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Biomedical subjects

L Chenet

Publications and source records attributed to L Chenet.

26 records · Page 2Linked to original sources
PubMed1996

Challenges of monitoring use of secondary care at local level: a study based in London, UK.

STUDY OBJECTIVE: To provide those working at district level with practical guidance on using hospital data linked to small geographic areas to explore patterns of care. DESIGN: Examination of the association between age standardised hospital episode rates for the commonest diagnostic categories and deprivation levels (Carstairs index) of the electoral ward of residence. SETTING: An inner London district, Kensington, Chelsea and Westminster, with a population of approximately 325,000. POPULATION: All finished consultant episodes recorded in NHS hospitals for the district population in the year to April 1994. MAIN RESULTS: Many, but not all, disease categories were associated strongly with deprivation, with high episode rates in the most deprived electoral wards. This is partly due to more of those in deprived areas being admitted to hospital and to them being admitted more often. CONCLUSIONS: A wide range of factors needs to be taken into account in interpreting these data. They include the contribution of the private sector and artifacts of both the numerator and denominator. This paper provides a framework for those working at district level to begin to analyse the association between hospitalisation and deprivation locally. It also identifies some of the issues that must be taken into account when seeking to interpret these data.

Episode of Care↗
PubMed1996

Changing life expectancy in the 1980s: why was Denmark different from Sweden?

OBJECTIVE: To identify the contribution from specific causes of death to the changes in life expectancy at birth in Denmark relative to Sweden in different age groups during the 1980s and to compare the difference in life expectancy between the two countries in 1990. DESIGN: Mortality data from WHO mortality tapes grouped in smaller series of clinically meaningful categories were used to calculate the contribution of each of these categories at each 10 year age group to the difference in life expectancy at birth in each country between 1979 and 1990 and between the two countries. SETTING: Denmark and Sweden. RESULTS: Between 1979 and 1990 life expectancy increased in both Denmark and Sweden. However, the increase in Sweden was more than two years while that in Denmark was less than one year. In both countries a decrease in cardiovascular disease mortality contributed most to the increase in life expectancy in males as well as females. In both sexes the smaller increase in life expectancy in Denmark was a result of differences in mortality trends in cardiovascular diseases and respiratory and non-respiratory cancers. CONCLUSION: Over a short time two Nordic countries experienced remarkable but different changes in mortality. These findings suggest that mortality rates are sensitive to even minor differences in social and cultural factors across countries and over short time periods.

Adolescent↗
PubMedDate not supplied

Health sector reform in the former Soviet Republics of Central Asia.

Health services in the former Soviet Republics of Central Asia face many challenges, not least a rising burden of disease and severe economic constraints. Each government has developed proposals for reform. This paper describes the key elements of the proposals developed in each country. They have many features in common, such as financing based on social insurance, although they also have many differences, reflecting national political, economic and historical circumstances. While most attention so far has concentrated on the design of the proposed systems, it is argued here that there has been inadequate attention to the obstacles to implementation. These stem from the many adverse factors in the context within which reforms are taking place, weaknesses in the process of reform, and failure to involve the groups whose actions will be necessary for success. It is argued that governments and those advising them must place greater emphasis on the challenges of implementation, including the development of a much better understanding of the context within which change must take place.

Asia, Central↗
PubMedDate not supplied

Down the road to deregulation.

A recent preliminary ruling by the European Court of Justice, that would have ended the Swedish state retail alcohol monopoly on grounds of European law on free movement of goods, highlights the international pressure on countries to deregulate further their alcohol markets. However, those countries that have recently taken the road to deregulation have not been able to prevent the alcohol industry encouraging people to drink more and they are experiencing increased alcohol-related problems. The international debates about tradeable commodities rarely take account of the consequences for public health. Alcohol is one such commodity that is also an important cause of premature death. It is essential that this is not overlooked in the race to promote free trade.

Alcohol Drinking↗