Knight of data. Interview by Alastair McLellan.
Explore the source record for details and available documents.
Hospitals, Public↗
Biomedical subjects
Brian Jarman
Publications and source records attributed to Brian Jarman.
Mortality rates. Dead confusing.
There is considerable disagreement over how hospital mortality rates should be measured. There are concerns that hospitals with a high number of geriatric beds and long-stay patients are bound to appear to do badly in terms of mortality rates. Analysis of death rates in English trusts shows mortality rates do vary for length of stay. After standardisation for age group and length of stay, the adjusted mortality rates show no bias against hospitals with more patients staying more than 28 days, or against hospitals with more geriatric beds.
Efficiency, Organizational↗
Effects of community based nurses specialising in Parkinson's disease on health outcome and costs: randomised controlled trial.
OBJECTIVE: To determine the effects of community based nurses specialising in Parkinson's disease on health outcomes and healthcare costs. DESIGN: Two year randomised controlled trial. SETTING: 438 general practices in nine randomly selected health authority areas of England. PARTICIPANTS: 1859 patients with Parkinson's disease identified by the participating general practices. MAIN OUTCOME MEASURES: Survival, stand-up test, dot in square test, bone fracture, global health question, PDQ-39, Euroqol, and healthcare costs. RESULTS: After two years 315 (17.3%) patients had died, although mortality did not differ between those who were attended by nurse specialists and those receiving standard care from their general practitioner (hazard ratio for nurse group v control group 0.91, 95% confidence interval 0.73 to 1.13). No significant differences were found between the two groups for the stand-up test (odds ratio 1.15, 0.93 to 1.42) and dot in square score (difference -0.7, -3.25 to 1.84). Scores on the global health question were significantly better in patients attended by nurse specialists than in controls (difference -0.23, -0.4 to -0.06), but no difference was observed in the results of the PDQ-39 or Euroqol questionnaires. Direct costs for patient health care increased by an average of 2658 pounds sterling during the study, although not differentially between groups: the average increase was 266 pounds sterling lower among patients attended by a nurse specialist (-981 pounds sterling to 449 pounds sterling ). CONCLUSIONS: Nurse specialists in Parkinson's disease had little effect on the clinical condition of patients, but they did improve their patients' sense of wellbeing, with no increase in patients' healthcare costs.
Adult↗