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Journal ArticleDOI

Semicontinuous screening of a whole community for hypertension

01 Aug 1970-The Lancet (Elsevier)-Vol. 296, Iss: 7666, pp 223-226
TL;DR: It is concluded that screening for hypertension, using these criteria, is feasible with existing resources, and that high response-rates can be achieved with little difficulty if the procedure is carried out within the community by its own health workers.
About: This article is published in The Lancet.The article was published on 1970-08-01. It has received 67 citations till now. The article focuses on the topics: Population.
Citations
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Journal ArticleDOI
TL;DR: The market distribution of medical care is a primitive and historically outdated social form, and any return to it would further exaggerate the maldistribution of medical resources.

2,653 citations

Journal ArticleDOI
TL;DR: A comprehensive summation of the major barriers to working with various disadvantaged groups is provided, along with proposed strategies for addressing each of the identified types of barriers.
Abstract: Background This study aims to review the literature regarding the barriers to sampling, recruitment, participation, and retention of members of socioeconomically disadvantaged groups in health research and strategies for increasing the amount of health research conducted with socially disadvantaged groups.

890 citations

Journal ArticleDOI
13 Jun 1998-BMJ
TL;DR: Hospital at home care did not reduce total healthcare costs for the conditions studied in this trial, and costs were significantly increased for patients recovering from a hysterectomy and those with chronic obstructive airways disease.
Abstract: Objectives:To examine the cost of providing hospital at home in place of some forms of inpatient hospital care. Design: Cost minimisation study within a randomised controlled trial. Setting: District general hospital and catchment area of neighbouring community trust. Subjects: Patients recovering from hip replacement (n=86), knee replacement (n=86), and hysterectomy (n=238); elderly medical patients (n=96); and patients with chronic obstructive airways disease (n=32). Interventions: Hospital at home or inpatient hospital care. Main outcome measures: Cost of hospital at home scheme to health service, to general practitioners, and to patients and their families compared with hospital care. Results: No difference was detected in total healthcare costs between hospital at home and hospital care for patients recovering from a hip or knee replacement, or elderly medical patients. Hospital at home significantly increased healthcare costs for patients recovering from a hysterectomy (ratio of geometrical means 1.15, 95% confidence interval 1.04 to 1.29, P=0.009) and for those with chronic obstructive airways disease (Mann-Whitney U test, P=0.01). Hospital at home significantly increased general practitioners9 costs for elderly medical patients (Mann-Whitney U test, P Conclusion: Hospital at home care did not reduce total healthcare costs for the conditions studied in this trial, and costs were significantly increased for patients recovering from a hysterectomy and those with chronic obstructive airways disease. There was some evidence that costs were shifted to primary care for elderly medical patients and those with chronic obstructive airways disease. Key messages Hospital at home schemes are a popular alternative to standard hospital care, but there is uncertainty about their cost effectiveness In our randomised controlled trial we compared the cost of hospital at home care with that of inpatient hospital care for patients recovering from hip replacement, knee replacement, and hysterectomy; elderly medical patients; and those with chronic obstructive airways disease There were no major differences in health service costs between the two arms of the trial for patients recovering from hip or knee replacement and elderly medical patients Hospital at home care increased healthcare costs for patients recovering from hysterectomy and for those with chronic obstructive airways disease Hospital at home care resulted in some costs shifting to general practitioners for elderly medical patients and those with chronic obstructive airways disease

175 citations

Journal ArticleDOI
13 Jun 1998-BMJ
TL;DR: This is the first in a series of six articles reflecting on the core values that will underpin the development of primary care.
Abstract: This is the first in a series of six articles reflecting on the core values that will underpin the development of primary care In 1920, the Dawson report advocated a population based approach to the organisation of health services, the allocation of resources, and the training of health care staff.1 It also introduced the concepts of primary and secondary levels of care and of primary care health centres. For several decades these ideas lay dormant, until medical specialisation, fragmentation of health services, and the introduction of publicly funded health care made their logic inescapable. The term “primary care” became common coinage, and in 1978 its fundamental importance was recognised by the World Health Organisation.2 In the same year, the US Institute of Medicine identified the four essentials of good primary care as accessibility, comprehensiveness, coordination, and continuity.3 For most of this century, the typical primary care professional has been a generalist practitioner,4 usually practising close to the population served by the practice, alone or in a small group, and supported by a small staff. (Generalist practitioners include practitioners from nursing and from general paediatrics or internal medicine.) The key relationship for most of these practitioners is with individual patients who consult about problems they have identified themselves. Until recently, screening for risk factors and early disease in asymptomatic patients has been unusual. But practitioners have often forged strong community links, especially in small towns and rural areas. For all its limitations, generalist practice has represented a strong tradition of personal care, comprehensive in its response to the needs of the people and reasonably accessible in their neighbourhoods and homes. It is on this living tradition that primary care should build as it evolves into new forms. Traditions are the bearers of values. In a living tradition, …

142 citations


Cites background from "Semicontinuous screening of a whole..."

  • ...The population perspective, ensuring that the services of the practice are made available to the whole practice population, has a long tradition in general practice.(16) Information technology has made it easier to maintain the necessary records....

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Journal ArticleDOI
S Ebrahim1
TL;DR: Searching MEDLINE (1966 to July 1996) was searched using a standard OVID filter for randomised controlled trials followed by the search terms 'hypertension' and 'high blood pressure' and the secondary terms 'detection', 'compliance' and'control'.
Abstract: Searching MEDLINE (1966 to July 1996) was searched using a standard OVID filter for randomised controlled trials followed by the search terms 'hypertension' and 'high blood pressure' and the secondary terms 'detection', 'compliance' and 'control'. A comprehensive searching of the reference lists in the articles found was performed. A further, but more limited search of the Cochrane Library was conducted using the terms 'hypertension' (all fields) and 'detection', 'compliance' and 'control' (title fields).

88 citations

References
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Journal ArticleDOI
TL;DR: The purpose of this paper is to describe the patterns seen in sixty cases of right ventricular hypertrophy and to differentiate normal rightaxis deviation (due to position of the heart) from abnormal right axis deviation ( due toright ventricularhypertrophy).

1,864 citations

Journal Article

49 citations