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Biomedical subjects

P Fenn

Publications and source records attributed to P Fenn.

5 recordsLinked to original sources
PubMed1991

The cost-effectiveness of thrombolytic therapy following acute myocardial infarction.

The increasing use of thrombolytic therapy following acute myocardial infarction has given rise to value for money questions. This study examines the cost-effectiveness of the thrombolytic agent anistreplase (Eminase). Using clinical trial data on the efficacy of anistreplase compared to placebo, and retrospectively obtained cost data from the National Health Service, the study estimates the cost per life-year saved of using this therapeutic agent. The results suggest that the cost-effectiveness of thrombolytic therapy compares favourably with that of other forms of coronary disease treatment. The study concludes that comparisons of the relative cost-effectiveness of different thrombolytic agents are an obvious next step, once full results from recent clinical trials are available.

Aged↗
PubMed1988

Medical malpractice claims in obstetrics and gynaecology: comparisons between the United States and Britain.

Obstetricians and gynaecologists have been particularly affected by the increase in the cost and number of medical malpractice claims in Britain. US obstetricians and gynaecologists have experienced a disproportionately higher rate of claim than other practitioners in that country. This article reviews the US experience of obstetrics and gynaecology malpractice claims and questions the validity of showing comparisons between the US and UK. However, even if British malpractice claims do not reach the level of American claims, the effects of claims on the National Health Service, recruitment to obstetrics and gynaecology, and clinical practice are significant.

Female↗
PubMed1987

Medical malpractice in perspective. II--The implications for Britain.

The "malpractice crisis" in the United States cannot be understood in isolation. Litigation is precipitated by features of the American health care and social security systems. Relative to the United Kingdom, there are fewer barriers of access to the courts, although the role of contingency fees has probably been exaggerated. Given the great institutional differences between the UK and the USA, the crisis seems unlikely to be replicated here unless there are further moves towards privatising both the costs of providing health care and the costs of its failures. It is concluded that a marginal change in the frequency or average cost of claims could have a serious impact on National Health Service resources, the medical defence societies, recruitment to specialties, and clinical practice. Debate over possible reforms is compromised by the dearth of good empirical data. Any changes, however, must address both the deterrence of bad practice and the compensation of injured patients.

Humans↗
PubMed1987

Medical malpractice in perspective. I--The American experience.

Concern over the possibility of an American style medical malpractice "crisis" in the United Kingdom has recently been voiced by members of both medical and legal professions. The validity of such fears is examined by reviewing the conditions that have given rise to the current American difficulties. It is argued that the rise in malpractice insurance premiums and associated restrictions in availability should be seen against the background of underwriting problems specific to medical liability in conjunction with a general decline in reinsurance cover. The evidence in relation to the clinical and resource implications of malpractice is analysed. In particular, arguments that increased litigation has influenced the practice of "defensive" medicine and the choice of specialty are critically examined. Medical malpractice claims and insurance are only part of a professional environment which is undergoing dramatic social and economic changes, many of which seem more plausible candidates to be treated as important influences on the nature and organisation of health care in the United States.

Costs and Cost Analysis↗