Can shared care deliver better outcomes for patients undergoing total hip replacement? A prospective assessment of patient outcomes and associated service use.

Objectives: To assess whether shared care for patients undergoing total hip replacement delivers better outcomes compared to care as usual.

Design: Prospective, observational cohort study.

Setting: Two regions in The Netherlands where different organisational health care models have been implemented: a shared care setting (experimental group) and a care as usual setting (control group).

[Initiating insulin therapy in patients with diabetes mellitus type 2: in a transmural setting is at least as effective as in an outpatient setting; a retrospective study with a 4-year follow-up].

Objective: Assessing whether the initiation of insulin therapy in patients with diabetes mellitus type 2 can be delivered as effectively in a structured transmural care model as in the more usual outpatients structure.

Design: Retrospective comparative cohort study.

Method: In 1997 data were collected from 52 patients with diabetes mellitus type 2 all of whom were above 40 years of age and transferred to insulin therapy in 1993: 25 in a transmural care setting and 27 in an outpatients setting, both in Amsterdam, the Netherlands.

The regulation of medical devices and quality of medical care.

Medical devices are now a pervasive part of modern medical care. They are in many cases associated with quality of care. In some cases, the use of devices has certainly improved quality.

Diagnostic ultrasound equipment. Safety and dosimetry.

A survey of present opinions on the safety of diagnostic ultrasound applications is presented together with some data on output levels. Physical mechanisms involved in potential adverse effects are described. Labelling requirements of the equipment are defined and specified.