ORCID Profile
0000-0003-4139-941X
Current Organisation
RTI Health Solutions Manchester
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: BMJ
Date: 17-03-2014
Publisher: Springer Science and Business Media LLC
Date: 26-07-2019
Publisher: Wiley
Date: 07-10-2015
DOI: 10.1002/HEC.3258
Publisher: Elsevier BV
Date: 12-2023
Publisher: Elsevier BV
Date: 2022
Publisher: Elsevier BV
Date: 09-2022
DOI: 10.1016/J.JHEALECO.2022.102668
Abstract: In publicly-funded healthcare systems, waiting times for care should be based on need rather than ability to pay. Studies have shown that in iduals with lower socioeconomic status face longer waits for planned inpatient care, but there is little evidence on inequalities in waiting times for emergency care. We study waiting times in emergency departments (EDs) following arrival by ambulance, where health consequences of extended waits may be severe. Using data from all major EDs in England during the 2016/17 financial year, we find patients from more deprived areas face longer waits during some parts of the ED care pathway. Inequalities in waits are small, but more deprived in iduals also receive less complex ED care, are less likely to be admitted for inpatient care, and are more likely to re-attend ED or die shortly after attendance. Patient-physician interactions and unconscious bias towards more deprived patients may be important sources of inequalities.
Publisher: Wiley
Date: 25-09-2020
DOI: 10.1002/HEC.4167
Publisher: Elsevier BV
Date: 02-2016
DOI: 10.1016/J.SOCSCIMED.2015.11.053
Abstract: Older people who live alone are a growing, high-cost group for health and social services. The literature on how living alone affects health and the costs and benefits of healthcare has focused on crude measures of health and utilisation and gives little consideration to other cost determinants and aspects of patient experience. We study the effect of living alone at each stage along an entire treatment pathway using a large dataset which provides information on pre-treatment experience, treatment benefits and costs of surgery for 105,843 patients receiving elective hip and knee replacements in England in 2009 and 2010. We find that patients who live alone are healthier prior to treatment and experience the same gains from treatment. However, living alone is associated with a 9.2% longer length of in-hospital stay and increased probabilities of readmission and discharge to expensive destinations. These increase the costs per patient by £179.88 (3.12%) and amount to an additional £4.9 million per annum. A lack of post-discharge support for those living alone is likely to be a key driver of these additional costs.
Publisher: Massachusetts Medical Society
Date: 07-08-2014
Publisher: National Institute for Health and Care Research
Date: 05-2015
DOI: 10.3310/HSDR03230
Abstract: Advancing Quality (AQ) is a voluntary programme providing financial incentives for improvement in the quality of care provided to NHS patients in the north-west of England. (1) To identify the impact of AQ on key stakeholders and clinical practice (2) to assess its cost-effectiveness (3) to identify key factors that assist or impede its successful implementation and (4) to provide lessons for the wider implementation of pay-for-performance schemes across the NHS. We tested whether or not the financial incentives of AQ had an impact on mortality using two methods: a between-region difference-in-differences analysis comparing the North West region and the rest of England for the incentivised and non-incentivised conditions and a triple-difference analysis comparing performance on the incentivised conditions, as well as the non-incentivised conditions, in the North West region and the rest of England. A cost-effectiveness analysis of AQ based on the first 18 months of the programme was also undertaken. We used interviews and observation to explore how and why changes occurred. Risk-adjusted mortality rates for all three of the conditions we studied (pneumonia, heart failure and myocardial infarction) decreased in both the North West region and the rest of England during the first 18 months of the scheme. The reduction in mortality for incentivised conditions was greater in the North West region than in the rest of England. Compared with non-incentivised conditions within the North West region, there was a significant reduction in overall mortality for incentivised conditions, comprising a statistically significant reduction in pneumonia and non-significant reductions in the other two conditions. Comparing mortality for the incentivised conditions with mortality for these conditions in other regions, there was a significant reduction in overall mortality in the North West region, again made up of in idually significant reductions in pneumonia and non-significant reductions in the other two conditions. The reduction in mortality over the 18-month period studied for non-incentivised conditions was not significantly different between the North West region and the rest of England. The between-region difference-in-differences analysis after 42 months showed that risk-adjusted mortality for the incentivised conditions fell in the rest of England and the North West region. This reduction in the rest of England was significantly larger than in the North West region and was concentrated in pneumonia. However, the reductions in mortality were larger for the non-incentivised conditions in the North West region than in the rest of England between these periods. For incentivised conditions, the triple-difference analysis shows a larger reduction in mortality for the rest of England than in the North West region between the short- and long-term periods. Based on the first 18 months, the AQ programme was a relatively effective and cost-effective intervention. However, findings at 42 months are open to interpretation. One interpretation is that the short-term improvements were not sustained and that the observed improvements in mortality in the non-incentivised conditions within hospitals participating in AQ were unrelated to the programme. An alternative interpretation is that these improvements are related to the positive spillover effect of AQ. Further research should be undertaken to determine the explanation for the findings. The National Institute for Health Research Health Services and Delivery Research programme.
Publisher: Elsevier BV
Date: 03-2021
Publisher: Springer Science and Business Media LLC
Date: 20-12-2017
DOI: 10.1007/S40273-017-0600-7
Abstract: The Paediatric Quality of Life Inventory (PedsQL™) questionnaire is a widely used, generic instrument designed for measuring health-related quality of life (HRQoL) however, it is not preference-based and therefore not suitable for cost-utility analysis. The Child Health Utility Index-9 Dimension (CHU-9D), however, is a preference-based instrument that has been primarily developed to support cost-utility analysis. This paper presents a method for estimating CHU-9D index scores from responses to the PedsQL™ using data from a randomised controlled trial of prednisolone therapy for treatment of childhood corticosteroid-sensitive nephrotic syndrome. HRQoL data were collected from children at randomisation, week 16, and months 12, 18, 24, 36 and 48. Observations on children aged 5 years and older were pooled across all data collection timepoints and were then randomised into an estimation (n = 279) and validation (n = 284) s le. A number of models were developed using the estimation data before internal validation. The best model was chosen using multi-stage selection criteria. Most of the models developed accurately predicted the CHU-9D mean index score. The best performing model was a generalised linear model (mean absolute error = 0.0408 mean square error = 0.0035). The proportion of index scores deviating from the observed scores by 13 years) or patient groups with particularly poor quality of life. 16645249.
Publisher: Elsevier BV
Date: 12-2021
DOI: 10.1016/J.EHB.2021.101059
Abstract: Studies examining the later-life health consequences of in-utero exposure to influenza have typically estimated effects on physical health conditions, with little evidence of effects on mental health outcomes or mortality. Previous studies have also relied primarily on reduced-form estimates of the effects of exposure to influenza pandemics, meaning they are unlikely to recover effects of influenza exposure at an in idual-level. This paper uses inverse probability of treatment weighting and "doubly-robust" methods alongside rare mother-reported data on in-utero influenza exposure to estimate the in idual-level effect of in-utero influenza exposure on mental health and mortality risk throughout childhood and adulthood. We find that in-utero exposure to influenza is associated with small reductions in mental health in mid-childhood, driven by increases in internalising symptoms, and increases in depressive symptoms in mid-life for males. There is also evidence that in-utero influenza exposure is associated with substantial increases in mortality, although these effects are primarily driven by a 75% increase in the probability of being stillborn, with limited evidence of additional survival disadvantages at later ages. The potential for mortality selection implies that estimated effects on mental health outcomes are likely to represent a lower bound.
Publisher: Springer International Publishing
Date: 2018
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 12-2014
Publisher: Elsevier BV
Date: 12-2020
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Alex J. Turner.