Publications
152 results found
Gibbons C, Greaves F, 2017, Lending a hand: could machine learning help hospital staff make better use of patient feedback?, BMJ Quality and Safety, Vol: 27, Pages: 93-95, ISSN: 2044-5415
Cowling TE, Laverty AA, Harris MJ, et al., 2017, Contract and ownership type of general practices and patient experience in England: multilevel analysis of a national cross-sectional survey, Journal of the Royal Society of Medicine, Vol: 110, Pages: 440-451, ISSN: 1758-1095
Objective: To examine associations between the contractand ownership type of general practices and patient experiencein England.Design: Multilevel linear regression analysis of a nationalcross-sectional patient survey (General Practice PatientSurvey).Setting: All general practices in England in 2013–2014(n ¼ 8017).Participants: 903,357 survey respondents aged 18 years orover and registered with a general practice for six monthsor more (34.3% of 2,631,209 questionnaires sent).Main outcome measures: Patient reports of experienceacross five measures: frequency of consulting a preferreddoctor; ability to get a convenient appointment; rating ofdoctor communication skills; ease of contacting the practiceby telephone; and overall experience (measured onfour- or five-level interval scales from 0 to 100). Modelsadjusted for demographic and socioeconomic characteristicsof respondents and general practice populations and arandom intercept for each general practice.Results: Most practices had a centrally negotiated contractwith the UK government (‘General Medical Services’54.6%; 4337/7949). Few practices were limited companieswith locally negotiated ‘Alternative Provider MedicalServices’ contracts (1.2%; 98/7949); these practices providedworse overall experiences than General MedicalServices practices (adjusted mean difference 3.04, 95%CI 4.15 to 1.94). Associations were consistent in directionacross outcomes and largest in magnitude for frequencyof consulting a preferred doctor (12.78, 95% CI15.17 to 10.39). Results were similar for practicesowned by large organisations (defined as having 20 practices)which were uncommon (2.2%; 176/7949).Conclusions: Patients registered to general practicesowned by limited companies, including large organisations,reported worse experiences of their care than otherpatients in 2013–2014.
Honeyford K, Greaves F, Aylin P, et al., 2017, Secondary analysis of hospital patient experience scores across England's National Health Service - How much has improved since 2005?, PLoS ONE, Vol: 12, ISSN: 1932-6203
OBJECTIVE: To examine trends in patient experience and consistency between hospital trusts and settings. METHODS: Observational study of publicly available patient experience surveys of three hospital settings (inpatients (IP), accident and emergency (A&E) and outpatients (OP)) of 130 acute NHS hospital trusts in England between 2004/05 and 2014/15. RESULTS: Overall patient experience has been good, showing modest improvements over time across the three hospital settings. Individual questions with the biggest improvement across all three settings are cleanliness (IP: +7.1, A&E: +6.5, OP: +4.7) and information about danger signals (IP: +3.8, A&E: +3.9, OP: +4.0). Trust performance has been consistent over time: 71.5% of trusts ranked in the same cluster for more than five years. There is some consistency across settings, especially between outpatients and inpatients. The lowest-scoring questions, regarding information at discharge, are the same in all years and all settings. CONCLUSIONS: The greatest improvement across all three settings has been for cleanliness, which has seen national policies and targets. Information about danger signals and medication side-effects showed least consistency across settings and scores have remained low over time, despite information about danger signals showing a big increase in score. Patient experience of aspects of access and waiting have declined, as has experience of discharge delay, likely reflecting known increases in pressure on England's NHS.
Rozenblum R, Greaves F, Bates DW, 2017, The role of social media around patient experience and engagement, BMJ QUALITY & SAFETY, Vol: 26, Pages: 845-848, ISSN: 2044-5415
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- Citations: 29
Michie S, Yardley L, West R, et al., 2017, Developing and Evaluating Digital Interventions to Promote Behavior Change in Health and Health Care: Recommendations Resulting From an International Workshop, Journal of Medical Internet Research, Vol: 19, ISSN: 1438-8871
Rutter H, Savona N, Glonti K, et al., 2017, The need for a complex systems model of evidence for public health., Lancet, Vol: 390, Pages: 2602-2604, ISSN: 0140-6736
Barber RM, Fullman N, Sorensen RJD, et al., 2017, Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990–2015: a novel analysis from the Global Burden of Disease Study 2015, The Lancet, Vol: 390, Pages: 231-266, ISSN: 0099-5355
BackgroundNational levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015.MethodsWe mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years of
Barber RM, Fullman N, Sorensen RJD, et al., 2017, Healthcare Access and Quality Index based on mortality from causes amenable to personal health care in 195 countries and territories, 1990-2015: a novel analysis from the Global Burden of Disease Study 2015, Lancet, Vol: 390, Pages: 231-266, ISSN: 1474-547X
Background National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015. Methods We mapped the most widely used list of causes amenable to personal health care developed by Nolte and McKee to 32 GBD causes. We accounted for variations in cause of death certification and misclassifications through the extensive data standardisation processes and redistribution algorithms developed for GBD. To isolate the effects of personal health-care access and quality, we risk-standardised cause-specific mortality rates for each geography-year by removing the joint effects of local environmental and behavioural risks, and adding back the global levels of risk exposure as estimated for GBD 2015. We employed principal component analysis to create a single, interpretable summary measure–the Healthcare Quality and Access (HAQ) Index–on a scale of 0 to 100. The HAQ Index showed strong convergence validity as compared with other health-system indicators, including health expenditure per capita (r=0·88), an index of 11 universal health coverage interventions (r=0·83), and human resources for health per 1000 (r=0·77). We used free disposal hull analysis with bootstrapping to produce a frontier based on the relationship between the HAQ Index and the Socio-demographic Index (SDI), a measure of overall development consisting of income per capita, average years
Luchenski S, Aldridge RW, Capewell S, et al., 2017, Public Health Science conference: a call for abstracts, LANCET, Vol: 389, Pages: 1593-1593, ISSN: 0140-6736
Greaves F, Rozenblum R, 2017, Social and Consumer Informatics, KEY ADVANCES IN CLINICAL INFORMATICS: TRANSFORMING HEALTH CARE THROUGH HEALTH INFORMATION TECHNOLOGY, Editors: Sheikh, Cresswell, Wright, Bates, Publisher: ACADEMIC PRESS LTD-ELSEVIER SCIENCE LTD, Pages: 257-278, ISBN: 978-0-12-809523-2
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- Citations: 5
Burton R, Henn C, Lavoie D, et al., 2016, A rapid evidence review of the effectiveness and cost-effectiveness of alcohol control policies: an English perspective, Lancet, Vol: 389, Pages: 1558-1580, ISSN: 0140-6736
This paper reviews the evidence for the effectiveness and cost-effectiveness of policies to reduce alcohol-related harm. Policies focus on price, marketing, availability, information and education, the drinking environment, drink-driving, and brief interventions and treatment. Although there is variability in research design and measured outcomes, evidence supports the effectiveness and cost-effectiveness of policies that address affordability and marketing. An adequate reduction in temporal availability, particularly late night on-sale availability, is effective and cost-effective. Individually-directed interventions delivered to at-risk drinkers and enforced legislative measures are also effective. Providing information and education increases awareness, but is not sufficient to produce long-lasting changes in behaviour. At best, interventions enacted in and around the drinking environment lead to small reductions in acute alcohol-related harm. Overall, there is a rich evidence base to support the decisions of policy makers in implementing the most effective and cost-effective policies to reduce alcohol-related harm.
Wang H, Naghavi M, Allen C, et al., 2016, Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015, Lancet, Vol: 388, Pages: 1459-1544, ISSN: 0140-6736
BackgroundImproving survival and extending the longevity of life for all populations requires timely, robust evidence on local mortality levels and trends. The Global Burden of Disease 2015 Study (GBD 2015) provides a comprehensive assessment of all-cause and cause-specific mortality for 249 causes in 195 countries and territories from 1980 to 2015. These results informed an in-depth investigation of observed and expected mortality patterns based on sociodemographic measures.MethodsWe estimated all-cause mortality by age, sex, geography, and year using an improved analytical approach originally developed for GBD 2013 and GBD 2010. Improvements included refinements to the estimation of child and adult mortality and corresponding uncertainty, parameter selection for under-5 mortality synthesis by spatiotemporal Gaussian process regression, and sibling history data processing. We also expanded the database of vital registration, survey, and census data to 14 294 geography–year datapoints. For GBD 2015, eight causes, including Ebola virus disease, were added to the previous GBD cause list for mortality. We used six modelling approaches to assess cause-specific mortality, with the Cause of Death Ensemble Model (CODEm) generating estimates for most causes. We used a series of novel analyses to systematically quantify the drivers of trends in mortality across geographies. First, we assessed observed and expected levels and trends of cause-specific mortality as they relate to the Socio-demographic Index (SDI), a summary indicator derived from measures of income per capita, educational attainment, and fertility. Second, we examined factors affecting total mortality patterns through a series of counterfactual scenarios, testing the magnitude by which population growth, population age structures, and epidemiological changes contributed to shifts in mortality. Finally, we attributed changes in life expectancy to changes in cause of death. We documented each step of the GB
Vos T, Allen C, Arora M, et al., 2016, Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015, The Lancet, Vol: 388, Pages: 1545-1602, ISSN: 0140-6736
Background Non-fatal outcomes of disease and injury increasingly detract from the ability of the world's population to live in full health, a trend largely attributable to an epidemiological transition in many countries from causes affecting children, to non-communicable diseases (NCDs) more common in adults. For the Global Burden of Diseases, Injuries, and Risk Factors Study 2015 (GBD 2015), we estimated the incidence, prevalence, and years lived with disability for diseases and injuries at the global, regional, and national scale over the period of 1990 to 2015. Methods We estimated incidence and prevalence by age, sex, cause, year, and geography with a wide range of updated and standardised analytical procedures. Improvements from GBD 2013 included the addition of new data sources, updates to literature reviews for 85 causes, and the identification and inclusion of additional studies published up to November, 2015, to expand the database used for estimation of non-fatal outcomes to 60 900 unique data sources. Prevalence and incidence by cause and sequelae were determined with DisMod-MR 2.1, an improved version of the DisMod-MR Bayesian meta-regression tool first developed for GBD 2010 and GBD 2013. For some causes, we used alternative modelling strategies where the complexity of the disease was not suited to DisMod-MR 2.1 or where incidence and prevalence needed to be determined from other data. For GBD 2015 we created a summary indicator that combines measures of income per capita, educational attainment, and fertility (the Socio-demographic Index [SDI]) and used it to compare observed patterns of health loss to the expected pattern for countries or locations with similar SDI scores. Findings We generated 9·3 billion estimates from the various combinations of prevalence, incidence, and YLDs for causes, sequelae, and impairments by age, sex, geography, and year. In 2015, two causes had acute incidences in excess of 1 billion: upper respiratory infections (
Tsai TC, Greaves F, Zheng J, et al., 2016, Better Patient Care At High-Quality Hospitals May Save Medicare Money And Bolster Episode-Based Payment Models, HEALTH AFFAIRS, Vol: 35, Pages: 1681-1689, ISSN: 0278-2715
Hawkins JB, Brownstein JS, Tuli G, et al., 2016, Measuring patient-perceived quality of care in US hospitals using Twitter, BMJ Quality & Safety, Vol: 25, Pages: 404-413, ISSN: 2044-5423
BACKGROUND: Patients routinely use Twitter to share feedback about their experience receiving healthcare. Identifying and analysing the content of posts sent to hospitals may provide a novel real-time measure of quality, supplementing traditional, survey-based approaches. OBJECTIVE: To assess the use of Twitter as a supplemental data stream for measuring patient-perceived quality of care in US hospitals and compare patient sentiments about hospitals with established quality measures. DESIGN: 404 065 tweets directed to 2349 US hospitals over a 1-year period were classified as having to do with patient experience using a machine learning approach. Sentiment was calculated for these tweets using natural language processing. 11 602 tweets were manually categorised into patient experience topics. Finally, hospitals with ≥50 patient experience tweets were surveyed to understand how they use Twitter to interact with patients. KEY RESULTS: Roughly half of the hospitals in the US have a presence on Twitter. Of the tweets directed toward these hospitals, 34 725 (9.4%) were related to patient experience and covered diverse topics. Analyses limited to hospitals with ≥50 patient experience tweets revealed that they were more active on Twitter, more likely to be below the national median of Medicare patients (p<0.001) and above the national median for nurse/patient ratio (p=0.006), and to be a non-profit hospital (p<0.001). After adjusting for hospital characteristics, we found that Twitter sentiment was not associated with Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings (but having a Twitter account was), although there was a weak association with 30-day hospital readmission rates (p=0.003). CONCLUSIONS: Tweets describing patient experiences in hospitals cover a wide range of patient care aspects and can be identified using automated approaches. These tweets represent a potentially untapped indicator of quality and may be valuable to
Aldridge RW, Capewell S, Greaves F, et al., 2016, Public Health Science conference: a call for abstracts, LANCET, Vol: 387, Pages: 1258-1259, ISSN: 0140-6736
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- Citations: 1
Hallsworth M, Chadborn T, Sallis A, et al., 2016, Provision of social norm feedback to high prescribers of antibiotics in general practice: a pragmatic national randomised controlled trial, Lancet, Vol: 387, Pages: 1743-1752, ISSN: 1474-547X
BackgroundUnnecessary antibiotic prescribing contributes to antimicrobial resistance. In this trial, we aimed to reduce unnecessary prescriptions of antibiotics by general practitioners (GPs) in England.MethodsIn this randomised, 2 × 2 factorial trial, publicly available databases were used to identify GP practices whose prescribing rate for antibiotics was in the top 20% for their National Health Service (NHS) Local Area Team. Eligible practices were randomly assigned (1:1) into two groups by computer-generated allocation sequence, stratified by NHS Local Area Team. Participants, but not investigators, were blinded to group assignment. On Sept 29, 2014, every GP in the feedback intervention group was sent a letter from England's Chief Medical Officer and a leaflet on antibiotics for use with patients. The letter stated that the practice was prescribing antibiotics at a higher rate than 80% of practices in its NHS Local Area Team. GPs in the control group received no communication. The sample was re-randomised into two groups, and in December, 2014, GP practices were either sent patient-focused information that promoted reduced use of antibiotics or received no communication. The primary outcome measure was the rate of antibiotic items dispensed per 1000 weighted population, controlling for past prescribing. Analysis was by intention to treat. This trial is registered with the ISRCTN registry, number ISRCTN32349954, and has been completed.FindingsBetween Sept 8 and Sept 26, 2014, we recruited and assigned 1581 GP practices to feedback intervention (n=791) or control (n=790) groups. Letters were sent to 3227 GPs in the intervention group. Between October, 2014, and March, 2015, the rate of antibiotic items dispensed per 1000 population was 126·98 (95% CI 125·68–128·27) in the feedback intervention group and 131·25 (130·33–132·16) in the control group, a difference of 4·27 (3·3%; incidence rate
Powell J, Boylan A-M, Greaves F, 2015, Harnessing patient feedback data: A challenge for policy and service improvement, Digital Health, Vol: 1, Pages: 1-3, ISSN: 2055-2076
Lagu T, Greaves F, 2015, From Public to Social Reporting of Hospital Quality, Journal of General Internal Medicine, Vol: 30, Pages: 1397-1399, ISSN: 0884-8734
Hargreaves DS, Greaves F, Levay C, et al., 2015, Comparison of Health Care Experience and Access Between Young and Older Adults in 11 High-Income Countries, JOURNAL OF ADOLESCENT HEALTH, Vol: 57, Pages: 413-420, ISSN: 1054-139X
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- Citations: 35
Newton JN, Briggs ADM, Murray CJL, et al., 2015, Changes in health in England, with analysis by English regions and areas of deprivation, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013, Lancet, Vol: 386, Pages: 2257-2274, ISSN: 1474-547X
Waterall J, Greaves F, Gresser C, et al., 2015, Invited debate NHS Health Checks-a naked emperor? Response, JOURNAL OF PUBLIC HEALTH, Vol: 37, Pages: 193-194, ISSN: 1741-3842
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- Citations: 2
Waterall J, Greaves F, Kearney M, et al., 2015, Invited debate NHS Health Check: an innovative component of local adult health improvement and well-being programmes in England, JOURNAL OF PUBLIC HEALTH, Vol: 37, Pages: 177-184, ISSN: 1741-3842
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- Citations: 13
Bardach NS, Hibbard JH, Greaves F, et al., 2015, Sources of Traffic and Visitors' Preferences Regarding Online Public Reports of Quality: Web Analytics and Online Survey Results, JOURNAL OF MEDICAL INTERNET RESEARCH, Vol: 17, ISSN: 1438-8871
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- Citations: 16
Greaves G, Laverty AA, Pape U, et al., 2015, Performance of new alternative providers of primary care services in England: an observational study, Journal of the Royal Society of Medicine, ISSN: 1758-1095
Kearney M, Waterall J, Greaves F, et al., 2015, The status quo is not an evidence-based option, BRITISH JOURNAL OF GENERAL PRACTICE, Vol: 65, Pages: 61-61, ISSN: 0960-1643
Greaves F, Laverty AA, Pape U, et al., 2014, Primary care competition and the effect of new providers on quality of care in England, European Public Health Science Conference, Publisher: ELSEVIER SCIENCE INC, Pages: 15-15, ISSN: 0140-6736
Greaves F, Millett C, Nuki P, 2014, England's Experience Incorporating "Anecdotal" Reports From Consumers into Their National Reporting System: Lessons for the United States of What to Do or Not to Do?, MEDICAL CARE RESEARCH AND REVIEW, Vol: 71, Pages: 65S-80S, ISSN: 1077-5587
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- Citations: 25
Sheikh A, Jha A, Cresswell K, et al., 2014, Adoption of electronic health records in UK hospitals: lessons from the USA, LANCET, Vol: 384, Pages: 8-9, ISSN: 0140-6736
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- Citations: 34
Greaves F, Jha AK, 2014, Quality and the curate's egg, BMJ QUALITY & SAFETY, Vol: 23, Pages: 525-527, ISSN: 2044-5415
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- Citations: 3
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