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  • Journal article
    Vamos EP, Millett C, Parsons M, Aylin P, Majeed A, Bottle Aet al., 2012,

    Nationwide study on trends in hospital admissions for major cardiovascular events and procedures among people with and without diabetes in England, 2004 to 2009

    , Diabetes Care, Vol: 15, Pages: 265-272, ISSN: 0149-5992

    OBJECTIVEIt is unclear whether people with and without diabetes equally benefitted from reductions in cardiovascular disease (CVD). We aimed to compare recent trends in hospital admission rates for angina, acute myocardial infarction (AMI), stroke, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) among people with and without diabetes in England.RESEARCH DESIGN AND METHODSWe identified all patients aged >16 years with cardiovascular events in England between 2004–2005 and 2009–2010 using national hospital activity data. Diabetes- and nondiabetes-specific rates were calculated for each year. To test for time trend, we fitted Poisson regression models.RESULTSIn people with diabetes, admission rates for angina, AMI, and CABG decreased significantly by 5% (rate ratio 0.95 [95% CI 0.94–0.96]), 5% (0.95 [0.93–0.97]), and 3% (0.97 [0.95–0.98]) per year, respectively. Admission rates for stroke did not significantly change (0.99 [0.98–1.004]) but increased for PCI (1.01 [1.005–1.03]) in people with diabetes. People with and without diabetes experienced similar proportional changes for all outcomes, with no significant differences in trends between these groups. However, diabetes was associated with an ~3.5- to 5-fold risk of CVD events. In-hospital mortality rates declined for AMI and stroke, remained unchanged for CABG, and increased for PCI admissions in both groups.CONCLUSIONSThis national study suggests similar changes in admissions for CVD in people with and without diabetes. Aggressive risk reduction is needed to further reduce the high absolute and relative risk of CVD still present in people with diabetes.
  • Journal article
    Tsang C, Majeed A, Aylin P, 2012,

    Consultations with general practitioners on patient safety measures based on routinely collected data in primary care.

    , JRSM Short Reports, Vol: 3, Pages: 1-9, ISSN: 2042-5333

    OBJECTIVES: To gauge the opinions of doctors working, or interested, in general practice on monitoring patient safety using administrative data. The findings will inform the development of routinely collected data-based patient safety indicators in general practice and elsewhere in primary care. DESIGN: Non-systematic participant recruitment, using personal contacts and colleagues' recommendations. SETTING: Face-to-face consultations at participants' places of work, between June 2010 and February 2011. PARTICIPANTS: Four general practitioners (GPs) and a final year medical student. The four clinicians had between eight to 34 years of clinical practice experience, and held non-clinical positions in addition to their clinical roles. MAIN OUTCOME MEASURES: Views on safety issues and improvement priorities, measurement methods, uses of administrative data, role of administrative data in patient safety and experiences of quality and safety initiatives. RESULTS: Medication and communication were the most commonly identified areas of patient safety concern. Perceived safety barriers included incident-reporting reluctance, inadequate medical education and low computer competency. Data access, financial constraints, policy changes and technology handicaps posed challenges to data use. Suggested safety improvements included better communication between providers and local partnerships between GPs. CONCLUSIONS: The views of GPs and other primary care staff are pivotal to decisions on the future of English primary care and the health system. Broad views of general practice safety issues were shown, with possible reasons for patient harm and quality and safety improvement obstacles. There was general consensus on areas requiring urgent attention and strategies to enhance data use for safety monitoring.
  • Journal article
    Bottle A, Tsang C, Parsons C, Majeed A, Soljak M, Aylin Pet al., 2012,

    Association between patient and general practice characteristics and unplanned first-time admissions for cancer: observational study

    , Br J Cancer, Vol: 107, ISSN: 1532-1827
  • Journal article
    Bottle A, Jarman B, Aylin P, 2011,

    Hospital Standardized Mortality Ratios: Sensitivity Analyses on the Impact of Coding

    , HEALTH SERVICES RESEARCH, Vol: 46, Pages: 1741-1761, ISSN: 0017-9124
  • Journal article
    Bottle A, Aylin P, 2011,

    Comorbidity scores for administrative data benefited from adaptation to local coding and diagnostic practices

    , JOURNAL OF CLINICAL EPIDEMIOLOGY, Vol: 64, Pages: 1426-1433, ISSN: 0895-4356
  • Journal article
    Alvarez LG, Aylin P, Tian J, King C, Catchpole M, Hassall S, Whittaker-Axon K, Holmes Aet al., 2011,

    Data linkage between existing healthcare databases to support hospital epidemiology

    , JOURNAL OF HOSPITAL INFECTION, Vol: 79, Pages: 231-235, ISSN: 0195-6701
  • Journal article
    Mayer EK, Bottle A, Aylin P, Darzi AW, Athanasiou T, Vale JAet al., 2011,

    The volume-outcome relationship for radical cystectomy in England: an analysis of outcomes other than mortality

    , BJU INTERNATIONAL, Vol: 108, Pages: E258-E265, ISSN: 1464-4096
  • Journal article
    Tsang C, Palmer W, Bottle A, Majeed A, Aylin Pet al., 2012,

    A Review of Patient Safety Measures Based on Routinely Collected Hospital Data

    , AMERICAN JOURNAL OF MEDICAL QUALITY, Vol: 27, Pages: 154-169, ISSN: 1062-8606
  • Conference paper
    Vamos EP, Millett C, Parsons M, Aylin P, Majeed A, Bottle Aet al., 2011,

    Trends in hospital admissions for major cardiovascular events and procedures among people with and without diabetes between 2004 and 2009 in England: a nationwide study

    , 47th Annual Meeting of the European-Association-for-the-Study-of-Diabetes (EASD), Publisher: SPRINGER, Pages: S28-S28, ISSN: 0012-186X
  • Journal article
    Alexandrescu R, Jen M-H, Bottle A, Jarman B, Aylin Pet al., 2011,

    Logistic Versus Hierarchical Modeling: An Analysis of a Statewide Inpatient Sample

    , JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, Vol: 213, Pages: 392-401, ISSN: 1072-7515

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by Paul Aylin and Alex Bottle

Statistical Methods for Healthcare Performance Monitoring
A book for those measuring, monitoring, comparing and improving healthcare performance