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Health and Social Care Health Care Public Health

The most important charts in health and social care

A few days ago I posted a pic from some analysis done in Sheffield with the bold strap line of “second most important chart in contemporary health care” Whether it IS indeed the second, third or most is probably immaterial I was then asked for my view on the most. Others then suggested others. It’s […]

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Health and Social Care Health Care Public Health population health

Population health management, revisiting segmentation

Population health management, revisiting segmentation The use and abuse of risk stratification. Population health management is all the rage. I’ve blogged on this a lot recently. This is a long, teccy blog. Largely based on something I wrote about 7 years ago. Basics haven’t changed since then. Thanks especially to Steve Laitner and Martin Vernon […]

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Ageing Health Care Public Health

Epidemiology of multi morbidity volume 2

A question rolled into my inbox from a senior clinician I know. It’s here “Do you have a few killer facts about: • Prevalence of LTCs, trends over last 5 years and predictions for next 5 years? • Ditto prevalence of multi morbidity • Ditto healthy life expectancy.. We have all sorts of conflicting stories […]

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Accountable Care Health and Social Care Health Care Public Health population health

Five capabilities for population health management

I had a careful think on this. People keep asking me on this. I definitely don’t know “the answer”, I don’t think such a thing exists. Everyone and their dog, and their dog’s dad is trying to define “population health” at the moment, hence my previous blogs on it attempting to set out my own […]

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Accountable Care Health Care Public Health Healthcare Reform population health Prevention Public Health Shared decisions STP

Population health, population health care, population managemen

More than 30 years ago Rose set out the importance of focusing on population factors and not just individuals. We’ve not really made good on the hypothesis yet. Population health is still all the rage, if not properly defined. I’ve had a few gos at defining. Firstly trying to distinguish “public health” and “population health”. […]

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Evidence Health Care Public Health Screening Value

Screening for cardiac risk in young adults – a poor way to save lives

This one has cropped up a lot over the years. See this thread from @CRY_UK inviting people between 14-35 to get free ECG heart screenings There’s a handy link to a website to get tested, with handy locations all over the uk. I mostly see the red mist at this point. I’ve also seen mass […]

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Health Care Public Health Value

innovation is NOT the same as shiny gadget or “invention”

people keep asking me to write a blog on “innovation” I recently wrote about our idolatry of gizmos. gizmos are certainly inventions, sometimes they are innovative. Sometimes they don’t add a lot (any) value thus Im mostly unconvinced they class as “innovative” I’m not sure I can summon the will to live to write more […]

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Health Care Public Health Shared decisions Value

Robotic prostatectomy. £60m capital cost on gizmo idolatry

I’ve previously had my rant about the ProtecT study. This broadly backs up earlier studies e.g. The PIVOT study suggesting radical prostatectomy doesn’t beat watchful waiting in terms of overall survival for localised prostate cancer. Surgery can do harm, watchful waiting will not. This is a development based on the hot of the press study […]

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Health and Social Care Health Care Public Health Prevention Smoking

Health optimisation as a strategy for financial saving

I’m distinguishing the financial from clinical benefit here, and mandatory threshold policies and system and pathway to support type approach to implementation. For those short on patience – it’s a poor strategy for financial saving, it may exacerbate inequalities, it’s a good idea health gain wise. I’ve been here a few times historically on smoking […]

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Clinical Evidence Health Care Public Health Value

Avastin in Opthalmology, after the draft AMD guideline

Christmas is here The AMD guideline is out https://www.nice.org.uk/guidance/indevelopment/gid-cgwave0658/documents p150 odd onwards of the full guideline is the business end https://www.nice.org.uk/guidance/gid-cgwave0658/documents/draft-guideline#page155 it is largely as expected very clear (& exceptionally detailed) appraisal of the evidence base around the management of AMD. For me (and many) we were all waiting for this CG to see the […]