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Biomedical subjects

U Harries

Publications and source records attributed to U Harries.

9 recordsLinked to original sources
PubMed1999

Evidence-based policy-making in the NHS: exploring the interface between research and the commissioning process.

BACKGROUND: The UK National Health Service (NHS) R&D strategy acknowledges the importance of developing an NHS where practice and policy is more evidence-based. This paper is based on a qualitative study which aimed to identify factors which facilitate or impede evidence-based policy-making at a local level in the NHS. METHODS: The study involved a literature review and case studies of social research projects which were initiated by NHS health authority managers or general practitioner (GP) fundholders in one region of the NHS. Data were collected through in-depth interviews with lead policy-makers, GPs and researchers working on each of the case studies and analysis of project documentation. RESULTS: An over-arching theme from the analysis was that of the complexity of R&D in purchasing. The two worlds of research and health services management often sit uncomfortably together. For this reason it was not possible to describe a 'blueprint' for successful R&D, although several important issues emerged. These include sharing an appropriate model for research utilization, the importance of relationships in shaping R&D, the importance of influence and commitment in facilitating evidence-based change, and the resourcing of R&D in purchasing. CONCLUSIONS: These issues have important implications for the strategic development of R&D as well as for individual project application. Moving beyond the rhetoric of evidence-based policy-making is more likely if both policy-makers and researchers openly acknowledge this complexity and give due concern to the issues outlined.

Evidence-Based Medicine↗
PubMed1996

Is the short form 36 (SF-36) suitable for routine health outcomes assessment in health care for older people? Evidence from preliminary work in community based health services in England.

STUDY OBJECTIVE: To examine the short form 36 (SF-36) health status measure when used to assess older people's views of the outcome of community based health care. DESIGN: Completion of a structured questionnaire, before and after intervention alongside in-depth interviews with a subsample of the interviewees. SETTING: Community based continence and mental health services in two health authorities in the North West Health Region. PATIENTS: Forty seven older people newly referred to mental health services or continence services between December 1992 and April 1993 participated. MAIN RESULTS: The SF-36 showed minimal change over time for both patient groups. The more detailed in-depth interviews showed that people experienced positive changes and derived value from contact with services in a number of important ways. For many reasons these benefits were not reflected in their SF-36 scores. CONCLUSIONS: The SF-36 is not likely to be the "measure of choice" for this type of evaluation, particularly where it involves older patient groups who have high levels of comorbidity. The content of the SF-36 and its lack of detail for individual assessment of change means it masks rather than illuminates patients' views of outcome.

Aged↗
PubMed1994

Visual disability among older people: a case study in assessing needs and examining services.

This paper presents preliminary findings from a research project aiming to assess the health and social care needs of older people with visual problems and to consider the implications of the data collected for the new commissioning authorities in the National Health Service. The project was based in four District Health Authorities in the North West of England. The needs assessment work consisted of a number of related elements: a review of the literature on visual impairment and disability; a survey of 1660 people aged over 64 years; a clinical assessment of visual problems among a sub-group of the survey sample; and a review of service provision. To explore the commissioning implications, a number of inter-agency workshops have been held across and within the participating districts. The preliminary findings are discussed within the framework of Maxwell's six dimensions of quality.

Age Factors↗
PubMed1992

How many people think they have hay fever, and what they do about it.

Little is known about the number of people who perceive themselves to be sufferers of hay fever. This study investigated how many people between the ages of 15 and 59 years perceived themselves to be hay fever sufferers and how they treated themselves. The study was carried out in a general practice in Arnold, Nottingham, using a postal questionnaire, to which the response rate was 77% from a sample size of 1062. Of the 813 respondents, 232 (29%) claimed to have had hay fever within the last two years. The prevalence of hay fever decreased significantly with age, and was associated with a history of asthma. One hundred and twenty five sufferers (54%) used over the counter treatments for their hay fever, and one third of these said that they felt drowsy after using them. These findings point to the need for general practitioners to be aware that a number of people, more than has been indicated by previous surveys, perceive themselves to be hay fever sufferers and are prepared to treat themselves using over the counter preparations.

Adolescent↗
PubMed1987

Interviewing the elderly about their health: validity and effects on family doctor contacts.

Health-related questions in a large interview schedule (designed to examine relationships between customary physical activity, physical and psychological well-being among the elderly) were found to be repeatable (overall agreement was 93%) when used by two independent interviewers. The sensitivity and specificity of the interview in discriminating between people with and without health problems were 80% and 92%, respectively, when compared with a physician's independent assessments. Family doctor case notes under-recorded many of the common health problems of elderly people and could not be used to validate the interviewees' responses. Comparisons between 41 interviewees and 75 age-, sex- and practice-matched controls demonstrated that interviewees were only slightly more likely to consult or request a repeat prescription in the week following the interview (19%) than controls (11%). The 95% confidence intervals of this 8% difference were wide (-6% to 22%) and it might well have occurred by chance. Practices intending to use screening or research interviews with elderly people should be reassured such activities are not associated with large increases in demand for their services.

Aged↗