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Biomedical subjects

S St Leger

Publications and source records attributed to S St Leger.

8 recordsLinked to original sources
PubMed1999

Commissioning--a postal questionnaire survey of the opinions of GPs and public health physicians in Wales.

A survey of general practitioners (GPs) and public health physicians (PHPs) in Wales was carried out to establish opinions on a range of matters concerning health care commissioning. Eighty-eight GPs and 46 PHPs were posted questionnaires, with responses received from 56 GPs and 40 PHPs. The results showed good support for the separation of the purchasing and providing roles of health management but little for the internal market or fundholding.

Attitude of Health Personnel↗
PubMed1996

Provision of environmental control systems in the north west of England.

BACKGROUND: Environmental control systems (ECS) enhance the independence of housebound severely physically disabled people and offer them the prospect of a greater quality of life. A Department of Health scheme has provided ECS to severely disabled people. Provision and quality of provision in the North West were examined. METHODS: Audit of five years' prescriptions within the North West of England was carried out. Postal questionnaires were sent to 41 voluntary and self-help groups. Additional qualitative data were collected by contacting manufacturers and voluntary group advisors. RESULTS: Eighty per cent of people referred for assessment received an ECS. However, there was geographical variation in referral rates and a bias toward younger people. There were unexplained variations among the assessors. The commonest diagnoses resulting in referral were multiple sclerosis, motor neurone disease and muscular dystrophy. Many other conditions, such as stroke and arthritis, for which an ECS might produce benefit were under-represented. There were some problems with the quality of the service, especially with the timescale of provision. CONCLUSION: It is concluded that doctors and other professionals need a heightened awareness of the categories of person who can benefit from an ECS. Clarification of criteria and training are required if assessors are to be more consistent. Moreover, the mechanism of provision needs review. Public health physicians should re-evaluate their roles in provision, and should concentrate on commissioning an appropriate and good quality service rather than on co-ordination of the scheme.

Adolescent↗
PubMed1996

Prioritising elective care: a cost utility analysis of orthopaedics in the north west of England.

STUDY OBJECTIVE: To produce a priority list for purchasers to use when purchasing elective care in the speciality of orthopaedics so that efficiency in health care purchasing (that is, maximising the benefit per unit of resource available for the resident population) can be achieved. DESIGN: The study used cost utility analysis in the elective speciality of orthopaedics. The diagnostic groups in the study were chosen on the basis of those conditions that constituted the greatest proportion of the orthopaedic waiting list, and consequently the greatest proportion of activity within the speciality. Costs were derived by two methods: the extra contractual referral tariff (ECR) and individual patient based costings. Outcome was assessed before surgery and again approximately six months afterwards. The outcome of the procedures was derived in two ways: Rosser and EuroQol indices. SETTING: The study took place at Wrightington hospital, a specialist orthopaedic hospital in north west England. PATIENTS: Prospective assessments were obtained from 99 patients for nine orthopaedics procedures. All the patients were individually interviewed on each occasion. Rosser and EuroQol assessments were completed for each patient by the patient and the patient's consultant before and after surgery. MAIN RESULTS: Priority lists presenting cost utility rankings for each of the procedures were derived from the patients' and consultants' assessments. CONCLUSIONS: It is feasible to generate priority lists in a systematic way. Purchasers may then use the results from these priority lists to help them maximise the benefits per unit of resource for their resident population.

Cost-Benefit Analysis↗