BACKGROUND Chronic kidney disease (CKD) is a major challenge for health care systems around the world, and the prevalence rates appear to be increasing. We estimate the costs of CKD in a universal health care system. METHODS Economic modelling was used to estimate the annual cost of Stages 3-5 CKD to the National Health Service (NHS) in England, including CKD-related prescribing and care, ren...

Objectives To evaluate the cost effectiveness of human papillomavirus testing after treatment for cervical intraepithelial neoplasia (CIN). Design Economic analysis using a Markov modelling approach to combine cost and epidemiological data from the NHS Sentinel Sites Study with data from previous studies of post-treatment recurrence rates. Setting English NHS Cervical Cancer Screening Programme...

The coalition government’s approach to competition in the English NHS represents a shift to a more systematic attempt to organise the NHS along the line of the former publicly owned utilities. There is to be supplier competition both in the market (providers seeking individual patients) and for the market (commissioners selecting providers for services to populations). But the market for tax fi...

OBJECTIVES To evaluate the cost effectiveness of human papillomavirus testing after treatment for cervical intraepithelial neoplasia (CIN). DESIGN Economic analysis using a Markov modelling approach to combine cost and epidemiological data from the NHS Sentinel Sites Study with data from previous studies of post-treatment recurrence rates. SETTING English NHS Cervical Cancer Screening Progr...

This paper describes the development and application of a simulation tool for modelling patient choice in healthcare systems. Patient choice is already offered in the English National Health Service (NHS) and proposed reforms will propel choice to the forefront of NHS re-structuring by offering it at all levels of treatment. A simulation model is proposed to study the effects of patient behavio...

BACKGROUND A National Health Service (NHS) contingent liability for medical error claims of over £26 billion. OBJECTIVES To evaluate the safety management and educational benefits of adapting aviation's Normal Operations Safety Audit (NOSA) to health care. METHODS In vivo research, a NOSA was performed by medical students at an English NHS Trust. After receiving training from the author, th...

OBJECTIVES To undertake an assessment of the association between coproduction and satisfaction with decisions made for local healthcare communities. DESIGN A coproduction scale was developed and tested to measure individual National Health Service (NHS) commissioners' satisfaction with commissioning decisions. SETTING 11 English Primary Care Trusts in 2010-2011. PARTICIPANTS Staff employe...