scholarly journals Distributive equity in the real world: would targeting the National Health Service Health Check programme to deprived groups be more cost effective?

The Lancet ◽  
2017 ◽  
Vol 390 ◽  
pp. S34
Author(s):  
Brendan Collins ◽  
Chris Kypridemos ◽  
Paula Parvulescu ◽  
Richard Cookson ◽  
Simon Capewell ◽  
...  
2018 ◽  
Vol 47 (2) ◽  
pp. 217-229
Author(s):  
Paul E. Jenkins ◽  
Ceri Morgan ◽  
Catherine Houlihan

Background: Underweight eating disorders (EDs) are notoriously difficult to treat, although a growing evidence base suggests that outpatient cognitive behaviour therapy for EDs (CBT-ED) can be effective for a large proportion of individuals. Aims: To investigate the effectiveness of CBT-ED for underweight EDs in a ‘real-world’ settings. Method: Sixty-three adults with underweight EDs (anorexia nervosa or atypical anorexia nervosa) began outpatient CBT-ED in a National Health Service setting. Results: Fifty-four per cent completed treatment, for whom significant changes were observed on measures of ED symptoms, psychological distress and psychosocial impairment. There was also a large effect on body weight at end-of-treatment. Conclusions: The results suggest that good outcomes can be achieved by the majority of those who complete treatment, although treatment non-completion remains a significant barrier to recovery. Future studies should focus on improving treatment retention, as evidence suggests that CBT-ED in ‘real-world’ settings is effective.


1994 ◽  
Vol 18 (12) ◽  
pp. 751-752
Author(s):  
D.P. Forster

Much of psychiatric practice involves understanding a patient's perception of reality and the influences that may affect this perception, including those of the environment. In organisations, such as the National Health Service, the need for consensus and approval within the organisational culture and environment may influence the publicly expressed views of employees, a process encouraged by short-term contracts and performance related pay. This article briefly describes some diverse experiences relevant to interpreting the real and the apparent.


2018 ◽  
Vol 132 (12) ◽  
pp. 1119-1127 ◽  
Author(s):  
J F Guest ◽  
K Rana ◽  
C Hopkins

AbstractObjectiveThis study aimed to estimate the cost-effectiveness of Coblation compared with cold steel tonsillectomy in adult and paediatric patients in the UK.MethodDecision analysis was undertaken by combining published clinical outcomes with resource utilisation estimates derived from a panel of clinicians.ResultsUsing a cold steel procedure instead of Coblation is expected to generate an incremental cost of more than £2000 for each additional avoided haemorrhage, and the probability of cold steel being cost-effective was approximately 0.50. Therefore, the cost-effectiveness of the two techniques was comparable. When the published clinical outcomes were replaced with clinicians’ estimates of current practice, Coblation was found to improve outcome for less cost, and the probability of Coblation being cost-effective was at least 0.70.ConclusionA best-case scenario suggests Coblation affords the National Health Service a cost-effective intervention for tonsillectomy in adult and paediatric patients compared with cold steel procedures. A worst-case scenario suggests Coblation affords the National Health Service an equivalent cost-effective intervention for adult and paediatric patients.


2016 ◽  
Vol 188 (10) ◽  
pp. E228-E238 ◽  
Author(s):  
Kiara Chu-Mei Chang ◽  
John Tayu Lee ◽  
Eszter P. Vamos ◽  
Michael Soljak ◽  
Desmond Johnston ◽  
...  

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