Comparison of apparent efficiency of haemodialysis satellite units in England and Wales using data envelopment analysis.

Objectives: To expand care for chronic haemodialysis (HD) patients throughout England and Wales by studying two aspects of service delivery that are important: to identify relative performance of haemodialysis satellite units (HDSUs), and understand the factors that influence the performance. As a first step toward these aspects, this work reports a study of apparent comparative efficiency in the delivery of HDSUs and demonstrates the potential of data envelopment analysis (DEA).

Methods: DEA was applied to data obtained from a national survey of the organizational structures and processes of delivering care at HDSUs in England and Wales.

How many patients with haematological malignancy need the facilities offered by a district general hospital?

Background: The objective of the study was to study the utilization of specialist clinical services for haematological malignancy in a defined patient population. Patients with haematological malignancy are mostly aged over 65 years. Demographic projections for the United Kingdom suggest that the incidence of haematological malignancy will increase by 20 per cent in the next 20 years, mostly as a result of demographic change.

The development of a simulation model of the treatment of coronary heart disease.

A discrete event simulation models the progress of patients who have had a coronary event, through their treatment pathways and subsequent coronary events. The main risk factors in the model are age, sex, history of previous events and the extent of the coronary vessel disease. The model parameters are based on data collected from epidemiological studies of incidence and prognosis, efficacy studies.

A simulation to evaluate screening for Helicobacter pylori infection in the prevention of peptic ulcers and gastric cancers.

A discrete event simulation model has evaluated a screening programme for Helicobacter pylori infection (H. pylori) in which individuals under the age of 50 years would be screened once. Eradication of H.

Late referral for end-stage renal disease: a region-wide survey in the south west of England.

Background: The proportion of patients referred for renal replacement therapy (RRT) at a late stage of disease appears to be similar to that first described nearly 20 years ago. This study investigated the current scale of the problem in a large region in England, identifying the prior health care, patient characteristics, referral pattern, and outcomes of those accepted onto RRT.

Methods: Three hundred and sixty-one (88%) out of 411 patients accepted for RRT in six renal units in the South and West Region of the UK between 1 June 1996 and 31 May 1997 were studied retrospectively.