世界経済・社会統計 = World development indicators

OBJECTIVES--To test the acceptability, validity, and reliability of the short form 36 health survey questionnaire (SF-36) and to compare it with the Nottingham health profile. DESIGN--Postal survey using a questionnaire booklet together with a letter from the general practitioner. Non-respondents received two reminders at two week intervals. The SF-36 questionnaire was retested on a subsample of respondents two weeks after the first mailing. SETTING--Two general practices in Sheffield. PATIENTS--1980 patients aged 16-74 years randomly selected from the two practice lists. MAIN OUTCOME MEASURES--Scores for each health dimension on the SF-36 questionnaire and the Nottingham health profile. Response to questions on recent use of health services and sociodemographic characteristics. RESULTS--The response rate for the SF-36 questionnaire was high (83%) and the rate of completion for each dimension was over 95%. Considerable evidence was found for the reliability of the SF-36 (Cronbach9s alpha greater than 0.85, reliability coefficient greater than 0.75 for all dimensions except social functioning) and for construct validity in terms of distinguishing between groups with expected health differences. The SF-36 was able to detect low levels of ill health in patients who had scored 0 (good health) on the Nottingham health profile. CONCLUSIONS--The SF-36 is a promising new instrument for measuring health perception in a general population. It is easy to use, acceptable to patients, and fulfils stringent criteria of reliability and validity. Its use in other contexts and with different disease groups requires further research.

https://www.bmj.com/content/bmj/305/6846/160.full.pdf

Validating the SF-36 health survey questionnaire: new outcome measure for primary care.

Criticism and the Growth of Knowledge. Edited by I. Lakatos and A. Musgrave. Pp. viii, 282. £3·50, paperback £1. 1970. (Cambridge University Press.)

Measuring Health: A Guide to Rating Scales and Questionnaires

Theory in Practice: Increasing Professional Effectiveness

Many applied health service researchers launch into patient satisfaction surveys without realizing the complexity of the task. This paper identifies the difficulties involved in executing patient satisfaction surveys. The recent revival of interest in 'satisfaction' and disagreements over the meaningfulness of a unitary concept itself are outlined, and the various perspectives and definitions of the components of satisfaction are explored. The difficulties of developing a comprehensive conceptual model are considered, and the issues involved in designing patient satisfaction surveys--and the disasters that occur when these issues are ignored--are then set out. The potential cost-effectiveness of qualitative techniques is discussed, and the paper concludes by discussing how health care management systems could more effectively absorb the findings of patient satisfaction surveys.

The measurement of patient satisfaction

This article uses data from the 1993 Health and Lifestyles Survey of England to present findings on how, why and when people use cooking skills; where and from whom people learn these skills. The implications for policy are explored. The survey data suggests that socio‐economic status and education are associated with the sources of people’s knowledge about cooking. The first or prime source of learning about cooking skills was reported to be mothers; cooking classes in school were cited as the next most important by the majority of correspondents, with some class and educational variations. The importance of mothers as sources of information on cooking skills is observed in all social classes. What emerges is a population unsure of specific cooking techniques and lacking in confidence to apply techniques and cook certain foods. Women still bear the burden of cooking for the household, with four out of every five women respondents cooking on most or every day, compared with one in five men. This may be related to the large number of men who claim to have no cooking skills (one in five).

The state of cooking in England: the relationship of cooking skills to food choice

Objective: To identify the socioeconomic determinants of consultation rates in general practice. Design: Analysis of data from the fourth national morbidity survey of general practices (MSGP4) including sociodemographic details of individual patients and small area statistics from the 1991 census. Multilevel modelling techniques were used to take account of both individual patient data and small area statistics to relate socioeconomic and health status factors directly to a measure of general practitioner workload. Results: Higher rates of consultations were found in patients who were classified as permanently sick, unemployed (especially those who became unemployed during the study year), living in rented accommodation, from the Indian subcontinent, living with a spouse or partner (women only), children living with two parents (girls only), and living in urban areas, especially those living relatively near the practice. When characteristics of individual patients are known and controlled for the role of “indices of deprivation” is considerably reduced. The effect of individual sociodemographic characteristics were shown to vary between different areas. Conclusions: Demographic and socioeconomic factors can act as powerful predictors of consultation patterns. Though it will always be necessary to retain some local planning discretion, the sets of coefficients estimated for individual level factors, area level characteristics, and for practice groupings may be sufficient to provide an indicative level of demand for general medical services. Although the problems in using socioeconomic data from individual patients would be substantial, these results are relevant to the development of a resource allocation formula for general practice. Key messages Characteristics of individual patients are much more powerful predictors of consulting patterns than the characteristics of the areas in which patients live The effects of individual socioeconomic factors themselves vary in different geographical areas Resource allocation methods based on area of residence (for example, Jarman score) will always be inferior to an approach that takes into account the characteristics of individual patients

/pdf/socioeconomic-determinants-of-rates-of-consultation-in-53px1e0tr5.pdf

Roy Carr-Hill

Papers

The measurement of patient satisfaction

The state of cooking in England: the relationship of cooking skills to food choice

Socioeconomic determinants of rates of consultation in general practice based on fourth national morbidity survey of general practices

Pre-eclampsia in second pregnancy

The repetition of spontaneous preterm labour