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J S Horner

Publications and source records attributed to J S Horner.

6 recordsLinked to original sources

Medical ethics and the public health.

The development of preventive medicine is reviewed from an historical perspective. In its third and current stage of development preventive medicine has become involved in the life cycle of individual diseases and this presents a number of ethical difficulties for doctors and not least those concerned with the public health. Some proposed responses are considered and rejected. It is concluded that participants should be given more detailed information about screening tests and that doctors are under an ethical obligation to consider with the utmost care any contra-indications to a particular vaccination or a screening procedure in an individual patient. Serious reservations are expressed about the ethics and scientific justification of some government preventive medicine programmes currently in operation or projected.

Ethics, Medical

Length of stay in general medical beds; implications for the NHS White Paper of variance within one performance indicator.

Data over several years have shown that the average length of stay in general medical beds in the Royal Preston Hospital is approximately 20 per cent above regional average. To investigate this we carried out a prospective study of 259 successive medical admissions to the hospital. We also carried out a retrospective study of routine data from the Korner episode system (KES) for the specialties of general medicine and geriatrics, using standardization techniques. After correcting for age and diagnostic group, the average length of stay in the hospital was close to the regional average. It is concluded that difference between districts in respect of age and diagnostic group can cause substantial difference in average length of stay. Future contracts between purchasing and providing health service authorities will need to take such difference into account if valid comparisons are to be made between two or more apparently similar alternatives.

Adult

Why me?

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Attitude of Health Personnel