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Showing posts from January, 2010

Impact of universal health coverage in the UK on health disparities

There is currently an ongoing debate in the USA about whether the US government should expand health coverage to include some groups that have limited access to health care. In the UK, we have had universal health coverage since 1948, when the NHS was introduced. The US health system has some stark disparities between ethnic groups. A recent article from Imperial College published in the Journal of Public Health examined change in the quality of care for people with diabetes over a 10 year period from 1997-2006. We found that although Although ethnic disparities persist in diabetes management, these are starting to be addressed, particularly in the South Asian group. It appears therefore that all ethnic groups have benefited from recent quality improvement initiatives in the UK.

Moving forward on the use of EPRs for research

A recent article in Informatics in Primary Care discussed how we can build on a Wellcome Trust report on the use of electronic patient records (EPRs) from general practice for research. The UK could significantly enhance its health research capability by making effective use of data from electronic patient records for secondary research. The Wellcome Trust report provides useful guidance to researchers and clinicians on why secondary research using data from electronic records in primary care is important. Combined with advances in NHS Information Technology systems, particularly the Research Capability Programme, and financial support from the NIHR, we need to make this potential a reality and ensure that the UK remains a world leader in primary care informatics.

The burden of alcohol related disease

A recent report from the NHS Confederation and the Royal College of Physicians examines the growing cost to the NHS of treating people with alcohol-related diseases. The report was also covered by the BBC News. One of the important complications of excessive alcohol intake is liver disease.

In a paper published in 2008 in the journal Alcohol and Alcoholism, along with colleagues from St.Georges Hospital and the Office for National Statistics, I examined trends in hospital admissions and mortality in England from chronic liver disease. Hospital admission rates for chronic liver disease increased by 71% in males and 43% in females between 1989 to 2003. This increase was largely due to alcoholic liver disease, admission rates for which more than doubled between 1989/1990 and 2002/2003. Mortality rates for chronic liver disease more than doubled between 1979 and 2005 with two thirds of these deaths attributable to alcohol-related liver disease in 2005. The highest rate of alcoholic liver …