Geographical access to imaging facilities for stroke patients in Scotland

Investigation of Relationship Between Spatial Distribution of Medical Equipment and Preventable Mortality

The aim of the study is to investigate the relationship between the spatial distribution of the selected medical equipment and the preventable mortality rate in the regions of the Slovak Republic. The main analytical approach is carried out through the cluster analysis based on a Euclidean distance technique in order to get similarity of the administrative divisions in form of a district and a pseudot2 approach aimed at the determination of a number of the districts in a cluster. A number of medical equipment had a rising tendency from the year 2008. The most extreme position according to a localisation distribution of the computed tomographs and the magnetic resonance imaging scanners is held by the Košice IV District at the level of 7.50630. From an angle of view of the preventable mortality, the Piešťany District holds the most extreme position peaking at the level of 10.97969 for the female sex and the Kežmarok District with the value of 9.44088. The study has the significant dissemination outputs for health policy interventions, especially to draw up regional health plans for computed tomography and magnetic resonance imaging deployment, mainly in locations with a high preventable mortality rate for both sexes.

A small-area study of environmental risk assessment of outdoor falls

Falls in public places are an issue of great health concern especially for the elderly. Falls among the elderly is also a major health burden in many countries. This study describes a spatial approach to assess environmental causes of outdoor falls using a small urban community in Hong Kong as an example. The method involves collecting data on fall occurrences and mapping their geographic positions to examine circumstances and environmental evidence that contribute to falls. High risk locations or hot spots of falls are identified on the bases of spatial proximity and concentration of falls within a threshold distance by means of kernel smoothing and standard deviational ellipses. This method of geographic aggregation of individual fall incidents for a small-area study yields hot spots of manageable sizes. The spatial clustering approach is effective in two ways. Firstly, it allows visualisation and isolation of fall hot spots to draw focus. Secondly and especially under conditions of resource decline, policy makers are able to target specific locations to examine the underlying causal mechanisms and strategise effective response and preventive measures based on the types of environmental risk factors identified.

Neurological negligence claims in the NHS from 1995 to 2005

The objective of this study was to review available data on negligence claims for neurological disease treated by National Health Service (NHS) clinicians in England and Wales. The study design was a retrospective review of the NHS Litigation Authority (NHSLA) database, which holds data on negligence claims against NHS clinicians from 1995 to 2005. This database was searched to retrieve abstracts of claims concerning neurological disease treated by clinicians of all specialties. Abstracts were systematically reviewed to extract the following information: specialty of clinician, pathology involved, misadventure, patient injury and value of claim. A complete data set was available for 559 cases. The chi-squared test was used to investigate differences in negligence claims between neurologists/neurosurgeons and non-specialists. The specialty most frequently cited was neurosurgery (241) followed by neurology (172). Non-neurologists and non-neurosurgeons were the defendant in 146 cases, predominantly general physicians (42), orthopaedic surgeons (39) and emergency physicians (33). The most common pathologies were intervertebral disc disease (27%), CNS tumours (21%), CNS infection (11%) and subarachnoid haemorrhage (9%). The most frequent misadventure was diagnostic error (44%). In 47% of cases major permanent injury (e.g. blindness, hemiplegia) resulted from the misadventure. The patient died in 17% of cases. The total cost for all closed claims was 37 million pounds (2% of expenditure on claims for medical and surgical specialites over 1995 to 2005). This is the first systematic study of negligence claims for the treatment of neurological disorders in the UK. The prominence of diagnostic error highlights the need for early assessment by neurologists and prompt use of neuroimaging during the acute phase.