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Biomedical subjects

D P Forster

Publications and source records attributed to D P Forster.

51 records · Page 3Linked to original sources
PubMed1982

Psychiatric units in district general hospitals and traditional mental hospitals: some recent evidence.

Using routine data from the Mental Health Enquiry, the work of two district general hospital (DGH) units and a mental hospital was examined. There was a marked difference in the way the two DGH units operated and between the way the mental hospital worked as support hospital or as independent complete in-patient service. The operational policy practised by psychiatrists is more important than the structure of the system. It is important to establish sensitive policies for a wide variety of organizational structures.

Adult↗
PubMed1981

Health and education expenditure in the United Kingdom: what priority?

Public expenditure on goods and services per head of population on the National Health Service (NHS) in the United Kingdom has risen less rapidly than some other forms of public expenditure such as education. Revenue expenditure at 1970 market prices on goods and services in the NHS per head of population rose by 38% during the period 1951 to 1968. During the same time interval, expenditure at 1970 market prices on goods and services in education per head of population rose by 84%. Health, as measured by standardised mortality ratios (SMRs), improved over a similar period. This paper argues that, in the long term, the priority given to education expenditure may not necessarily be detrimental to further improvements in community health.

Cost-Benefit Analysis↗
PubMed1980

The prospects for "preventing" Down's syndrome in an English region.

In the Trent Region, changes in the number and maternal age of livebirths have had a marked effect on the estimated number of Down's births. These changes mean that, if pre-natal screening had been available in 1963, one half of all Down's syndrome livebirths could have been detected by screening all mothers in the age group 35 years and above. Currently, however only about a quarter of livebirths with Down's syndrome is potentially detectable by screening this same age group. Using projections for future years, it seems likely that about 28 to 33% of Down's syndrome livebirths will be potentially detectable by screening mothers aged 35+. The prospects for "preventing" Down's syndrome suggested by demographic data alone also have to be considered in the light of the accuracy and safety of the tests, the service offered, acceptance of the procedure, cost-benefit analysis and ethical issues.

Abortion, Therapeutic↗
PubMed1977

Mortality, morbidity, and resource allocation.

The correlation between age and sex standardised mortality-rates, and morbidity-rates from the General Household Survey (G.H.S.) similarly standarised, were examined for the 10 standard statistical regions for 1972 and 1973 combined. The correlations between mortality and acute sickness and between mortality and bed sickness were not significant. A significant correlation was found between mortality and chronic sickness, but not between mortality and work or school absence due to illness or injury in males. It is concluded that, on present evidence, there is some doubt whether mortality can be considered to be a valid indicator of morbidity in a population. Serious consideration should therefore be given to the removal of standarised mortality ratios (S.M.R.S.) from the formula for the distribution of revenue as recommended by the Resource Allocation Working Party (RAWP).

Absenteeism↗
PubMed1977

The ante-natal detection of Down's syndrome: some demographic aspects.

The numbers of Down's syndrome live births in the area covered by the Sheffield Regional Hospital Board (Trent Regional Health Authority) were estimated using age specific incidence data from a recent detailed Swedish study. The estimated number and proportion of Down's syndrome live births, which could have been detected by prenatal screening of elderly mothers at high risk, fell substantially in recent years. In the maternal age group forty to forty-four the estimated number of Down's syndrome livebirths decreased from thirty-three (24.6 per cent) in 1963 to thirteen (15.7 per cent) in 1973. Over the same period there was a fall in estimated numbers in the thirty-five to thirty-nine age group from twenty-seven (20.2 per cent) to twelve (14.5 per cent). This trend has been due predominantly to a rapid decline in the fertility rates of women aged thirty-five and over. However, projections based on the best available evidence suggest that about 11.4 per cent to 13.8 per cent of all Down's livebirths up to 1991 could be detected by screening all pregnancies in the forty to forty-four age group. A further 11.7 per cent to 14.4 per cent of Down's livebirths could be detected by screening pregnancies in the thirty-five to thirty-nine age group.

Abortion, Induced↗
PubMedDate not supplied

Monitoring regional performance in general hospital psychiatry: England, Wales and Czechoslovakia.

The purpose of this article is to consider how the regional performance of general hospital psychiatry may be adequately monitored using routine information. Limitations on the types of information available for monitoring regional performance are discussed, in the context of the main functions which a routine information service may be expected to fulfill. English and Welsh routine data are used in a study of the utilisation of general hospital psychiatric beds, and then compared with similar data for Czechoslovakia. The findings suggest that regional equity in the provision of beds: as measured by the coefficient of variation of the bed supply rate, and national performance, as measured by the 'marginal throughput' of these beds; is superior in Czechoslovakia despite recent additions to such beds in England and Wales. The model of utilisation, which was used to assess national performance, may be used to identify the regions whose performance is substandard when compared to other regions or countries. Finally, the relevance of these proposals for monitoring Health Service performance generally is discussed.

Czechoslovakia↗
PubMedDate not supplied

Routine information systems in psychiatry.

Studies using data from routine psychiatric information systems must be interpreted in the light of the biases that can arise from their use. Data on utilisation of services is most commonly available but subject to the influence of enabling factors. Direct measures of quality are usually missing from routine systems. The results of a study of equity, performance and the influence of resource supply in general hospital psychiatry are summarised.

England↗