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Biomedical subjects

R A McNay

Publications and source records attributed to R A McNay.

11 recordsLinked to original sources
PubMed1989

Evaluation of diagnosis-related groups in the National Health Service.

Evaluation of the use of diagnosis-related groups (DRGs) has revealed a number of technical problems in coding of diagnoses and operative procedures, as well as unresolved issues in the clinical acceptability of existing groupings. An investigation of the statistical homogeneity of DRGs, in terms of duration of patient stay, is described. Consideration of data relating to some 990,000 episodes of in-patient care in three English Regions discloses wide variations in statistical homogeneity, both between DRGs and in relation to individual clinical specialties. The greatest homogeneity is found in ENT surgery and gynaecology; and the least in general medicine and orthopaedic surgery. The need for improved data collection and coding procedures is discussed, together with the advisability of sensitivity in the interpretation of DRGs, as well as the need for a co-ordinated approach to their refinement for application in any wider introduction in the NHS.

Diagnosis-Related Groups↗
PubMed1983

Changing patterns of home visiting in the north of England.

The visiting habits of general practitioners in the north of England in 1969 and in 1980 have been compared. During this period overall visiting was reduced by 41%. The reduction was most pronounced in repeat visits, particularly to children. There was a greater reduction in visits to patients with respiratory disease than to those with other illness. The reduction was least in visits to patients over the age of 65. New visits requested by patients were reduced by 31%, but the general practitioner still considered that about the same percentage of patients could have attended the surgery as in 1969. The reasons for these differences include flexible appointment systems, improved efficiency, better organisation of the surgery, and more flexible arrangements for certification of absence from work. Though total workload (as measured by the number of consultations with patients) has diminished, general practice has changed, being more concerned with prevention, chronic disease, and vocational training.

Adolescent↗
PubMed1983

Surgical operation rates: a twelve year experience in Stockton on Tees.

A review of twelve years surgical practice in a district in the North East of England is presented. During this period 63 562 surgical operations were undertaken. Analyses of these operations show that the amount of elective general surgery undertaken has almost doubled and the rate of emergency general surgery has remained remarkably constant. There has been a significant increase in the number of gallbladder, varicose vein and minor general surgical procedures performed. There has also been a significant increase in urological surgery and in orthopaedic surgery which has doubled over the study period.

Adolescent↗
PubMed1976

A study of HL-A types in Rh haemolytic disease of the newborn.

The HL-A types of 288 women, immunised to the Rh(D) antigen as a result of pregnancy, have been compared to the HL-A types of 139 women who although they have had Rh(D)-positive children have not produced anti-Rh(D). There is an indication that an increased incidence of the HL-A3 antigen is associated with the immunised mothers. A study of the HL-A types of husbands and children of both immunised and non-immunised women did not suggest that their HL-A types played a significant role in anti-Rh(D) production. The frequencies of the HL-A antigens in each category studied have been tabulated for record purposes, as well as the frequencies in a random panel of persons living in the Newcastle environs. Full ABO, Rh and HL-A details of 50 immunised mothers and their families and of 58 non-immunised mothers and their families are available.

ABO Blood-Group System↗
PubMed1976

Bone disease in long-term haemodialysis: the association of radiological with histological abnormalities.

The radiological findings in the skeletal surveys of 70 patients receiving long-term haemodialysis for chronic renal failure have been correlated with histological findings in a specimen obtained by biopsy of the iliac crest. Many significant associations were found, and the ones presented are those thought to be most useful in the interpretation of the radiological abnormalities. The main conclusions are that fractures and severe medullary rarefaction appear to be most commonly the result of osteomalacia; subperiosteal erosions are associated with the more severe grades of osteitis fibrosa; cortical striations and sclerosis are associated with an increased amount of osteoid, and sclerosis is diagnosed more frequently by radiological means than by iliac-crest biopsy.

Adult↗
PubMed1974

Team work load in an English general practice. I.

A survey of the total care provided by a general practitioner and his paramedical team for 3,137 patients in Teesside in 1972 showed that even in this area of high morbidity and mortality the work load was very small. The doctor held an average of 2.3 consultations per patient per year, and the overall average for the team of doctor, nurse, and health visitor was only 3.1. By delegating work to a team of trained paramedical workers, by increasing the proportion of personal medicine, and by engaging the co-operation of his patients, the general practitioner reduced his work load considerably, without any apparent reduction in standard of care.

Age Factors↗
PubMed1974

Factors affecting work load in general practice. II.

The second part of a survey studying factors that affect a general practitioner's work load considers the effects of age, sex, social class and time on list. Women, the old, and the young created the most work for the doctor and his paramedical team. Patients in the lower social classes also generated more work, even though a larger proportion of the higher social classes used the resources of the general practice-and more fully. Newly-registered patients generated slightly more work than the more permanent residents. Not only the size of a doctor's list, therefore, but also the demographic features of the community should be taken into account in determining the size and structure of the general-practice team needed for an area.

Adolescent↗
PubMed1972

Survey of home visiting by general practitioners in North-east England.

A total of 190 general practitioners in North-east England recorded the details of each home visit they made during a two-week period towards the end of 1969. Altogether 17,200 visits were made and these have been analysed. Two major points emerge: firstly, the extreme variation in visiting habits by general practitioners; and, secondly, the feeling that many home visits were unnecessary.

Adolescent↗