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Mike Pringle

Publications and source records attributed to Mike Pringle.

23 records · Page 2Linked to original sources
PubMed2002

Quality of care indicators for population-based primary care in New Zealand.

AIM: To develop a set of non-invasive, evidence-based, population-based quality of care indicators for primary care in New Zealand and to test their feasibility. METHODS: New Zealand, British and Australian publications were reviewed and a set of quality of care indicators was constructed. These were trialed on data collected from seventeen fully computerised practices from the FirstHealth network of general practices. RESULTS: 28 indicators are proposed in five categories: smoking cessation, preventive health activities, prescribing quality, chronic disease management and data quality. We were able to calculate ten indicators from data already collected routinely, a further twelve could be calculated now with more sophisticated data queries and six would require the trial practices to collect further data. CONCLUSIONS: While any set of indicators is arbitrary there are sufficient research data to support a set of evidence-based, population-focused, quality of care indicators in New Zealand primary health care. In computerised practices these indicators can be calculated from routinely collected data.

Chronic Disease↗
PubMed2002

A comparison of research general practices and their patients with other practices--a cross-sectional survey in Trent.

BACKGROUND: When interpreting results of studies undertaken by research networks we need to know how representative volunteer practices and their registered patients are of the total population of practices and patients in their locality. AIM: To compare the following in research and non-research general practices in one region: practice and population demography, morbidity and mortality, selected performance indicators, and health outcomes. DESIGN OF STUDY: Cross-sectional survey. SETTING: Sixty-six Trent Focus Collaborative Research Network general practices and 749 other general practices in Trent, United Kingdom. METHOD: Practice characteristics and GP contract data were obtained from the NHS Executive, Quarry House, Leeds. The Trent Regional NHS Hospital Admission Database was searched to identify all relevant admissions to hospital from all practices between 1 April 1993 and 31 March 1997. Ward-linked data on cancer were obtained from the Trent Cancer Registry. RESULTS: Of the 815 general practices in Trent Region in the study period, 66 (8%) were in the Trent Focus network. They were more likely to be involved in training GPs and to have a female partner. They tended to be larger, with fewer single-handed doctors and younger GPs. Network practices prescribed a higher proportion of generics (median % prescribed/practice = 70%, versus 51%, Mann-Whitney U = 1615, P<0.0001). There were no clinically important differences between hospital admission rates between the two groups or waiting times for surgical procedures. There was no difference in the incidence of cancer and standardised mortality ratios related to the electoral wards of the GP surgery. CONCLUSION: Although there were differences in practice structure and some aspects of performance, we found no important differences in the demography of registered patients, nor in morbidity, mortality, or access to or use of secondary care.

Cross-Sectional Studies↗
PubMedDate not supplied

Teenagers at risk of unintended pregnancy: identification of practical risk markers for use in general practice from a retrospective analysis of case records in the United Kingdom.

The United Kingdom has one of the highest teenage pregnancy rates in Western Europe with a high proportion of unintended pregnancies resulting in termination. General practice is one source of contraceptive and sexual advice for teenagers but it is difficult to target young women most at risk. This study was performed to determine whether it was possible to identify any markers that could alert general practitioners to the need to give appropriate opportunistic preventive advice. This was a retrospective case-control study in which the general practice medical records of young women with a recorded history of termination of pregnancy resulting from conception between the ages of 13-19 years inclusive were examined for details of consultations and contraceptive provision prior to conception. Where appropriate, comparison was made with an age and practice-matched control group. A total of 53 cases were identified and compared with 159 controls. In the 12 months prior to conception approximately half of the cases had discussed contraception and two-fifths had been prescribed oral contraception. A significantly higher proportion of cases than controls had consulted for emergency contraception and also for urinary tract symptoms. Weaker associations were also found with younger age of starting contraception, and also recorded side-effects or dissatisfaction with contraception. Lapsed contraception and previous pregnancy were noted as other potential markers of risk. The findings from this study may assist primary care professionals in focussing opportunistic sexual health interventions at some teenagers who are at higher risk of unintended pregnancy.

Abortion, Induced↗
PubMedDate not supplied

Assisted delivery in the teenage population: the effect of inter-hospital variation, deprivation, and age.

UNLABELLED: The objective was to determine the relationship between the risk of assisted delivery in women aged under 20 years and place of treatment, deprivation and age. DESIGN: Cross sectional survey utilising routinely collected hospitals admissions data. POPULATION: Teenagers (women aged under 20 years) whose delivery resulted in a hospital admission in the period April 1st 1994 to March 31st 1997 in the Trent Health Region of England. METHODS: The cases were identified using Office of Population Census and Surveys procedural codes, and International Classification of Diseases diagnostic codes associated with delivery. Variables collected included type of delivery, age at delivery and place of treatment. The data were analysed using the chi-square test for categorical data and the independent samples t-test for continuous data. Logistic regression analysis was used to calculate adjusted odds ratios for the variables of type of assisted delivery and place of treatment. MAIN OUTCOME MEASURES: Factors associated with increased risk of assisted delivery. RESULTS: There was variation in rates of instrumental delivery between hospitals, with two having a significantly increased risk of assisted delivery, suggesting that place of treatment may be a factor in the risk of teenage patients experiencing an assisted delivery. There was also a large amount of variation in terms of the risk of experiencing a forceps or vacuum extraction compared to caesarean section. Age (under 16 years and 16-19 years of age) had no effect on the risk of a teenage patient experiencing an assisted delivery (X2 = 2.59 df = 1 P = 0.11 OR 1.27 (95% CI 0.94 to 1.72)). Similarly, teenagers who experience an assisted delivery were not more likely to come from a more deprived area than teenagers who did not have an assisted delivery (P = 0.189). CONCLUSIONS: The risk of assisted delivery varied between hospitals, suggesting that this factor is important in terms of a young women's risk of an assisted delivery. The young women in this study who had experienced an assisted delivery were not significantly different to young women who had a normal delivery. They were not more likely to be aged under 16 years of age, and were not more likely to be from a more deprived area.

Adolescent↗