The Effect of the Community Care Act 1990 on Discharge from a Psychogeriatric Unit to Residential and Nursing Homes

1996 ◽  
Vol 36 (4) ◽  
pp. 328-330 ◽  
Author(s):  
Ajit Shah
Keyword(s):  
National Health Service ◽  
Nursing Homes ◽  
Health Service ◽  
Hospital Admission ◽  
Social Services ◽  
Community Care ◽  
Hospital Admissions ◽  
Considerable Time ◽  
Health And Social Services ◽  
Before And After

This study compares the proportion of patients discharged to residential and nursing homes from a psychogeriatric unit and the length of hospital admissions before and after the introduction of the National Health Service and Community Care Act 1990. This Act appeared not to influence the proportion of patients discharged to residential and nursing homes and the length of hospital admission. A year after the introduction of this Act may be too soon to observe an effect as the actual implementation of the Act by the health and social services may take considerable time.

scholarly journals Biphasic pattern in the effect of severe measles infection; the difference between additive and multiplicative scale

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nhat Thanh Hoang Le ◽  
Nhan Thi Ho ◽  
Bryan Grenfell ◽  
Stephen Baker ◽  
Ronald B. Geskus
Keyword(s):  
Infectious Diseases ◽  
Hospital Admission ◽  
Measles Virus ◽  
Hospital Admissions ◽  
Admission Rate ◽  
Second Phase ◽  
Before And After ◽  
The Difference ◽  
Two Phases ◽  
Additive Scale

Abstract Background Infection with measles virus (MeV) causes immunosuppression and increased susceptibility to other infectious diseases. Only few studies reported a duration of immunosuppression, with varying results. We investigated the effect of immunosuppression on the incidence of hospital admissions for infectious diseases in Vietnamese children. Methods We used retrospective data (2005 to 2015; N = 4419) from the two pediatric hospitals in Ho Chi Minh City, Vietnam. We compared the age-specific incidence of hospital admission for infectious diseases before and after hospitalization for measles. We fitted a Poisson regression model that included gender, current age, and time since measles to obtain a multiplicative effect measure. Estimates were transformed to the additive scale. Results We observed two phases in the incidence of hospital admission after measles. The first phase started with a fourfold increased rate of admissions during the first month after measles, dropping to a level quite comparable to children of the same age before measles. In the second phase, lasting until at least 6 years after measles, the admission rate decreased further, with values up to 20 times lower than in children of the same age before measles. However, on the additive scale the effect size in the second phase was much smaller than in the first phase. Conclusion The first phase highlights the public health benefits of measles vaccination by preventing measles and immune amnesia. The beneficial second phase is interesting, but its strength strongly depends on the scale. It suggests a complicated interaction between MeV infection and the host immunity.

scholarly journals “It’s not like I’m more Indigenous there and I’m less Indigenous here.”: urban Métis women’s identity and access to health and social services in Toronto, Canada

2020 ◽  
Vol 16 (4) ◽  
pp. 323-331
Author(s):  
Renée Monchalin ◽  
Janet Smylie ◽  
Cheryllee Bourgeois
Keyword(s):  
Health Service ◽  
Qualitative Study ◽  
Social Services ◽  
Survival Strategies ◽  
Health And Social Services ◽  
Women's Identity ◽  
Access To Health ◽  
Learning Journey ◽  
One Step ◽  
Service Gap

Colonial policies and identity debates have resulted in major gaps in access to culturally safe health and social services for Métis Peoples living in Canada. To address the Métis health service gap, this qualitative study explores urban Métis women’s identity and their experiences with health and social services in Toronto, Canada. Métis women ( n = 11) understand Métis identity as having connection to community, intergenerational identity survival strategies, a learning journey, and connection to land. Building Métis community determined understandings of Métis identity into urban health and social services may be one step toward addressing existing culturally safe health service gaps.

National Health Service Nursing Homes

1989 ◽  
Vol 18 (5) ◽  
pp. 289-291 ◽  
Author(s):  
J. GRIMLEY EVANS
Keyword(s):  
National Health Service ◽  
Nursing Homes ◽  
Health Service ◽  
National Health

Psychiatric Out-Patients in Plymouth—An Area Service Analysed

1965 ◽  
Vol 111 (470) ◽  
pp. 10-17 ◽  
Author(s):  
Neil Kessel ◽  
Christine Hassall ◽  
Robert Blair ◽  
John M. Gilroy ◽  
Francis Pilkington ◽  
...  
Keyword(s):  
National Health Service ◽  
Health Service ◽  
National Health ◽  
Mental Hospital ◽  
Psychiatric Care ◽  
Community Care ◽  
Psychiatric Patients ◽  
Patient Department

Out-patient services in Britain for psychiatric patients have expanded enormously under the National Health Service. Well over half a million patients are seen at clinics annually. Concomitant with this increase the out-patient department has changed in function. No longer is it principally concerned with providing follow up and support for discharged mental hospital in-patients; instead, because of the greatly increased demand for psychiatric care for less severe disorders and under the influence of the movement for community care it now should play a part not at all subservient to the in-patient department. The clinic, properly run, should be an arena of treatment in its own right.

Psychiatrists and Citizens

1991 ◽  
Vol 159 (1) ◽  
pp. 1-6 ◽  
Author(s):  
J. L. T. Birley
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Community Care ◽  
Medical Profession ◽  
Basic Premise ◽  
The Public ◽  
False Dichotomy ◽  
The Times ◽  
The Relationship ◽  
Lasting Change

During the last two years, the medical profession in Britain has been participating in a public debate – perhaps in a more exposed way than for some time. Eminent Presidents have been writing letters to The Times, and less eminent ones demonstrating in Downing Street. This can all be seen as contributions to the discussion on the state of the National Health Service. But there is, I believe, a wider and in my view a more long-lasting change going on, namely the relationship between the medical profession and the public – the citizens of this country. You may feel that the basic premise is based on a false dichotomy, rather like the sterile debates on community care. Hospitals are part of the community. Doctors are citizens. Yet there is an implicit or explicit contract, social if not financial, between a country's medical profession and its citizens. As we are in the era of negotiating or inventing or specifying contracts, I wanted to consider this.

Domiciliary Nebuliser Therapy — A Valuable Option in Chronic Asthma and Chronic Obstructive Pulmonary Disease?

1998 ◽  
Vol 43 (2) ◽  
pp. 48-51 ◽  
Author(s):  
D.J. Godden ◽  
A. Robertson ◽  
N. Currie ◽  
J.S. Legge ◽  
J.A.R. Friend ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Admission ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Severe Disease ◽  
Structured Interview ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Technical Performance ◽  
Before And After

Domiciliary nebulisers are in widespread use for patients who have severe chronic airways disease, both asthma and chronic obstructive pulmonary disease (COPD). We report a study of the use of domiciliary nebulisers designed to assess practical problems and the value of such therapy in preventing hospital admissions. A total of 405 patients underwent a structured interview at home and their case records were reviewed. Technical performance of the nebuliser compressors was assessed The mean (SD) age of those interviewed was 64.5 (12) years. 185 patients had a physician diagnosis of asthma, and 208 had COPD. 87% patients used their nebuliser at least once daily. Side effects, reported by 54%, were related to frequency of use and commoner in younger patients. 29 subjects (7%) died within 2 years of receiving their nebuliser. Among the survivors, the 2 year periods before and after supply of the nebuliser were compared The percentage of patients requiring hospital admission for exacerbations of lung disease fell from 56% to 46% (p<0.01) but the number and duration of admissions was unchanged Those whose admission duration increased had more severely impaired spirometry when the nebuliser was supplied and had lower activity scores and higher breathlessness scores at the time of interview indicating more severe disease. Approximately half of the compressors were malfunctioning and patients' understanding of the principles of nebuliser treatment was poor. The provision of domiciliary nebuliser can influence hospital admission inpatients with obstructive airways disease. There is also a need for improved patient education and for technical support which may require the development of a nurse-run nebuliser service.

Competition in the Mixed Economy of Care

1996 ◽  
Vol 25 (2) ◽  
pp. 201-221 ◽  
Author(s):  
Julien Forder ◽  
Martin Knapp ◽  
Gerald Wistow
Keyword(s):  
National Health Service ◽  
Health Service ◽  
Social Welfare ◽  
National Health ◽  
Market Failure ◽  
Social Care ◽  
Community Care ◽  
Economic Framework ◽  
Social Welfare Services ◽  
Basic Understanding

ABSTRACTThe 1990 National Health Service and Community Care Act introduced sweeping changes to health and social welfare services. The reforms to community care were dominated by the introduction of markets for social care. We argue that the new markets cannot be guaranteed to deliver the range of services required to meet community care objectives. When they began to assume their new responsibilities, few key purchasers had a basic understanding of the functioning and imperfections of markets. Consequently, they were poorly equipped to anticipate or ameliorate the sources of market failure that we identify. Like any other relatively ill-informed purchaser, local authorities risk being unable to buy what they want on behalf of their residents and at an appropriate volume, cost and quality. We discuss where and how market imperfections are likely to occur. In this context, we offer an economic framework to help in the shaping and managing of social care markets.

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