2016-10-01 00:00:00

  • The iterative use of economic evaluation as part of the process of health technology assessment.

    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

    authors: Sculpher M,Drummond M,Buxton M

    更新日期:1997-01-01 00:00:00

  • Treatment for stable HIV patients in England: can we increase efficiency and improve patient care?

    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

    authors: Adams E,Ogden D,Ehrlich A,Hay P

    更新日期:2014-07-01 00:00:00

  • Improving referrals for glue ear from primary care: are multiple interventions better than one alone?

    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

    authors: Bennett K,Haggard M,Churchill R,Wood S

    更新日期:2001-07-01 00:00:00

  • CLAHRCs in practice: combined knowledge transfer and exchange strategies, cultural change, and experimentation.

    abstract:OBJECTIVES:The nine NIHR CLAHRCs are collaborations between universities and local NHS organizations that seek to improve patient outcomes through the conduct and application of applied health research. The theoretical and practical context within which the CLAHRCs were set up was characterized by a considerable degree...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章

    doi:10.1177/1355819613499903

    authors: Soper B,Yaqub O,Hinrichs S,Marjanovich S,Drabble S,Hanney S,Nolte E

    更新日期:2013-10-01 00:00:00

  • In praise of chiropractic.

    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

    authors: Breen A

    更新日期:2009-07-01 00:00:00

  • Effect of physicians' gender on communication and consultation length: a systematic review and meta-analysis.

    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

    authors: Jefferson L,Bloor K,Birks Y,Hewitt C,Bland M

    更新日期:2013-10-01 00:00:00

  • Do managers pay their way? The impact of management input on hospital productivity in the NHS internal market.

    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

    authors: Söderlund N

    更新日期:1999-01-01 00:00:00

  • Evaluation of explicit prioritisation for elective surgery: a prospective study.

    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

    authors: Derrett S,Paul C,Herbison P,Williams H

    更新日期:2002-07-01 00:00:00

  • Partnership working and improved service delivery: views of staff providing sexual health services.

    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

    authors: Pow J,Elliott L,Raeside R,Themessl-Huber M,Claveirole A

    更新日期:2013-07-01 00:00:00

  • Integrating mental health services through reimbursement reform and managed mental health care.

    abstract::People with serious and persistent mental illness require a range of community services typically provided by different specialized agencies. At the clinical level, assertive team case management is the strategy commonly used to achieve integration of services across specialized sectors. The USA also has used various ...

    journal_title:Journal of health services research & policy

    pub_type: 杂志文章

    doi:10.1177/135581969700200206

    authors: Mechanic D

    更新日期:1997-04-01 00:00:00