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  • Journal article
    Langford KM, Bottle A, Aylin PP, Ward Het al., 2012,

    Using routine data to monitor inequalities in an acute trust: a retrospective study

    , BMC Health Services Research, Vol: 12
  • Journal article
    Jen M-H, Saxena S, Bottle A, Pollok R, Holmes A, Aylin Pet al., 2012,

    Assessment of administrative data for evaluating the shifting acquisition of Clostridium difficile infection in England

    , JOURNAL OF HOSPITAL INFECTION, Vol: 80, Pages: 229-237, ISSN: 0195-6701
  • Journal article
    Tsang C, Palmer W, Bottle A, Majeed A, Aylin Pet al., 2012,

    A Review of Patient Safety Measures Based on Routinely Collected Hospital Data

    , AMERICAN JOURNAL OF MEDICAL QUALITY, Vol: 27, Pages: 154-169, ISSN: 1062-8606
  • Journal article
    Alexandrescu R, Bottle A, Jarman B, Aylin Pet al., 2012,

    Impact of transfer for angioplasty and distance on AMI in-hospital mortality.

    , Acute Card Care, Vol: 14, Pages: 5-12

    BACKGROUND: The aim of the study was to evaluate the impact of transfer status and distance on in-hospital mortality for acute myocardial infarction (AMI) patients undergoing angioplasty on the same or next day of hospital admission. METHODS: Retrospective analysis of English hospital administrative data using logistic regression modelling. RESULTS: After risk adjustment for the patient baseline characteristics, transferred patients had a higher in-hospital mortality rate than those admitted directly to hospital for angioplasty performed on the same or next day: OR=1.25 (95% confidence interval: 1.02-1.52), P=0.029. There was no statistically significant increased risk of in-hospital mortality with increasing distance between home and angioplasty centre (OR=0.98 (0.84-1.16), P=0.842 for 6-15 km and 1.03 (0.87-1.22), P=0.768 for >15 km when compared with <6 km) or with increasing inter-hospital transfer distance for angioplasty (OR=0.84 (0.55-1.29), P=0.435 for 16-34 km and 0.88 (0.58-1.35), for >34 km when compared with <16 km). CONCLUSIONS: Transfer status is associated with in-hospital mortality rate for AMI patients undergoing angioplasty on the same or next day of hospital admission. No relation between in-hospital mortality and the distance from home to angioplasty centre or inter-hospital transfer distance for angioplasty was found in these patients.

  • Journal article
    Almoudaris AM, Burns E, Bottle A, Aylin P, Darzi A, Vincent Cet al., 2012,

    Single measures of performance do not reflect overall institutional quality in colorectal cancer surgery

    , Gut

    Objective To evaluate overall performance of English colorectal cancer surgical units identified as outliers for a single quality measure—30 day inhospital mortality.Design 144 542 patients that underwent primary major colorectal cancer resection between 2000/2001 and 2007/2008 in 149 English National Health Service units were included from hospital episodes statistics. Casemix adjusted funnel plots were constructed for 30 day inhospital mortality, length of stay, unplanned readmission within 28 days, reoperation, failure to rescue-surgical (FTR-S) and abdominoperineal excision (APE) rates. Institutional performance was evaluated across all other domains for institutions deemed outliers for 30 day mortality. Outliers were those that lay on or breached 3 SD control limits. ‘Acceptable’ performance was defined if units appeared under the upper 2 SD limit.Results 5 high mortality outlier (HMO) units and 15 low mortality outlier (LMO) units were identified. Of the five HMO units, two were substandard performance outliers (ie, above 3 SD) on another metric (both on high reoperation rates). A further two HMO institutions exceeded the second but not the third SD limits for substandard performance on other outcome metrics. One of the 15 LMO units exceeded 3 SD for substandard performance (APE rate). One LMO institution exceeded the second but not the third SD control limits for high reoperation rates. Institutional mortality correlated with FTR-S and reoperations (R=0.445, p<0.001 and R=0.191, p<0.020 respectively).Conclusions Performance appraisal in colorectal surgery is complex and dependent on stakeholder perspective. Benchmarking units solely on a single performance measure is over simplistic and potentially hazardous. A global appraisal of institutional outcome is required to contextualise performance.

  • Journal article
    Mamidanna R, Bottle A, Aylin P, Faiz O, Hanna GBet al., 2012,

    Short-Term Outcomes Following Open Versus Minimally Invasive Esophagectomy for Cancer in England A Population-Based National Study

    , ANNALS OF SURGERY, Vol: 255, Pages: 197-203, ISSN: 0003-4932
  • Journal article
    Tsang C, Majeed A, Aylin P, 2012,

    Routinely recorded patient safety events in primary care: a literature review

    , FAMILY PRACTICE, Vol: 29, Pages: 8-15, ISSN: 0263-2136
  • Journal article
    Tsang C, Majeed A, Aylin P, 2012,

    Consultations with general practitioners on patient safety measures based on routinely collected data in primary care.

    , JRSM Short Rep, Vol: 3

    OBJECTIVES: To gauge the opinions of doctors working, or interested, in general practice on monitoring patient safety using administrative data. The findings will inform the development of routinely collected data-based patient safety indicators in general practice and elsewhere in primary care. DESIGN: Non-systematic participant recruitment, using personal contacts and colleagues' recommendations. SETTING: Face-to-face consultations at participants' places of work, between June 2010 and February 2011. PARTICIPANTS: Four general practitioners (GPs) and a final year medical student. The four clinicians had between eight to 34 years of clinical practice experience, and held non-clinical positions in addition to their clinical roles. MAIN OUTCOME MEASURES: Views on safety issues and improvement priorities, measurement methods, uses of administrative data, role of administrative data in patient safety and experiences of quality and safety initiatives. RESULTS: Medication and communication were the most commonly identified areas of patient safety concern. Perceived safety barriers included incident-reporting reluctance, inadequate medical education and low computer competency. Data access, financial constraints, policy changes and technology handicaps posed challenges to data use. Suggested safety improvements included better communication between providers and local partnerships between GPs. CONCLUSIONS: The views of GPs and other primary care staff are pivotal to decisions on the future of English primary care and the health system. Broad views of general practice safety issues were shown, with possible reasons for patient harm and quality and safety improvement obstacles. There was general consensus on areas requiring urgent attention and strategies to enhance data use for safety monitoring.

  • Journal article
    Bottle A, Tsang C, Parsons C, Majeed A, Soljak M, Aylin Pet al., 2012,

    Association between patient and general practice characteristics and unplanned first-time admissions for cancer: observational study

    , Br J Cancer, Vol: 107, ISSN: 1532-1827
  • Journal article
    Bottle A, Jarman B, Aylin P, 2011,

    Hospital Standardized Mortality Ratios: Sensitivity Analyses on the Impact of Coding

    , HEALTH SERVICES RESEARCH, Vol: 46, Pages: 1741-1761, ISSN: 0017-9124

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