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Journal articleVamos EP, Millett C, Parsons M, et al., 2012, , 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.
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Journal articleTsang C, Majeed A, Aylin P, 2012, , 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.
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Journal articleBottle A, Tsang C, Parsons C, et al., 2012, , Br J Cancer, Vol: 107, ISSN: 1532-1827
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Journal articleBottle A, Jarman B, Aylin P, 2011, , HEALTH SERVICES RESEARCH, Vol: 46, Pages: 1741-1761, ISSN: 0017-9124
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- Citations: 33
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Journal articleBottle A, Aylin P, 2011, , JOURNAL OF CLINICAL EPIDEMIOLOGY, Vol: 64, Pages: 1426-1433, ISSN: 0895-4356
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- Citations: 86
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Journal articleAlvarez LG, Aylin P, Tian J, et al., 2011, , JOURNAL OF HOSPITAL INFECTION, Vol: 79, Pages: 231-235, ISSN: 0195-6701
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- Citations: 26
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Journal articleMayer EK, Bottle A, Aylin P, et al., 2011, , BJU INTERNATIONAL, Vol: 108, Pages: E258-E265, ISSN: 1464-4096
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- Citations: 21
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Journal articleTsang C, Palmer W, Bottle A, et al., 2012, , AMERICAN JOURNAL OF MEDICAL QUALITY, Vol: 27, Pages: 154-169, ISSN: 1062-8606
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- Citations: 18
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Conference paperVamos EP, Millett C, Parsons M, et 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 articleAlexandrescu R, Jen M-H, Bottle A, et al., 2011, , JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS, Vol: 213, Pages: 392-401, ISSN: 1072-7515
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- Citations: 11
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