Abstract:
OBJECTIVE:To cost the relation between socioeconomic status and various measures of primary care workload and assess the adequacy of current "deprivation" payments in relation to actual costings for patients living in qualifying areas. DESIGN:Retrospective data on primary care were collected over a 4.5 year period from both computerised and manually filed records. Standardised data on socioeconomic status were obtained by postal questionnaire. SETTING:Inner city group practice with a socioeconomically diverse population. SUBJECTS:382 male and female subjects of all ages, with a total of 1296 person years of observation. MAIN OUTCOME MEASURES:Primary care costs resulting from consultations with a general practitioner or a practice nurse and both new and repeat prescriptions. RESULTS:Morbidity, workload, and costs of drug treatment increased with decreasing socioeconomic status. The difference in cost for patients in social classes IV and V combined compared with those in I and II combined was about 150 Pounds per person year at risk (47 Pounds for workload and 103 Pounds for drugs). Deprivation payments met only half the extra workload cost for patients from qualifying wards. CONCLUSIONS:The greater workload caused by social disadvantage has been previously underestimated by simple consultation rates. The absolute difference in costs for socially disadvantaged patients increase as more detailed measures of workload and drug treatment are included. Current deprivation payments only partially offset the increased expenditure on workload. This shortfall will have to be addressed to attract general practitioners to, or retain them in, deprived areas.
journal_name
BMJjournal_title
BMJ (Clinical research ed.)authors
Worrall A,Rea JN,Ben-Shlomo Ydoi
10.1136/bmj.314.7073.38subject
Has Abstractpub_date
1997-01-04 00:00:00pages
38-42issue
7073eissn
0959-8138issn
1756-1833journal_volume
314pub_type
杂志文章abstract:OBJECTIVE:To assess the effect on time to diagnosis of recurrence and on quality of life of transferring primary responsibility for follow up of women with breast cancer in remission from hospital to general practice. DESIGN:Randomised controlled trial with 18 month follow up in which women received routine follow up ...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.313.7058.665
更新日期:1996-09-14 00:00:00
abstract:OBJECTIVE:To assess the effectiveness of health checks by nurses in reducing risk factors for cardiovascular disease in patients from general practice. DESIGN:Randomised controlled trial. SETTING:Five urban general practices in Bedfordshire. SUBJECTS:2136 patients receiving an initial health check in 1989-91 and sch...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1994-01-29 00:00:00
abstract:OBJECTIVE:To compare effectiveness and acceptability of early discharge to a hospital at home scheme with that of routine discharge from acute hospital. DESIGN:Pragmatic randomised controlled trial. SETTING:Acute hospital wards and community in north of Bristol, with a catchment population of about 224 000 people. S...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.316.7147.1796
更新日期:1998-06-13 00:00:00
abstract:OBJECTIVE:To study the impact of skin surgery in general practice on the workload of a pathology laboratory and to identify what further training might be helpful. DESIGN:Analysis of skin biopsy specimens from general practitioners before and after their new contract to determine numbers of specimens, changes in diagn...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6819.93
更新日期:1992-01-11 00:00:00
abstract:OBJECTIVES:To determine the prevalence of drug and alcohol use among newly remanded prisoners, assess the effectiveness of prison reception screening, and examine the clinical management of substance misusers among remand prisoners. DESIGN:A consecutive case study of remand prisoners screened at reception for substanc...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.315.7099.18
更新日期:1997-07-05 00:00:00
abstract:OBJECTIVES:To investigate the claim that 90% of episodes of low back pain that present to general practice have resolved within one month. DESIGN:Prospective study of all adults consulting in general practice because of low back pain over 12 months with follow up at 1 week, 3 months, and 12 months after consultation. ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.316.7141.1356
更新日期:1998-05-02 00:00:00
abstract:OBJECTIVE:To determine whether rates of suicide changed in Toronto after a barrier was erected at Bloor Street Viaduct, the bridge with the world's second highest annual rate of suicide by jumping after Golden Gate Bridge in San Francisco. DESIGN:Natural experiment. SETTING:City of Toronto and province of Ontario, Ca...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.c2884
更新日期:2010-07-06 00:00:00
abstract:OBJECTIVE:To examine changes in immunisation performance in Grampian region after the introduction of the 1990 contract for general practitioners. DESIGN:Retrospective descriptive study using data held on the Grampian immunisation record system's computer. SETTING:All 95 general practices in Grampian region (313 gene...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.304.6830.816
更新日期:1992-03-28 00:00:00
abstract::Robots designed for surgery have three main advantages over humans. They have greater three dimensional spatial accuracy, are more reliable, and can achieve much greater precision. Although few surgical robots are yet in clinical trials one or two have advanced to the stage of seeking approval from the UK's Medical De...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.311.7018.1479
更新日期:1995-12-02 00:00:00
abstract:OBJECTIVE:To investigate the long term effectiveness of integrated disease management delivered in primary care on quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with usual care. DESIGN:24 month, multicentre, pragmatic cluster randomised controlled trial SETTING:40 general prac...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.g5392
更新日期:2014-09-10 00:00:00
abstract:OBJECTIVES:To determine whether measurement of total cholesterol concentration is sufficient to identify most patients at lipoprotein mediated risk of coronary heart disease without measurement of triglyceride and high density lipoprotein (HDL) cholesterol concentrations. DESIGN:Cross sectional screening programme. S...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.301.6752.584
更新日期:1990-09-22 00:00:00
abstract:OBJECTIVE:To investigate associations between Apgar scores of 7, 8, and 9 (versus 10) at 1, 5, and 10 minutes, and neonatal mortality and morbidity. DESIGN:Population based cohort study. SETTING:Sweden. PARTICIPANTS:1 551 436 non-malformed live singleton infants, born at term (≥37 weeks' gestation) between 1999 and ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.l1656
更新日期:2019-05-07 00:00:00
abstract:OBJECTIVES:To examine the association of plasma caffeine concentrations during pregnancy with fetal growth and to compare this with relations with reported caffeine intake. DESIGN:Prospective population based study. SETTING:District general hospital, inner London. SUBJECTS:Women booking for delivery between 1982 and...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.313.7069.1358
更新日期:1996-11-30 00:00:00
abstract:OBJECTIVE:To confirm the findings of pilot studies that interferon alfa is an effective treatment of Europid men with chronic hepatitis B virus infection. DESIGN:Randomised controlled trial of three months treatment with interferon alfa followed by 12 months of observation. SETTING:Outpatient clinic of a tertiary ref...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1136/bmj.299.6700.652
更新日期:1989-09-09 00:00:00
abstract:OBJECTIVE:To describe and quantify the patients and clinical activities of independent short stay hospitals. DESIGN:Retrospective survey of hospital records for sampled periods of one financial year and comparison with data from 1981 to 1986. SETTING:217 independent hospitals in England and Wales, 1992-3. MAIN OUTCO...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.308.6945.1699
更新日期:1994-06-25 00:00:00
abstract:OBJECTIVES:To explore general practitioners' reasons for recent changes in their prescribing behaviour. DESIGN:Qualitative analysis of semistructured interviews. SETTING:General practice in south east London. SUBJECTS:A heterogeneous sample of 18 general practitioners. RESULTS:Interviewees were able to identify bet...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7036.949
更新日期:1996-04-13 00:00:00
abstract:OBJECTIVE:To prepare and assess the sensitivity and specificity of a latex agglutination test specific for the serotype of antigen in diagnosing pneumococcal pneumonia in Gambian children. DESIGN:Comparison of agglutination test specific for serotype with culture of blood and lung aspirates, countercurrent immunoelect...
journal_title:BMJ (Clinical research ed.)
pub_type: 临床试验,杂志文章
doi:10.1136/bmj.298.6680.1061
更新日期:1989-04-22 00:00:00
abstract:OBJECTIVE:To systematically review the accuracy of physicians' clinical predictions of survival in terminally ill cancer patients. DATA SOURCES:Cochrane Library, Medline (1996-2000), Embase, Current Contents, and Cancerlit databases as well as hand searching. STUDY SELECTION:Studies were included if a physician's tem...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,meta分析,评审
doi:10.1136/bmj.327.7408.195
更新日期:2003-07-26 00:00:00
abstract:OBJECTIVE:To characterise the functional morphology of the nasal microcirculation in humans in comparison with reindeer as a means of testing the hypothesis that the luminous red nose of Rudolph, one of the most well known reindeer pulling Santa Claus's sleigh, is due to the presence of a highly dense and rich nasal mi...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.e8311
更新日期:2012-12-14 00:00:00
abstract:OBJECTIVE:To describe the association between epithelial cell IgM, which has previously been associated with an increased incidence of loss of renal graft in children, with a novel cutaneous eruption and unexplained native renal disease. DESIGN:Observational study on children with epithelial cell antibody presenting w...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.303.6795.161
更新日期:1991-07-20 00:00:00
abstract:OBJECTIVE:Although the Polypill concept (proposed in 2003) is promising in terms of benefits for cardiovascular risk management, the potential costs and adverse effects are its main pitfalls. The objective of this study was to identify a tastier and safer alternative to the Polypill: the Polymeal. METHODS:Data on the ...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.329.7480.1447
更新日期:2004-12-18 00:00:00
abstract:OBJECTIVE:To compare the risk of detention under the Mental Health Act 1983 in a representative group of people with psychotic disorders from different ethnic groups. SETTING:Two defined geographical areas in south London. DESIGN:Annual period prevalent cases of psychosis were identified in 1993 in the study areas fr...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.312.7030.533
更新日期:1996-03-02 00:00:00
abstract:OBJECTIVE:To independently evaluate the impact of the second phase of the Health Foundation's Safer Patients Initiative (SPI2) on a range of patient safety measures. Design A controlled before and after design. Five substudies: survey of staff attitudes; review of case notes from high risk (respiratory) patients in med...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d199
更新日期:2011-02-03 00:00:00
abstract::The benefits to medical practitioners of using the Internet are growing rapidly as the Internet becomes easier to use and ever more biomedical resources become available on line. The Internet is the largest computer network in the world; it is also a virtual community, larger than many nation states, with its own rule...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,评审
doi:10.1136/bmj.311.7017.1422
更新日期:1995-11-25 00:00:00
abstract::Organs for donation are in short supply in the United Kingdom, resulting in allegations that relatives of potential donors are not being asked for consent. Legislation on "required request" has been proposed to overcome this. The incidence, causes, complications, and patterns of organ donation in brain stem dead patie...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.299.6706.1009
更新日期:1989-10-21 00:00:00
abstract:OBJECTIVES:To examine the reporting characteristics and methodological details of randomised trials indexed in PubMed in 2000 and 2006 and assess whether the quality of reporting has improved after publication of the Consolidated Standards of Reporting Trials (CONSORT) Statement in 2001. DESIGN:Comparison of two cross...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.c723
更新日期:2010-03-23 00:00:00
abstract:OBJECTIVES:To investigate whether the use of graduated compression stockings (GCS) offers any adjuvant benefit when pharmaco-thromboprophylaxis is used for venous thromboembolism prophylaxis in patients undergoing elective surgery. DESIGN:Open, multicentre, randomised, controlled, non-inferiority trial. SETTING:Seven...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1136/bmj.m1309
更新日期:2020-05-13 00:00:00
abstract::In July 1992 Dr Keith Mumby, a clinical ecologist, appeared before the professional conduct committee of the General Medical Council on five charges to do with his practice of clinical ecology. He was found guilty of two of the charges--touting for publicity and failing to give a patient adequate medical attention--an...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.306.6870.122
更新日期:1993-01-09 00:00:00
abstract::To assess the prevalence of both diagnosed and undiagnosed diabetes mellitus in an area of predominantly Asian population the Coventry diabetes study is carrying out house to house screening for diabetes in people aged 20 and over in Foleshill, Coventry. In the first five of 12 areas to be studied 2130 of 2283 Asian (...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.298.6665.18
更新日期:1989-01-07 00:00:00
abstract:OBJECTIVES:To estimate life expectancy for people with HIV undergoing treatment compared with life expectancy in the general population and to assess the impact on life expectancy of late treatment, defined as CD4 count <200 cells/mm(3) at start of antiretroviral therapy. DESIGN:Cohort study. SETTING:Outpatient HIV c...
journal_title:BMJ (Clinical research ed.)
pub_type: 杂志文章
doi:10.1136/bmj.d6016
更新日期:2011-10-11 00:00:00