Publications
409 results found
Bottle A, Millett C, Xie Y, et al., 2008, Quality of primary care and hospital admissions for diabetes mellitus in England., J Ambul Care Manage, Vol: 31, Pages: 226-238, ISSN: 0148-9917
The National Health Service in England has invested substantially in recent years to improve the quality of primary care services for patients with chronic diseases such as diabetes. A key aim of this investment is to reduce associated complication rates and decrease consequent hospital admission rates. The goal of the study was to examine associations between the quality of primary care services and hospital admission rates for diabetes mellitus in England. An ecological cross-sectional study design was used. Three hundred three primary care trusts in England participated in the public reporting and performance-linked reimbursement of quality measures, including measures relevant to diabetes care. A total of 1,760,898 persons with diabetes registered with 8441 family practices in England. Hospital admission rates (total admissions for diabetes, admissions for ketoacidosis) were compared with quality of care scores, diabetes prevalence and neighborhood socio-economic status. We found a 10-fold variation across the country in total admissions for diabetes despite uniformly high scores on quality measures over the first year of the new family practitioner contract. Significant but weak inverse associations were found between primary care quality scores and hospital admission rates in patients aged 60 years and older, with a correlation coefficient of -0.21 (P < .001) between glycemic control and total admissions. Neighborhood socioeconomic status was more strongly correlated with total hospital admission rates than quality scores in patients aged 25-59 years (r = 0.58; P < .001) and 60 years and older (r = 0.45; P < .001). Quality of care scores and prevalence data were available only at the practice level rather than at the patient level. Improving the quality of primary care services may lead to modest reductions in demand for hospital services among older patients with diabetes. However, low neighborhood socioeconomic status is more strongly associated wit
Faiz O, Blackburn SC, Clark J, et al., 2008, Laparoscopic and conventional appendicectomy in children: outcomes in English hospitals between 1996 and 2006, Pediatric surgery international, Vol: 24, Pages: 1223-1227, ISSN: 0179-0358
BACKGROUND: Laparoscopic appendicectomy is increasingly used in children. This national retrospective study compared outcomes of paediatric open and laparoscopic appendicectomy. METHODS: Length of stay, readmission rates and mortality in children undergoing open and laparoscopic appendicectomy in English NHS Trusts between 1 April 1996 and 31 March 2006 were compared. Procedures coded as emergency excision of appendix (OPCS-4 H01) on the Hospital Episode Statistics (HES) database in patients less than 15 years of age were included. Multivariate analysis was used to identify independent predictors of length of hospital stay and mortality. RESULTS: Eighty-nine thousand, four-hundred and ninety-seven (89,497) appendicectomies were studied; of which, 2,689 (3%) were performed laparoscopically. The percentage of laparoscopic cases rose from 0.6 to 8.4% between 1996 and 2006 (Pearson's r = 0.954, P < 0.001). Length of stay (median 3, interquartile range 2 days, P = 0.068) and 28-day readmission rates were similar (6.3 vs. 7.2%, respectively; P = 0.072) between groups. No independent hospital stay advantage for laparoscopy was observed (P = 0.121). No difference in 30-day mortality (P = 0.986) or 365-day mortality (P = 0.598) was demonstrated. CONCLUSION: Hospital stay, readmission rates and mortality are similar following laparoscopic and open appendicectomy in children.
Faiz O, Aylin P, Bottle A, 2008, Changing trends in surgery for acute appendicitis (Br J Surg 2008; 95: 363-368), The British journal of surgery, Vol: 95, ISSN: 1365-2168
Aylin P, Bottle A, 2007, Are hospital league tables calculated correctly? A commentary, PUBLIC HEALTH, Vol: 121, Pages: 905-906, ISSN: 0033-3506
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- Citations: 3
Aylin P, Bottle A, Elliott P, 2007, Surgical mortality -: Hospital episode statistics <i>v</i> central cardiac audit database, BRITISH MEDICAL JOURNAL, Vol: 335, Pages: 839-839, ISSN: 0959-8146
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- Citations: 13
Aylin P, Bottle A, Elliott P, et al., 2007, Hospital episode statistics v central cardiac audit database, BMJ, Vol: 335, ISSN: 0959-8138
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- Citations: 15
Aylin P, Bottle A, Majeed A, 2007, Use of administrative data or clinical databases as predictors of risk of death in hospital: comparison of models, BMJ-BRITISH MEDICAL JOURNAL, Vol: 334, Pages: 1044-1047, ISSN: 0959-535X
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- Citations: 221
Bottle A, Xie Y, Majeed A, et al., 2007, Is there an association between quality of primary care and admissions for diabetes?, DIABETIC MEDICINE, Vol: 24, Pages: 68-68, ISSN: 0742-3071
Bottle A, Aylin P, Majeed A, 2006, Identifying patients at high risk of emergency hospital admissions: a logistic regression analysis, JOURNAL OF THE ROYAL SOCIETY OF MEDICINE, Vol: 99, Pages: 406-414, ISSN: 0141-0768
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- Citations: 97
Bottle A, Aylin P, 2006, Mortality associated with delay in operation after hip fracture: Observational study., BMJ, Vol: 332, Pages: 947-951
Aylin P, Williams S, Bottle A, 2005, Dr Foster's case notes - Obesity and type 2 diabetes in children, 1996-7 to 2003-4, BRITISH MEDICAL JOURNAL, Vol: 331, Pages: 1167-+, ISSN: 0959-8146
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- Citations: 10
Aylin P, Williams S, Jarman B, et al., 2005, Dr Foster's case notes - Trends in day surgery rates, BRITISH MEDICAL JOURNAL, Vol: 331, Pages: 803-+, ISSN: 0959-8146
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- Citations: 26
Aylin P, Williams S, Jarman B, et al., 2005, Dr Foster's case notes, BRITISH MEDICAL JOURNAL, Vol: 331, Pages: 539-539, ISSN: 0959-8146
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- Citations: 4
Williams S, Bottle A, Aylin P, 2005, Dr Foster's case notes - Length of hospital stay and subsequent emergency readmission, BRITISH MEDICAL JOURNAL, Vol: 331, Pages: 371-+, ISSN: 0959-8146
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- Citations: 10
Williams S, Bottle A, Rogers R, et al., 2005, Dr Foster's case notes - "Frequent flier" patients, BRITISH MEDICAL JOURNAL, Vol: 330, Pages: 869-+, ISSN: 0959-535X
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- Citations: 5
Bottle A, Aylin P, 2005, Variations in vaginal and abdominal hysterectomy by region and trust in England, BJOG-AN INTERNATIONAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Vol: 112, Pages: 326-328, ISSN: 1470-0328
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- Citations: 13
Jarman B, Bottle A, Aylin P, et al., 2005, Dr Foster's case notes, BRITISH MEDICAL JOURNAL, Vol: 330, Pages: 329-+, ISSN: 0959-535X
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- Citations: 40
Williams S, Hickman M, Boule M, et al., 2005, Dr Foster's case notes - Hospital admissions for drug and alcohol use in people aged under 45, BRITISH MEDICAL JOURNAL, Vol: 330, Pages: 115A-115, ISSN: 0959-535X
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- Citations: 1
Aylin P, Williams S, Bottle A, et al., 2004, Counting hospital activity: spells or episodes?, BRITISH MEDICAL JOURNAL, Vol: 329, Pages: 1206A-1207, ISSN: 0959-535X
Bottle A, Wakefield J, 2004, Controlling for provider of treatment in the modelling of respiratory disease risk near cokeworks, STATISTICS IN MEDICINE, Vol: 23, Pages: 3139-3158, ISSN: 0277-6715
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- Citations: 3
Aylin P, Bottle A, Tanna S, et al., 2004, Adverse events reporting in English hospital statistics - Patients should be involved as partners - Reply, BRITISH MEDICAL JOURNAL, Vol: 329, Pages: 857-857, ISSN: 0959-535X
Aylin P, Bottle A, Jarman B, et al., 2004, Paediatric cardiac surgical mortality in England after Bristol: descriptive analysis of hospital episode statistics 1991-2002, BRITISH MEDICAL JOURNAL, Vol: 329, Pages: 825-827, ISSN: 0959-535X
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- Citations: 42
Majeed A, Aylin P, Williams S, et al., 2004, Dr. Foster's case notes, British Medical Journal, Vol: 329, ISSN: 0959-8146
, 2004, Prescribing of lipid regulating drugs and admissions for myocardial infarction in England, BMJ-BRITISH MEDICAL JOURNAL, Vol: 329, Pages: 645-+, ISSN: 1756-1833
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- Citations: 3
Foster, 2004, How often are adverse events reported in English hospital statistics?, BMJ-BRITISH MEDICAL JOURNAL, Vol: 329, Pages: 369-+, ISSN: 1756-1833
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- Citations: 26
Aylin P, Jarman B, Bottle A, et al., 2004, Social class and elective caesareans in the NHS - Dr Foster is cheap and offensive - Reply, BRITISH MEDICAL JOURNAL, Vol: 329, Pages: 291-291, ISSN: 0959-535X
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- Citations: 1
Macfarlane AJ, Grant JM, Aylin P, et al., 2004, Social class and elective caesareans in the NHS [2] (multiple letters), British Medical Journal, Vol: 329, ISSN: 0959-8146
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- Citations: 2
Barley K, Aylin P, Bottle A, et al., 2004, Social class and elective caesareans in the English NHS (vol 328, pg 1399, 2004), BMJ-BRITISH MEDICAL JOURNAL, Vol: 329, Pages: 148-148, ISSN: 1756-1833
Jarman B, Aylin P, Bottle A, 2004, Dr Foster's case notes, British Medical Journal, Vol: 329, ISSN: 0959-8146
The measurement of acute hospital performance is an issue of intense political interest. In England, the Department of Health has published star ratings for NHS units based on a range of different indicators. This system, in which higher numbers of stars (up to a maximum of three) are intended to indicate higher quality, has now been extended to cover other NHS organisations. The Commission for Health Improvement (CHI) (now subsumed into the Healthcare Commission) also conducts on-site inspections that give hospitals scores for a variety of issues related to quality of care. First we analysed whether there is a relation between the star ratings and hospital standardised mortality ratios (HSMRs); then we determined the degree to which the inspection scores correlate with HSMRs. We found no significant relation between HSMRs and star ratings, but did find a significant relationship with inspection scores. This indicates that inspection scores may provide the public with a better guide to quality than star ratings.
Bottle A, Jarman B, Aylin P, et al., 2004, Implementing guidance on hip fracture - Advice is misleading - Reply, BRITISH MEDICAL JOURNAL, Vol: 328, Pages: 1568-1568, ISSN: 0959-535X
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