A5060001295- Healthcare Policy and Management
- Chronic Disease Management Strategies
- Primary Care and Health Outcomes
- Emergency and Acute Care Studies
- Health Systems, Economic Evaluations, Quality of Life
- Healthcare cost, quality, practices
- Health Promotion and Cardiovascular Prevention
- Geriatric Care and Nursing Homes
- Global Health Workforce Issues
- Nursing Roles and Practices
- Diabetes Management and Education
- Health Policy Implementation Science
- Family Caregiving in Mental Illness
- Obesity and Health Practices
- Adolescent and Pediatric Healthcare
- Global Health Care Issues
University of Manchester
2018-2024
Manchester Academic Health Science Centre
2018-2024
The NHS Diabetes Prevention Programme (DPP) is the first nationwide type 2 diabetes prevention programme targeting people with prediabetes. It was rolled out across England from 2016 in three waves. We evaluate population level impact of DPP on incidence rates diabetes.We use data National Audit, which records all individuals who have been diagnosed by 2019. difference-in-differences regression models to estimate phased introduction incidence. compare patients registered 3,282 general...
Innovative ways of delivering care are needed to improve outcomes for older people with multimorbidity. Health coaching involves 'a regular series phone calls between patient and health professional provide support encouragement promote healthy behaviours'. This intervention is promising, but evidence insufficient a wider role in multimorbidity care. We evaluated multimorbidity.We used the innovative 'Trials within Cohorts' design. A cohort was recruited, trial conducted using...
Background Primary care plays a crucial role in identifying patients’ needs and referring at-risk individuals to preventive services. However, well-established variations delivery may be replicated this prevention activity. Objective To examine whether recruiting patients the English NHS Diabetes Prevention Programme via primary reinforces existing inequalities provision between practices, terms of clinical quality, accessibility resources. Methods We generated annual practice-level counts...
Background The Salford Integrated Care Programme (SICP) was a large-scale transformation project to improve care for older people with long-term conditions and social needs. We report an evaluation of the ability SICP deliver enhanced experience care, improved quality life, reduced costs cost-effectiveness. Objectives To explore process implementation impact on patient outcomes costs. Design Qualitative methods (interviews observations) implementation, cohort multiple randomised controlled...
Abstract Little is known about how prospective provider payment affects the provision of services led by unpredictable demand. We investigate hospital responses to a 32% increase in price for two treatments emergency departments England April 2011 using data on 11,532,304 attendances (79 hospitals) between 2009/2010 and 2013/2014. compare changes volumes these treatment not attracting additional reimbursement difference‐in‐differences framework. Additional 76% 152% increases incentivised...
Background Improvements in primary care quality are often proposed as a solution to rises emergency department (ED) attendances. However, there is little agreement on what constitutes an avoidable attendance, and the relationship between ED demand remains poorly understood. Objective To estimate size of associations volumes attendances classified avoidable. Methods Retrospective observational study all at EDs England during 2015/2016, applying three definitions attendance. We linked...
Prevention programmes typically incur short-term costs and uncertain long-term benefits. We use the National Health Service (NHS) England Diabetes Programme (NHS-DPP) to investigate whether behaviour change may be cost-effective even within participation period. analysed 384,611 referrals between June 2016 March 2019. estimated NHS using implementation provider payments. used linear regressions relate utility changes number of sessions attended, based on responses five-level EQ-5D (EQ-5D-5L)...
Abstract Background We evaluated the dose–response relationship between level of attendance at English National Health Service Diabetes Prevention Programme (DPP) and risk progression to type 2 diabetes amongst individuals participating in programme. Methods linked data on DPP for 51,803 that were referred programme 1st June 2016 31st March 2018 attended least one session, with primary care records diagnoses from Audit up 2020. Weibull survival regressions used estimate association number...
Introduction . Shifting care from hospitals into community‐based settings is a major policy goal internationally. Community health services in England currently face the greatest workforce shortages of all sectors, threatening feasibility this policy. Moreover, little known about extent variation community provision regionally and how relates to determinants need. Aim To analyse regional between 2010 2021. Methods We obtained NHS statistics data on number nurses nursing support staff...
Admissions for ambulatory care sensitive conditions (ACSCs) are often used to measure potentially preventable emergency care. Visits departments with ACSCs may also be but excluded from such measures if patients not admitted. We established the extent and composition of this care.We analysed 1,505,979 department visits (5% national total) between 1 April 2015 31 March 2017 at six hospital Trusts in England, using International Classification Diseases diagnostic coding. calculated number each...