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Introduction
Skills and Expertise
Current institution
Publications
Publications (39)
Background
Recent evidence shows that after several decades of gains in life expectancy, Scotland has firmly entered a period of slow-down. Trend data show that the prevalence of morbidity continues to increase resulting in a frailer and more vulnerable population. Burden of Disease (BOD) studies measure the causes of health loss and their attribut...
The aim of this study was to estimate the percentage of hospital resource use due to
overweight and obesity in 2015/16. This was measured by specialty-level admission to
hospital and the direct cost of hospital episodes (HEs) in Scotland.
Background
Cause-specific mortality trends are routinely reported for Scotland. However, ill-defined deaths are not routinely redistributed to more precise and internationally comparable categories nor is the mortality reported in terms of years of life lost to facilitate the calculation of the burden of disease. This study describes trends in Year...
Tables A-H. Ill-defined deaths by age, sex, time, SIMD and health board.
(XLSX)
Tables A-B. EASR rates and YLL by SIMD.
(XLSX)
Table A. Ill-defined death types and target diseases.
(DOCX)
Tables A-F. Ill-defined deaths by type.
(XLSX)
Table A. Ill-defined deaths redistribution coefficients.
(XLSX)
Table A. Crude and EASR YLL by time and cause.
(XLSX)
Table A. EASR rates and YLL by geography.
(XLSX)
The impact of alcohol consumption in Scotland in terms of harms to health as well as the wider impact on individuals, families, communities and the economy is well documented. This report presents revised estimates of patients admitted to hospital, deaths and the overall burden of disease attributable to alcohol consumption in Scotland by age group...
The Scottish Government are committed to expanding the provision of funded early learning and childcare for some 2 year olds and all 3-4 year olds. By 2020 children will be entitled to 1140 hours per year. NHS Health Scotland evaluation team undertook an evaluability assessment of the policy expansion in collaboration with key stakeholders. This re...
A Soft Drinks Industry Levy on sugar-sweetened beverages (SSBs) was announced in the Westminster budget on 16 March 2016. The UK Government plans to introduce the SSB levy in 2018, with legislation enacted in 2017. The aim of the levy is ‘…..to give companies plenty of space to change their product mix’.
The levy is a banded duty on soft drinks wit...
OBJECTIVE:
The gap between a population's actual and ideal health can be quantified by Disability-Adjusted Life Years (DALY). This metric combines the Years Lived with Disability (YLD) and Years of Life Lost (YLL). When supplemented by a Comparative Risk Assessment (CRA) it can depict the magnitude of disease burden and the effect that modifiable e...
Objective:
To provide a basis for evaluating post-2007 alcohol policy in Scotland, this paper tests the extent to which pre-2007 policy, the alcohol market, culture or clinical changes might explain differences in the magnitude and trends in alcohol-related mortality outcomes in Scotland compared to England & Wales (E&W).
Study design:
Rapid lit...
Objective:
This paper tests the extent to which differing trends in income, demographic change and the consequences of an earlier period of social, economic and political change might explain differences in the magnitude and trends in alcohol-related mortality between 1991 and 2011 in Scotland compared to England & Wales (E&W).
Study design:
Com...
An assessment of the options for evaluating the provision of free school meals for all children in the first three years of primary school in Scotland.
Background:
It has been suggested that to meet information needs of multiple stakeholders, evaluation of public health interventions should specify a broader range of outcomes, evaluate a wider range of interventions and use more varied methods, in particular for dealing with complexity. Current outcomes approaches in public policy are potentially...
In 2006, The Lancet published a landmark paper showing a substantial increase in liver cirrhosis mortality in Scotland in the 1990s. Faced with this major public health challenge, and coinciding with a shift to an outcomes-based approach to formulate policy, in 2009 the Scottish Government set out a long-term strategy to change Scotland's relation...
IntroductionThe basics of economic evaluationThe current approach to implementing evidenceCost considerations in practiceAlternative options for promoting economic considerations in practiceExtending the definition of acceptable evidence and the type of evidence usedConclusion
AcknowledgementsReferences
Background Many general practitioners (GPs) are concerned about the increasing dominance of economic issues in major decisions about clinical care, and feel their opinions on economic matters have not been heard. It is unclear whether this information has any impact on everyday clinical practice in a primary care setting.
Aim To investigate GPs’ pe...
To evaluate the costs and benefits of alternative systems of coronary heart disease monitoring in Scotland.
An option appraisal was conducted to evaluate the costs and benefits of implementing a coronary heart disease monitoring system. This involved a review of existing Scottish datasets and relevant reports, specification of options, definition a...
The push towards a 'primary care-led' National Health Service (NHS) has far-reaching implications for the future structure of the NHS. The policy involves both a growing emphasis on the role of primary care practitioners in the commissioning of health services, and a change from hospital to primary and community settings for a range of services and...
Abstract
Objective: to measure the net costs to the health and personal social services of an early supported discharge
policy for stroke.
Design and setting: cost analysis, using data from a pragmatic randomized controlled trial conducted in three
hospitals in Newcastle upon Tyne, UK.
Subjects: 92 people admitted with acute stroke within 72 h of o...
To investigate the benefit of carotid endarterectomy relative to medical treatment, by comparing the outcome for different groups of patients following transient ischaemic attacks.
A Markov model was used to describe the survival and quality of life of patients treated for a transient ischaemic attack. The benefit is measured in terms of quality ad...
This paper is the second in a series explaining key concepts and techniques used in health economics in the context of mental health care. The paper describes the different types of economic analysis and the circumstances in which they should be used. It explains key aspects of the methods used in economic evaluation to measure costs and benefits....
This is the first of two papers which summarise key concepts in health economics and explains the differences in the various types of economic evaluation published in the economics literature. Examples from the economic analysis of mental health care are used to illustrate the key points. This paper explains the concepts of scarcity, rationing, opp...
Programme Budgeting (PB) has been widely promoted as a model for the better conduct of the work of Health Authorities in the National Health Service in the United Kingdom. This paper reports on a project which looked at the development of PB in Newcastle and North Tyneside Health Authority (NNTHA), concentrating on the construction of a computerise...
Choices need to be made between competing uses of health care resources. There is debate about how these choices should be made, who should make them and the criteria upon which they should be made. Evaluation of health care is an important part of this debate. It has been suggested that the contribution of health economics to the evaluation of hea...
When the internal market was introduced, the National Health Service Management Executive envisaged purchasing as a process by which contracts would be developed from information concerning current services, modified in the light of strategic purchasing objectives, epidemiological needs assessment and indicators of comparative performance and effic...
EDITOR,—We congratulate David Cohen on two counts: firstly, on achieving formal acceptance of a framework for assessing purchasing priorities and seeing this through to changes in contracts; and, secondly, on achieving a disinvestment list of 10 areas.1 Many purchasing authorities seem to have no framework (some even seem unaware that they need one...
EDITOR, - Jennifer Dixon and colleagues' conclusion that fundholding practices have been funded more generously than health agencies may be valid in the former North West Thames region.1 There are, however, fundamental weaknesses in the authors' methods.The average cost per hospital day for a specialty, which is used to cost fundholding activity, i...
The performance of the National Health Service is assessed in part by an Efficiency Index (EI) which is applied to the service as a whole as well as to individual health authorities. The EI relates increases in the amount of patient care activity to increases in total expenditure. The index can give a misleading impression of performance, creates p...
