Imperial College Publications
New publications include papers on the impact of pay for performance on ethnic inequalities and disparities in the quality of care; and trends in admission for for cardiovascular disease for people with diabetes. You can view links to these publications on my Imperial College Publications page.
Pay for performance and ambulatory care sensitive admissions
Many countries are considering paying primary care physicians to improve the quality of care they provide to their patients (commonly known as 'pay for performance' or P4P). A recent study in the Journal of General Internal Medicine found very little association between quality scores in a pay for performance scheme in England and admission rates for coronary heart disease. This suggests that improving the quality of primary care may not reduce demands on the hospital sector.
Primary Health Care Conference in Mauritius
The Department of Primary Care & Social Medicine organised a very successful joint conference in Mauritius with the University of Mauritius and the Ministry of Health and Quality of Life. A number of topics were discussed and conference proceeedings will be prepared soon.
Recent Research Articles
Recent research articles published by the Department of Primary Care and Social Medicine have appeared in PLoS Medicine (deaths from paracetamol poisoning), CMAJ and the Journal of Public Health (trends in diabetes prescribing), and Diabetologia (future trends in diabetes in the USA). Forthcoming articles on the impact of paying doctors for performance on the quality of care they provide and an international comparison of primary care practice will appear in PLoS Medicine, CMAJ and the BMJ.
Imperial College Applied Ethics Course
More than ever before, clinicians are confronted with complex ethical issues in their medical practice. These include disagreements between patients, relatives, and healthcare staff over treatment decisions, difficulties in obtaining informed consent, and issues of medical error, truth-telling and patient confidentiality. Recognising the growing importance of ethical awareness in medicine, the recent Ethics in Practice report of the Royal College of Physicians (2005) concluded that key medical personnel should be suitably trained in clinical ethics. Increasingly, formal examinations in medicine assess applicants on aspects of clinical ethics.The new Applied Clinical Ethics (ACE) course is aimed at practising clinicians and members of CECs, focusing entirely on clinical ethics and practical decision-making. Several of the speakers are both clinicians and ethicists. The convenient arrangement of modules, each falling on a Saturday at monthly intervals, will enable practising clinicians to apply their knowledge in between sessions and attend the course without taking time off work. See the Course Website for further details.
Visit to Malaysia
I've just returned from a visit to Kuala Lumpur in Malaysia after being invited to act as an external examiner for the Master of Family Medicine programme run by the UKM (National University of Malaysia), UM (University of Malaya) and USM (Science University of Malaysia). Although the core of medical practice is similar across the world, there are striking differences in the organisation and delivery of health services between the UK and Malaysia. As well as examining, I was also able to give several lectures during my stay in Malaysia.
Imperial College Publications
Patients in England with diabetes are better managed than their counterparts in the United States of America due to access to universal healthcare available in the United Kingdom, according to new research.
Writing in the September issue of the Journal of the Royal Society of Medicine, researchers from England and the USA compared diabetes management in the two countries.
“Our evidence shows that universal healthcare when treating a common disease like diabetes, works,” said Professor Arch Mainous from the Medical University of South Carolina. “In both countries, diabetes sufferers are effectively managed as outpatients and our research shows that when patients have access to free healthcare, they have better clinical outcomes.
See the full text of the article or the press release for more details.
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