Clinical Effectiveness in Primary Care 1st Edition by Mark Baker, Simon Kirk, Allen Hutchinson ISBN 1315349078 9781315349077

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Product details:

ISBN 10: 1315349078

ISBN 13: 9781315349077

Author:  Mark Baker, Simon Kirk, Allen Hutchinson 

Clinical Effectiveness in Primary Care 1st Edition: Examines how evidence-based medicine can be applied in general practice, and how its benefits can be realized in the form of effective treatments. It argues for rational rationing, using clinical effectiveness to exclude ineffective measures.

 

Clinical Effectiveness in Primary Care 1st Edition Table of contents:

1. An introduction to primary care

• Primary care and the cost equation
• Whence primary care?
• Whither primary care?
• The global context
• The primary care vision
• Primary care policy
• What is happening to primary care?
• Is general practice changing too?
• The policy-drivers
• The paradigm shift takes hold
• References

2. A primary care-led NHS in the modern world

• The independent contractor
• The impact of reform
• Continuing reform
• The political objectives of reform
• The need for leadership
• A new primacy for primary care
• The politics of primary care
• Medical politics
• The extension of partnership
• The power thing again
• Party politics and primary care
• References

3. Evidence-based medicine in general practice

• The NHS R&D strategy and beyond
• It’s not as bad as it seems
• In fact, it’s quite promising
• Off-the-shelf information and experience
• The future will look like this
• And these are worth more than a passing glance
• References

4. A hierarchy of primary care needs

• The grief reaction
• The pace of change
• Management
• Practice administration or practice management?
• A hierarchy of needs in primary care
• References

5. Delivering the evidence

• Continuing medical education for the 21st century
• Can we start from here?
• Chance, bias, and confounding variables
• Types of study
  • Observational – hypothesis-forming
  • Analytical – hypothesis testing
• Tests of significance
  • Probability
  • Confidence intervals
• Advantages and disadvantages of different types of study
• Getting appraisal skills into practice
• Barriers
• Sources of information
  • Uses of Medline
  • The Internet
• Guidelines, protocols, and electronic reminders
• Managing the environment
• Overcoming professional inertia and perceived usefulness
• Bringing it all together
• References

6. Choosing priorities and targeting action

• Linking to need
• Local commissioning
• The Health of the Nation
• The example of heart disease
• Selecting a disease or condition
• Collecting data
• Problems with the GP computer data
• Making audit work
• Collaborative enquiry
• Summary
• References

7. Realizing the benefits

• Benefits for the patients
• Benefits for the doctors
• Benefits for the economics of health services
• Better clinical outcomes and population benefits
• Improving prescribing practice
• Effective use of health services
• Effective and appropriate care
• The trouble with nihilism
• The Health of the Nation and evidence-based medicine
• An evidence-based health care market
• References

8. Future prospects for clinical effectiveness in primary care

• The role of the public voice
• The educational challenge
• The paradoxes of knowledge
• The financial aspects of effective health care
• The limitations of clinical effectiveness
• The future of primary care

 

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