BACKGROUND Emergency admission rates have been rising steadily in recent years, with the majority of the increase owing to emergency medical admissions. Possible causative factors include changing demography, incidence of disease, admission thresholds, multiple admissions, and appropriateness of admission. AIM To investigate the impact of patient and practice factors on variance in general pr...

After widespread use and misuse of antimalarial drugs led to the emergence of resistance, new guidelines for malaria treatment with artemisinine-based combination therapy (ACT) were introduced in Burkina Faso in 2005. To describe the management (drug therapy and other practices) of patients with suspected malaria before their admission to the district hospital of Dô, seven years later. This cro...

OBJECTIVE The incidence of medically treated attempted suicides was investigated in a defined area in the western part of The Netherlands, and demographic groups at risk were identified. DATA AND METHODS Suicide attempts treated at general hospitals, psychiatric hospitals, and in general practice were monitored between 1 January 1989 and 1 January 1993. Information on demographic characterist...

OBJECTIVES To quantify service integration achieved in the national exemplar programme for single call access to out of hours care through NHS Direct, and its effect on the wider health system. DESIGN Observational before and after study of demand, activity, and trends in the use of other health services. PARTICIPANTS 34 general practice cooperatives with NHS Direct partners (exemplars): fo...

BACKGROUND Teaching of medication prescribing is a specific challenge in general practice curriculum. The aim of this study was to identify and rank the competencies required for prescribing medication for general practice residents in France. METHODS Qualitative consensus study using the nominal group technique. We invited different stakeholders of the general practice curriculum and medicat...

This article is concerned with the key economic characteristics of Australia's mental health system. First, some brief conceptual and empirical descriptions are provided of Australia's mental health services, both as a total system, and of its two principal components, viz. public psychiatric institutions and private psychiatry services. Expenditures on public psychiatric hospitals clearly demo...

Under the UK fundholding scheme, general practices could elect to hold a budget to meet the costs of some types of elective surgery (chargeable admissions) for their patients. It was alleged that patients of fundholding practices had shorter waits for elective surgery than the patients of non-fundholders. Comparison of waiting times between fundholding and non-fundholding practices are potentia...

BACKGROUND End-of-life planning means decision making with patients, formulating and recording decisions regarding their end-of-life care. Although clearly linked with benefits including improved quality of life, reduced hospital admissions, and less aggressive medical care, it is still infrequently undertaken and is regarded as challenging by healthcare professionals. AIM To ascertain the fe...

Geriatric patients comprise a rapidly expanding age segment of the population of developed countries. It is the fastest growing population segment in the United States. Individuals older than 65 years of age currently represent 13% of the US population, but the US Census Bureau projects that by 2050, they will represent more than 21%. Accidental injurywas the fifthmost frequent cause ofmortalit...

Ford and Britting’s editorial in this month’s Journal of Hospital Medicine raises important questions concerning the use of nonphysician providers in hospital medicine. They focus primarily on the use of mid-level providers (MLPs), namely physician-assistants (PAs) and nurse practitioners (NPs), as a potential solution to the current physician workforce shortages in our field. While we acknowle...