How to obtain copies of this and other HTA programme reports An electronic version of this publication, in Adobe Acrobat format, is available for downloading free of charge for personal use from the HTA website (www.hta.ac.uk). A fully searchable CD-ROM is also available (see below).Printed copies of HTA monographs cost £20 each (post and packing free in the UK) to both public and private sector purchasers from our Despatch Agents.Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment programmeT he Health Technology Assessment (HTA) programme, part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the effectiveness, costs and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined as all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care. The research findings from the HTA programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA programme is needs led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in t...
Healthcare-associated infections represent one of the most significant challenges for modern medicine as they can significantly impact patients' lives. Carbapenemase-producing Enterobacteriaceae (CPE) pose the greatest clinical threat, given the high levels of resistance to carbapenems, which are considered as agents of 'last resort' against life-threatening infections. Understanding patterns of CPE infection spreading in hospitals is paramount to design effective infection control protocols to mitigate the presence of CPE in hospitals. We used patient electronic health records from three urban hospitals to: i) track microbiologically confirmed carbapenemase producing Escherichia coli (CP-Ec) carriers and ii) trace the patients they shared place and time with until their identification. We show that yearly contact networks in each hospital consistently exhibit a core-periphery structure, highlighting the presence of a core set of wards where most carrier-contact interactions occured before being distributed to peripheral wards. We also identified functional communities of wards from the general patient movement network. The contact networks projected onto the general patient movement community structure showed a comprehensive coverage of the hospital. Our findings highlight that infections such as CP-Ec infections can reach virtually all parts of hospitals through first-level contacts.
Background Patient portals are made available and widely promoted in healthcare systems in the USA and Europe. These technologies can help patients access healthcare, receive timely treatment, and manage their health through services such as appointment booking and repeat prescription ordering. However, it is not clear if all patients who need the services are using them. This study explored patient portal use (online appointment booking and repeat prescription ordering features) and patient characteristics among NHS England GP practice patients. Methods The study used cross-sectional participant-level data from the GP Patient Survey (GPPS) of 2018, 2019, and 2020. Performing multilevel regression analysis, we explored the association between patient portal feature use and ethnicity and deprivation and controlled for eight other patient characteristics and one GP practice level characteristic, and modelled GP practice as a random effect in the model. Results In the fully adjusted model controlled for all patient characteristics and GP characteristics, participants of the Black and Other ethnic groups were less likely to have used online appointment booking (OR: 0.84, 95% CI:0.81, 0.86, and OR: 0.96, 95% CI: 0.92, 0.99, respectively) and online repeat prescription ordering (OR: 0.76, 95% CI: 0.74-0.78 and OR: 0.78, 95% CI: 0.75-0.81, respectively) compared to the White ethnic group. Association with patient portal use increased proportionally with reduced deprivation ranking. Conclusions In NHS England GP practices, certain ethnic minority groups and high deprivation ranking is associated with a reduced likelihood of using patient portals. If patient portals are the only route to access services, it is likely to lead to inequalities in use by some patient groups introducing unfair access to the services. Patients could continue to be provided with alternatives to patient portals to prevent potential inequities in access to services. Key messages • Patient portals are widely used in the healthcare system and can benefit all patients given that disparities are prevented by understanding patient groups who cannot access portals. • Understanding patient groups less likely to use patient portals could help adapt healthcare system services and meet the needs of all patient groups.
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