Public Health Wales Observatory

Wales, United Kingdom

Public Health Wales Observatory

Wales, United Kingdom
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Mukherjee M.,University of Edinburgh | Gupta R.,St George's, University of London | Farr A.,University of Swansea | Heaven M.,University of Swansea | And 89 more authors.
BMJ Open | Year: 2014

Introduction: Asthma is now one of the most common long-term conditions in the UK. It is therefore important to develop a comprehensive appreciation of the healthcare and societal costs in order to inform decisions on care provision and planning. We plan to build on our earlier estimates of national prevalence and costs from asthma by filling the data gaps previously identified in relation to healthcare and broadening the field of enquiry to include societal costs. This work will provide the first UK-wide estimates of the costs of asthma. In the context of asthma for the UK and its member countries (ie, England, Northern Ireland, Scotland and Wales), we seek to: (1) produce a detailed overview of estimates of incidence, prevalence and healthcare utilisation; (2) estimate health and societal costs; (3) identify any remaining information gaps and explore the feasibility of filling these and (4) provide insights into future research that has the potential to inform changes in policy leading to the provision of more cost-effective care. Methods and analysis: Secondary analyses of data from national health surveys, primary care, prescribing, emergency care, hospital, mortality and administrative data sources will be undertaken to estimate prevalence, healthcare utilisation and outcomes from asthma. Data linkages and economic modelling will be undertaken in an attempt to populate data gaps and estimate costs. Separate prevalence and cost estimates will be calculated for each of the UKmember countries and these will then be aggregated to generate UK-wide estimates. Ethics and dissemination: Approvals have been obtained from the NHS Scotland Information Services Division's Privacy Advisory Committee, the Secure Anonymised Information Linkage Collaboration Review System, the NHS South-East Scotland Research Ethics Service and The University of Edinburgh's Centre for Population Health Sciences Research Ethics Committee. We will produce a report for Asthma-UK, submit papers to peer-reviewed journals and construct an interactive map.


Davies G.R.,Public Health Wales Observatory | Roberts I.,London School of Hygiene and Tropical Medicine
International Journal of Epidemiology | Year: 2014

Background: Road traffic crashes are a major cause of death and injury worldwide and are set to increase as low- and middle-income countries motorize. United Nations (UN) and World Health Organization (WHO) road traffic injury prevention efforts depend on support from external organizations, many of which have commercial interests in increasing car use. Because of concerns about conflict of interest, this study objectively assessed the activities of a key WHO collaborator, the Global Road Safety Partnership (GRSP). Methods: We conducted a quantitative content analysis comparing GRSP publications and the 2004 WHO World Report on Road Traffic Injury Prevention. Dictionaries of terms were constructed for each of the evidence-based interventions detailed in the World Report. Text analysis software was used to generate word frequency counts of those terms to compare the World Report and GRSP documents. Results: Education, information and publicity featured far more commonly in the GRSP publications than in the WHO World Report [word frequency ratios and 95% confidence intervals: GRSP Newsletter 3.09, 2.53 to 3.78; Around GRSPs World 4.69, 3.76 to 5.87; GRSP Project summaries 3.42, 2.59 to 4.51] On the other hand, compared with the World Report, reducing car use [GRSP Newsletter 0.36, 0.27 to 0.48], minimizing exposure to high-risk scenarios [GRSP Newsletter 0.04, 0.02 to 0.09] and encouraging the use of safer modes of travel [GRSP Newsletter 0.02, 0.01 to 0.08] rarely featured in GRSP publications. Conclusions: The GRSP focuses on educational interventions, for which there is no evidence of effectiveness. Furthermore, the GRSP does not appear to consider the full range of WHO interventions. As motorization growth has serious negative implications for health, including those associated from physical inactivity, climate change and air and noise pollution, it is imperative that the UN and WHO do not allow business interests to dominate public health interests. © The Author 2014; all rights reserved.


Hill A.,Oxford Business Park | Balanda K.,Ireland and Northern Irelands Population Health Observatory | Galbraith L.,Scottish Public Health Observatory | Greenacre J.,Public Health Wales Observatory | Sinclair D.,Oxford Business Park
Public Health | Year: 2010

The technique of describing health using a range of measures has been termed 'health profiling'. This article discusses the emergence of health profiling in the UK and Ireland over recent years, led by the public health observatories (PHOs). The steps in developing health profiles are described, including defining the purpose, consulting users, choosing indicators, establishing the methods of presentation, disseminating and evaluating. Health profiles have developed and improved through collaboration between the PHOs in the UK and Ireland. Looking to the future, the PHOs are developing inter-related health profiles ranging from small area to European regions, enhanced and informed by the addition of themed profiles for different population groups, lifestyles and diseases. © 2010 The Royal Society for Public Health.


Evans L.W.,Public Health Wales Observatory | Van Woerden H.,NHS Highland | Davies G.R.,Public Health Wales Observatory | Fone D.,University of Cardiff
BMJ Open | Year: 2016

Aim: To investigate the impact of service redesign in the provision of revascularisation procedures on the historical socioeconomic inequity in revascularisation rates for patients with acute myocardial infarction (AMI). Design: Natural experiment and retrospective cohort study using linked data sets in the Secure Anonymised Information Linkage databank. Non-randomised intervention: An increase in the capacity of revascularisation procedures and service redesign in the provision of revascularisation in late 2011 to early 2012. Setting: South Wales cardiac network, Census 2011 population 1 359 051 aged 35 years and over. Participants: 9128 participants admitted to an NHS hospital with a first AMI between 1 January 2010 and 30 June 2013, with 6-months follow-up. Main outcome measure: Hazard ratios (HRs) for the time to revascularisation for deprivation quintiles, age, gender, comorbidities, ruralurban classification and revascularisation facilities of admitting hospital. Results: In the preintervention period, there was a statistically significant decreased adjusted risk of revascularisation for participants in the most deprived quintile compared to the least deprived quintile (HR 0.80; 95% CI 0.69 to 0.92, p=0.002). In the postintervention period, the increase in revascularisation rates was statistically significant in all quintiles, and there was no longer any statistically significant difference in the adjusted revascularisation risk between the most and the least deprived quintile (HR 1.04; 95% CI 0.89 to 1.20, p<0.649). However, inequity persisted for those aged 75 years and over (HR 0.40; 95% CI 0.35 to 0.46, p<0.001) and women (HR 0.77; 95% CI 0.70 to 0.86, p<0.001). Conclusions: Socioeconomic inequity of access to revascularisation was no longer apparent following redesign of revascularisation services in the south Wales cardiac network, although inequity persisted for women and those aged 75+ years. Increasing the capacity of revascularisation did not differentially benefit participants from the least deprived areas.


PubMed | Public Health Wales Observatory, NHS Highland and University of Cardiff
Type: Journal Article | Journal: BMJ open | Year: 2016

To investigate the impact of service redesign in the provision of revascularisation procedures on the historical socioeconomic inequity in revascularisation rates for patients with acute myocardial infarction (AMI).Natural experiment and retrospective cohort study using linked data sets in the Secure Anonymised Information Linkage databank.An increase in the capacity of revascularisation procedures and service redesign in the provision of revascularisation in late 2011 to early 2012.South Wales cardiac network, Census 2011 population 1359051 aged 35years and over.9128 participants admitted to an NHS hospital with a first AMI between 1 January 2010 and 30 June 2013, with 6-months follow-up.Hazard ratios (HRs) for the time to revascularisation for deprivation quintiles, age, gender, comorbidities, rural-urban classification and revascularisation facilities of admitting hospital.In the preintervention period, there was a statistically significant decreased adjusted risk of revascularisation for participants in the most deprived quintile compared to the least deprived quintile (HR 0.80; 95% CI 0.69 to 0.92, p=0.002). In the postintervention period, the increase in revascularisation rates was statistically significant in all quintiles, and there was no longer any statistically significant difference in the adjusted revascularisation risk between the most and the least deprived quintile (HR 1.04; 95% CI 0.89 to 1.20, p<0.649). However, inequity persisted for those aged 75years and over (HR 0.40; 95% CI 0.35 to 0.46, p<0.001) and women (HR 0.77; 95% CI 0.70 to 0.86, p<0.001).Socioeconomic inequity of access to revascularisation was no longer apparent following redesign of revascularisation services in the south Wales cardiac network, although inequity persisted for women and those aged 75+years. Increasing the capacity of revascularisation did not differentially benefit participants from the least deprived areas.

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