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Biomedical subjects

S V Lo

Publications and source records attributed to S V Lo.

18 recordsLinked to original sources
PubMed2006

Domestic health expenditure in Hong Kong: 1989/90 to 2001/02.

OBJECTIVE: To estimate the total domestic health expenditure in Hong Kong between fiscal years 1989/90 and 2001/02, with breakdown by financing source, provider, and function over time. METHODS: The standard health accounting methods as per the Organisation for Economic Co-operation and Development System of Health Accounts guidelines of 2000 were adopted. RESULTS: Total domestic health expenditure was $68,620 million in the fiscal year 2001/02. In real terms, expenditure grew at an average rate of 7% while gross domestic product increased by 4% during the same period. This indicates a growing share of health spending relative to gross domestic product, from 3.8% in 1989/90 to 5.5% in 2001/02. This upward trend was largely driven by increased public spending that rose 208% in real terms over the period, compared with 76% for private spending. Out-of-pocket payments by households accounted for about 70% of private spending while employers and insurance accounted for 28%. Private insurance plays an increasingly important role in financing private spending whereas household expenditure has shown a corresponding decrease during the period. Expenditure incurred at providers of ambulatory services and hospitals accounted for more than 70% of total health expenditure during the observed period. Hospitals' share of total spending increased by 18%, reaching 45% of total expenditure in 2001/02, whilst the share of providers of ambulatory services reduced to 30% in 2001/02. The two largest functional components of total health expenditure were ambulatory care (35-41%) and in-patient curative care (20-27%). Public spending generally financed in-patient curative care and ambulatory services; private spending was concentrated on ambulatory services and medical goods outside the patient care setting. CONCLUSION: These data provide important information for the public, policymakers, and researchers to assess the performance of the health care system longitudinally, and to evaluate health expenditure-related policies.

Ambulatory Care↗
PubMed2004

Understanding the spatial clustering of severe acute respiratory syndrome (SARS) in Hong Kong.

We applied cartographic and geostatistical methods in analyzing the patterns of disease spread during the 2003 severe acute respiratory syndrome (SARS) outbreak in Hong Kong using geographic information system (GIS) technology. We analyzed an integrated database that contained clinical and personal details on all 1,755 patients confirmed to have SARS from 15 February to 22 June 2003. Elementary mapping of disease occurrences in space and time simultaneously revealed the geographic extent of spread throughout the territory. Statistical surfaces created by the kernel method confirmed that SARS cases were highly clustered and identified distinct disease "hot spots." Contextual analysis of mean and standard deviation of different density classes indicated that the period from day 1 (18 February) through day 16 (6 March) was the prodrome of the epidemic, whereas days 86 (15 May) to 106 (4 June) marked the declining phase of the outbreak. Origin-and-destination plots showed the directional bias and radius of spread of superspreading events. Integration of GIS technology into routine field epidemiologic surveillance can offer a real-time quantitative method for identifying and tracking the geospatial spread of infectious diseases, as our experience with SARS has demonstrated.

Databases, Factual↗
PubMed2001

Ensuring the quality of health care.

The importance of high standards and striving for excellence in the Hong Kong health care system have been affirmed in the debate following release of the Harvard Report. This paper reviews the issue of quality in health care and recommends a triad quality framework to achieve this, consisting of enhancing professional practice, empowering patients, and providing a facilitative environment in which quality of care is encouraged.

Humans↗
PubMed1995

Rugby injuries.

Explore the source record for details and available documents.

Adolescent↗
PubMed1995

Injury surveillance in children--usefulness of a centralised database of accident and emergency attendances.

OBJECTIVE: To assess the usefulness of a centralised injury database in monitoring progress towards nationally set health targets for the reduction of childhood injuries. SETTING: West Glamorgan County, Wales. METHODS: Analysis was undertaken of data held in the West Glamorgan injury database which amalgamates population data with data from the three hospital units covering a population of 370,000. All first attendances due to a new injury in children aged 0-14 occurring in 1993 were analysed, with subgroup analysis for injuries occurring in the home and injuries resulting in fractures. Standardised injury ratios were compared with the distance travelled, car ownership, and Townsend index of deprivation at the ward level, using multiple linear regression. RESULTS: A total of 10,117 first time visits due to injuries were recorded, representing a rate of 182 injuries/1000 children aged 0-14 in West Glamorgan County. Distance from home to the accident and emergency departments was inversely correlated with total injury attendances, and injuries occurring at home, but not with injuries resulting in fractures. Visit rates for any type of injury were not associated with local car ownership rates or deprivation indices. CONCLUSIONS: Proximity to accident and emergency departments is a strong determinant of the use of the service by children with overall injuries, and injuries occurring at home. The lack of a significant association between travel distance and injuries resulting in fractures suggests that it is more meaningful to use a centralised database of accident and emergency department attendances to monitor the more severe spectrum of childhood injuries in assessing progress towards national targets for their reduction. The absence of an association between severe injuries and local socioeconomic factors suggests that national targets for the reduction of socioeconomic differentials in childhood injuries may need to be reassessed. These databases are also useful in generating information to direct preventive strategies and to target resources to areas of greatest need.

Accident Prevention↗
PubMed1994

The role of the pre-symptomatic food handler in a common source outbreak of food-borne SRSV gastroenteritis in a group of hospitals.

A common source outbreak of small round structure virus (SRSV) gastroenteritis affected 81 patients and 114 staff in four hospitals served by one central hospital kitchen. Eating salad items was found to be significantly associated with illness. In a cohort study of a staff buffet function eating turkey salad sandwiches was associated with illness (relative risk = 2.4; 95% CI = 1.4-4.1; P = 0.003), and a case control study of patients in one hospital showed an odds ratio of 6.6 (95% CI = 1.0-71.6; P = 0.04) for eating tuna salad and becoming ill. One of two food handlers who prepared the salads became ill the day following food preparation; she also had a young child at home who had been ill with a gastrointestinal illness during the previous two days. Contamination of food by mechanical transmission of the virus from the child via clothes and hands of the mother, or pre-symptomatic faecal excretion in the mother are possible explanations of contamination of food.

Caliciviridae Infections↗
PubMed1994

Abnormalities of left ventricular flow following mitral valve replacement: a colour flow Doppler study.

Left ventricular flow patterns were studied at rest by colour flow Doppler echocardiography in 33 patients with mitral tilting-disc prostheses (group 1), in 38 patients with mitral tissue prostheses (group 2) and in 18 healthy volunteers (controls). A 'crossed' flow pattern was seen in 14 patients with mechanical (42%) and in 15 patients with tissue prostheses (39%). The remaining patients and all controls had either 'parallel' or 'intermediate' flow patterns which were classified as 'normal'. There was a significant correlation between the type of flow pattern and the position of the mitral prosthesis in both study groups. The presence of a crossed flow pattern, however, was not related to functional status (assessed clinically by NYHA class) or to abnormalities on the electrocardiogram. Left atrial size was greater in patients with crossed flow than in those without, but all other echocardiographic parameters were similar. Eight patients with crossed and eight with normal flow patterns underwent treadmill exercise testing; there was no difference between the two groups with regard to exercise performance as determined by exercise duration, maximum oxygen consumption and the ventilatory response to exercise. The results of this study indicate that the pattern of blood flow within the left ventricle may be fundamentally altered by the orientation of both mechanical and tissue prostheses. The presence of a crossed flow pattern is not, however, accompanied by significant deleterious haemodynamic or functional consequences.

Adult↗
PubMed1994

Comparative health status of patients with 11 common illnesses in Wales.

OBJECTIVE: To assess the health status of patients with 11 common illnesses--asthma, diabetes, arthritis, back pain, sciatica, hypertension, angina, anxiety, depression, and heart attack and stroke. DESIGN: Face to face interview using a structured questionnaire which contained the Short Form 36 questionnaire (SF-36) and questions on lifestyle, health service utilisation, and self reported conditions treated by physicians. SETTING: Patients' homes, in West Glamorgan, Wales. SUBJECTS: Twelve hundred adults, aged 20-89 years, were randomly selected from the register of the family health services authority. MAIN OUTCOME MEASURES: The eight scales within the SF-36 health profile. RESULTS: The response rate was 82%. Each illness had a distinctive profile; patients with anxiety or depression reported the worst health experience in role limitations because of emotional problems and mental health, while patients with back pain, arthritis, or sciatica registered the three highest negative scores in bodily pain and role limitations due to physical problems. For all disease groups, the general health perceptions of those with the disease was significantly worse than those without it (p < 0.01). CONCLUSIONS: The SF-36 allows comparison of the health status of patients suffering from different conditions. Data such as these can be used to inform better purchasing decisions on how resources might be more effectively deployed and as a bench mark to monitor the effects of multiple health care interventions by conducting serial surveys.

Adult↗
PubMedDate not supplied

Fracture incidence in England and Wales: a study based on the population of Cardiff.

Despite the importance of fractures as an economic and health problem, and consequent interest in osteoporosis, few workers have previously attempted to define the overall incidence of fracture. This population based study was based in the Accident and Emergency Department of Cardiff Royal Infirmary and identified all patients presenting with fractures of any type. Over a single year a total of 6467 fractures were identified among the 306,600 people who live in the city of Cardiff. This gives an overall fracture incidence of 21.1/1000/year, (23.5/1000/year in males and 18.8/1000/year in females); a result very similar to those from similar work in the USA, Australia and Norway. This result is over twice the previous estimate of fracture incidence in the UK; the figure of 9/1000/year from the only equivalent study performed since the 1960s. In part, this discrepancy appears to reflect our more rigorous definition of the study population, and our improved ascertainment of minor fractures. We believe our result to offer the most accurate estimate of fracture incidence currently available for a UK population.

Adolescent↗
PubMedDate not supplied

Evaluation of a journal club as a forum to practise critical appraisal skills.

Critical appraisal skills are important if clinicians are to practise evidence-based medicine. This is an evaluation of the first six months of a journal club in a department of public health medicine. We analysed attendance, types of paper reviewed, impact on commissioning policy and publication of letters to editors and conclude that journal clubs can be an effective learning environment and further the Clinical Effectiveness Initiative.

Correspondence as Topic↗