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Showing posts from July, 2012

Unplanned first-time admissions for cancer

Cancer survival in the United Kingdom is poorer than in many other European countries. For many patients with cancer, their diagnosis is first made when they are admitted to hospital as an emergency with complications of cancer. Hence, studying patients in whom cancer is diagnosed in this sway may provide information that can be used to improve the detection of cancer by the NHS. In a paper published recently in the British Journal of Cancer, Alex Bottle and colleagues from the Department of Primary Care & Public Health at Imperial College London examined patient and general practice characteristics associated with emergency (unplanned) first hospital admissions for cancer in England.

They reported that there were around 640,000 patients with a first-time admission for cancer, of which around 140,000 were unplanned, coming from 7957 GP practices. The unplanned proportion ranged from 14% (patients aged 15–44 years) to 45% (patients aged 85 years and older), with a large variation …

Epidemiology of end-stage renal disease in the countries of the Gulf Cooperation Council

End-stage renal disease (ESRD) is an irreversible decline in kidney function, when renal replacement therapy (RRT) is needed for survival. The countries of the Gulf Cooperation Council (GCC), which consist of Saudi Arabia, the United Arab Emirates, Kuwait, Qatar, Bahrain, and Oman have an increasing burden of non-communicable diseases, including ESRD.

In a paper published recently in JRSM Short Reports, Amal Hassanien and colleagues reviewed the epidemiological studies of ESRD in the countries of the GCC. The studies included in this review showed that the incidence of ESRD has increased while the prevalence and mortality rate of ESRD in the GCC has not been well reported. The leading primary cause of ESRD is diabetes and the most common co-morbid conditions are Hypertension and Hepatitis C Virus infection. The most common causes of death were cardiovascular disease and sepsis.

The study highlighted that the lack of national renal registries data is a critical issue in the countries …

Emergency admissions from sickle cell crisis in Brent

Sickle cell disease (SCD) is a common genetic disorder, largely affecting Black and ethnic minorities (BME) groups. The prevalence in England has increased significantly in recent decades, particularly in urban areas. The increase in the number of people with SCD in England  and the associated burden on the health of patients with SCD  have led to gaining increased attention from the NHS.

In article published in JRSM Short Reports, Stuart Green and colleagues examined admissions from SCD in people living in the London Borough of Brent. The looked at admission between January 2008 and July 2010 by length of stay (average and <2 days versus ≥2 days), age group and registered GP practice of the patient. They reported that 36% of sickle cell disease admission spells resulted in a length of stay of less than two days. Seventy four percent of total bed days are associated with patients with more than one admission during the period of analysis, i.e. multiple admissions.  The figure shows…

The North West London Integrated Care Pilot

The North West London Integrated Care Pilot (ICP) was launched in June 2011. The ICP includes around 100 general practices, 2 acute care trusts, 5 primary care trusts, 2 mental health care trusts, 3 community health trusts, 5 local authorities, and 2 voluntary sector organizations (Age UK and Diabetes UK). The programme aims  to improve the care for older people and people with diabetes in the 550, 000 people living in the area covered by the pilot.

The key objectives of the ICP are discussed in article published in the Journal of Ambulatory Care Management by Matthew Harris and colleagues. These objectives include:

Early identification of at-risk diabetic or elderly peopleRisk stratification using simple assessment scales (combined predictive model)Proactive care planning and delivery by community teamMultidisciplinary teams led by a general practitioner or consultant Improved information flows and system redesignImproved systems and processes to share patient notes and care plans ac…