Bruce Guthrie
Biographic Data
| ID | 284089 |
|---|---|
| NAME | Bruce Guthrie |
| GIVEN NAMES | Bruce |
| FAMILY NAME | Guthrie |
| SIGNATURE | GUTHRIE B |
| AFFILIATIONS | University of Dundee |
| ORCID | 0000-0003-4191-4880 |
| VERIFIED | Yes |
| TOTAL WORKS | 21 |
| TOTAL CITATIONS | 46 |
| AUTHOR COUNT | 21 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 1996 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 3 |
Excluded by design: A qualitative study of inequalities in health and social care innovation
Innovations, especially those involving digital technologies, are expanding rapidly in health and social care in many countries around the world, but the extent to which the needs of underserved populations are considered is unclear. The aim of this study was to explore if and how socioeconomic health inequalities are considered in the design and delivery of health and social care innovations in the United Kingdom. A qualitative study using 23 se…
Can Topic Modeling of Local Newspaper Texts Enhance Understanding of Neighborhood Effects on Health
Social attributes of neighborhoods, like heritage, and low‐level social disorder, are not reflected in official metrics such as deprivation indices. However, research suggests these attributes are important for understanding spatial variations in health and social outcomes. This exploratory study investigated whether recurring themes in local newspaper articles capture meaningful social characteristics that help explain neighborhood health resili…
Impact of household characteristics on patient outcomes post hip fracture: A Welsh nationwide observational cohort study
Hip fracture patients who live alone have higher one-year mortality, but associations are explained by the demographic and clinical characteristics of those living alone. However, living alone or living with a co-resident with dementia was independently associated with an additional doubling of the risk of care home admission. Household-based approaches to research and health policy may help target risk groups following hip fracture community dis…
Income Trajectories and Precarity in Later life
This paper captures trajectories of income in later-life and considers how membership of particular income trajectories is patterned by social class, sex and precarity in housing, pensions relationships, care and retirement. Using the English Longitudinal Study of Ageing (2002-19) for over-50s, latent class analysis identifies 10 income trajectory clusters and on the basis of comparable income levels from around statutory retirement age (65), we …
The impact of place on multimorbidity: A systematic scoping review
Multimorbidity, commonly defined as the co-existence of two or more long-term conditions, is a major global public health challenge with significant impacts for health and social care systems. There is a substantial body of work identifying different individual- and household-level determinants of multimorbidity, yet the role of place-based characteristics in affecting multimorbidity remains limited. This systematic scoping review identifies plac…
Frailty or frailties: Exploring frailty index subdimensions in the English Longitudinal Study of Ageing
BACKGROUND: Frailty, a state of increased vulnerability to adverse health outcomes, has garnered significant attention in research and clinical practice. Existing constructs aggregate clinical features or health deficits into a single score. While simple and interpretable, this approach may overlook the complexity of frailty and not capture the full range of variation between individuals. METHODS: Exploratory factor analysis was used to infer lat…
Using Video-Reflexive Ethnography on an Acute Medical Unit: Methodological Challenges, Solutions and Opportunities within a Complex and Busy Clinical Setting
Video-Reflexive Ethnography (VRE) is an innovative and participatory research and improvement methodology that involves videoing in-situ work practices and collaboratively analysing this footage with participants during reflexive sessions. This involves participants 'slowing down', engaging reflexively with their everyday working practices, and taking time out to discuss issues collectively. VRE has increasingly been used across a range of differ…
A comparative overview of health and social care policy for older people in England and Scotland, United Kingdom (UK)
BACKGROUND: Responsibility for health and social care was devolved to Scotland in 1999 with evidence of diverging policy and organisation of care compared to England. This paper provides a comparative overview of major health and social care policies in England and Scotland published between 2011 and 2023 relating to the care of older people. METHODS: We searched United Kingdom (UK) and Scotland government websites for macro-level policy document…
Multimorbidity
Global, regional, and national estimates of the population at increased risk of severe Covid-19 due to underlying health conditions in 2020: A modelling study
BACKGROUND: The risk of severe COVID-19 if an individual becomes infected is known to be higher in older individuals and those with underlying health conditions. Understanding the number of individuals at increased risk of severe COVID-19 and how this varies between countries should inform the design of possible strategies to shield or vaccinate those at highest risk. METHODS: We estimated the number of individuals at increased risk of severe dis…
Between demarcation and discretion: The medical-administrative boundary as a locus of safety in high-volume organisational routines
How Does Sex Influence Multimorbidity? Secondary Analysis of a Large Nationally Representative Dataset
Multimorbidity increases with age and is generally more common in women, but little is known about sex effects on the "typology" of multimorbidity. We have characterized multimorbidity in a large nationally representative primary care dataset in terms of sex in ten year age groups from 25 years to 75 years and over, in a cross-sectional analysis of multimorbidity type (physical-only, mental-only, mixed physical and mental; and commonest condition…
Spatio-temporal elements of articulation work in the achievement of repeat prescribing safety in UK general practice
Prescribing is the most common healthcare intervention, and is both beneficial and risky. An important source of risk in UK general practice is the management of 'repeat prescriptions', which are typically requested from and issued by non-clinically trained reception staff with only intermittent reauthorisation by a clinical prescriber. This paper ethnographically examines the formal and informal work employed by GPs and receptionists to safely c…
Soft governance, restratification and the 2004 general medical services contract: The case of UK primary care organisations and general practice teams
In the UK National Health Service, primary care organisation (PCO) managers have traditionally relied on the soft leadership of general practitioners based on professional self-regulation rather than direct managerial control. The 2004 general medical services contract (nGMS) represented a significant break from this arrangement by introducing new performance management mechanisms for PCO managers to measure and improve general practice work. Thi…
Double trouble: The impact of multimorbidity and deprivation on preference-weighted health related quality of life a cross sectional analysis of the Scottish Health Survey
PW_HRQoL decreases markedly with multimorbidity, and is exacerbated by higher deprivation and younger age. There is a need to prioritise interventions to improve the HRQoL for (especially younger) adults with multimorbidity in deprived areas. BOX 1: What Is Known?Prevalence and premature onset of multimorbidity increases as socioeconomic position worsens. Previous studies have investigated the effect of multimorbidity on Health Related Quality of…
Epidemiology of multimorbidity and implications for health care, research, and medical education: A cross-sectional study
The impact of pay-for-performance on professional boundaries in UK general practice: An Ethnographic Study
The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact …
Biomedicine, holism and general medical practice: Responses to the 2004 General Practitioner contract
In 2004 a new contract was introduced for General Practitioners in the UK, which introduced a significant element of ‘pay‐for‐performance’, including both clinical and organisational targets. The introduction of this contract has caused interest across the world, particularly amongst those responsible for commissioning primary care services. It can be argued that the clinical targets in the contract (known as the Quality and Outcomes Framework, Q…
Designing and evaluating complex interventions to improve health care
Determining the effectiveness of complex interventions can be difficult and time consuming. Neil C Campbell and colleagues explain the importance of ground work in getting usable results
Deprivation and quality of primary care services: Evidence for persistence of the inverse care law from the UK Quality and Outcomes Framework
Objective: To examine whether the quality of primary care measured by the 2004 contract varies with socioeconomic deprivation. Design: Retrospective analysis of publicly available data, comparing quality indicators used for payment that allow exclusion of patients (payment quality) and indicators based on the care delivered to all patients (delivered quality). Setting and participants: 1024 general practices in Scotland. Main outcome measures: Re…
Are people with HIV in London able to die where they plan
Being able to die where you plan is a measure of quality of life near death, in that it implies awareness of diagnosis and prognosis, adequate symptom control and involvement in decision-making in late-stage HIV disease. This study presents trends in place of death for patients attending a large central London HIV centre and examines whether patients dying over a 6-month period in 1994 were able to die where they planned. Early in the epidemic al…
Biomedicine, holism and general medical practice: Responses to the 2004 General Practitioner contract
In 2004 a new contract was introduced for General Practitioners in the UK, which introduced a significant element of ‘pay‐for‐performance’, including both clinical and organisational targets. The introduction of this contract has caused interest across the world, particularly amongst those responsible for commissioning primary care services. It can be argued that the clinical targets in the contract (known as the Quality and Outcomes Framework, Q…
The impact of pay-for-performance on professional boundaries in UK general practice: An Ethnographic Study
The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact …
Spatio-temporal elements of articulation work in the achievement of repeat prescribing safety in UK general practice
Prescribing is the most common healthcare intervention, and is both beneficial and risky. An important source of risk in UK general practice is the management of 'repeat prescriptions', which are typically requested from and issued by non-clinically trained reception staff with only intermittent reauthorisation by a clinical prescriber. This paper ethnographically examines the formal and informal work employed by GPs and receptionists to safely c…
Soft governance, restratification and the 2004 general medical services contract: The case of UK primary care organisations and general practice teams
In the UK National Health Service, primary care organisation (PCO) managers have traditionally relied on the soft leadership of general practitioners based on professional self-regulation rather than direct managerial control. The 2004 general medical services contract (nGMS) represented a significant break from this arrangement by introducing new performance management mechanisms for PCO managers to measure and improve general practice work. Thi…
Deprivation and quality of primary care services: Evidence for persistence of the inverse care law from the UK Quality and Outcomes Framework
Objective: To examine whether the quality of primary care measured by the 2004 contract varies with socioeconomic deprivation. Design: Retrospective analysis of publicly available data, comparing quality indicators used for payment that allow exclusion of patients (payment quality) and indicators based on the care delivered to all patients (delivered quality). Setting and participants: 1024 general practices in Scotland. Main outcome measures: Re…
Income Trajectories and Precarity in Later life
This paper captures trajectories of income in later-life and considers how membership of particular income trajectories is patterned by social class, sex and precarity in housing, pensions relationships, care and retirement. Using the English Longitudinal Study of Ageing (2002-19) for over-50s, latent class analysis identifies 10 income trajectory clusters and on the basis of comparable income levels from around statutory retirement age (65), we …
Between demarcation and discretion: The medical-administrative boundary as a locus of safety in high-volume organisational routines
Are people with HIV in London able to die where they plan
Being able to die where you plan is a measure of quality of life near death, in that it implies awareness of diagnosis and prognosis, adequate symptom control and involvement in decision-making in late-stage HIV disease. This study presents trends in place of death for patients attending a large central London HIV centre and examines whether patients dying over a 6-month period in 1994 were able to die where they planned. Early in the epidemic al…
Deprivation and quality of primary care services: Evidence for persistence of the inverse care law from the UK Quality and Outcomes Framework
Objective: To examine whether the quality of primary care measured by the 2004 contract varies with socioeconomic deprivation. Design: Retrospective analysis of publicly available data, comparing quality indicators used for payment that allow exclusion of patients (payment quality) and indicators based on the care delivered to all patients (delivered quality). Setting and participants: 1024 general practices in Scotland. Main outcome measures: Re…
Designing and evaluating complex interventions to improve health care
Determining the effectiveness of complex interventions can be difficult and time consuming. Neil C Campbell and colleagues explain the importance of ground work in getting usable results
Biomedicine, holism and general medical practice: Responses to the 2004 General Practitioner contract
In 2004 a new contract was introduced for General Practitioners in the UK, which introduced a significant element of ‘pay‐for‐performance’, including both clinical and organisational targets. The introduction of this contract has caused interest across the world, particularly amongst those responsible for commissioning primary care services. It can be argued that the clinical targets in the contract (known as the Quality and Outcomes Framework, Q…
The impact of pay-for-performance on professional boundaries in UK general practice: An Ethnographic Study
The 2004 new General Medical Services (nGMS) contract exemplifies trends across the public services towards increased definition, measurement and regulation of professional work, with general practice income now largely dependent on the quality of care provided across a range of clinical and organisational indicators known collectively as the 'Quality and Outcomes Framework' (QOF). This paper reports an ethnographically based study of the impact …
Epidemiology of multimorbidity and implications for health care, research, and medical education: A cross-sectional study
Double trouble: The impact of multimorbidity and deprivation on preference-weighted health related quality of life a cross sectional analysis of the Scottish Health Survey
PW_HRQoL decreases markedly with multimorbidity, and is exacerbated by higher deprivation and younger age. There is a need to prioritise interventions to improve the HRQoL for (especially younger) adults with multimorbidity in deprived areas. BOX 1: What Is Known?Prevalence and premature onset of multimorbidity increases as socioeconomic position worsens. Previous studies have investigated the effect of multimorbidity on Health Related Quality of…
Soft governance, restratification and the 2004 general medical services contract: The case of UK primary care organisations and general practice teams
In the UK National Health Service, primary care organisation (PCO) managers have traditionally relied on the soft leadership of general practitioners based on professional self-regulation rather than direct managerial control. The 2004 general medical services contract (nGMS) represented a significant break from this arrangement by introducing new performance management mechanisms for PCO managers to measure and improve general practice work. Thi…
How Does Sex Influence Multimorbidity? Secondary Analysis of a Large Nationally Representative Dataset
Multimorbidity increases with age and is generally more common in women, but little is known about sex effects on the "typology" of multimorbidity. We have characterized multimorbidity in a large nationally representative primary care dataset in terms of sex in ten year age groups from 25 years to 75 years and over, in a cross-sectional analysis of multimorbidity type (physical-only, mental-only, mixed physical and mental; and commonest condition…
Spatio-temporal elements of articulation work in the achievement of repeat prescribing safety in UK general practice
Prescribing is the most common healthcare intervention, and is both beneficial and risky. An important source of risk in UK general practice is the management of 'repeat prescriptions', which are typically requested from and issued by non-clinically trained reception staff with only intermittent reauthorisation by a clinical prescriber. This paper ethnographically examines the formal and informal work employed by GPs and receptionists to safely c…
Between demarcation and discretion: The medical-administrative boundary as a locus of safety in high-volume organisational routines
Global, regional, and national estimates of the population at increased risk of severe Covid-19 due to underlying health conditions in 2020: A modelling study
BACKGROUND: The risk of severe COVID-19 if an individual becomes infected is known to be higher in older individuals and those with underlying health conditions. Understanding the number of individuals at increased risk of severe COVID-19 and how this varies between countries should inform the design of possible strategies to shield or vaccinate those at highest risk. METHODS: We estimated the number of individuals at increased risk of severe dis…
Multimorbidity
A comparative overview of health and social care policy for older people in England and Scotland, United Kingdom (UK)
BACKGROUND: Responsibility for health and social care was devolved to Scotland in 1999 with evidence of diverging policy and organisation of care compared to England. This paper provides a comparative overview of major health and social care policies in England and Scotland published between 2011 and 2023 relating to the care of older people. METHODS: We searched United Kingdom (UK) and Scotland government websites for macro-level policy document…
Impact of household characteristics on patient outcomes post hip fracture: A Welsh nationwide observational cohort study
Hip fracture patients who live alone have higher one-year mortality, but associations are explained by the demographic and clinical characteristics of those living alone. However, living alone or living with a co-resident with dementia was independently associated with an additional doubling of the risk of care home admission. Household-based approaches to research and health policy may help target risk groups following hip fracture community dis…
Income Trajectories and Precarity in Later life
This paper captures trajectories of income in later-life and considers how membership of particular income trajectories is patterned by social class, sex and precarity in housing, pensions relationships, care and retirement. Using the English Longitudinal Study of Ageing (2002-19) for over-50s, latent class analysis identifies 10 income trajectory clusters and on the basis of comparable income levels from around statutory retirement age (65), we …
The impact of place on multimorbidity: A systematic scoping review
Multimorbidity, commonly defined as the co-existence of two or more long-term conditions, is a major global public health challenge with significant impacts for health and social care systems. There is a substantial body of work identifying different individual- and household-level determinants of multimorbidity, yet the role of place-based characteristics in affecting multimorbidity remains limited. This systematic scoping review identifies plac…
Frailty or frailties: Exploring frailty index subdimensions in the English Longitudinal Study of Ageing
BACKGROUND: Frailty, a state of increased vulnerability to adverse health outcomes, has garnered significant attention in research and clinical practice. Existing constructs aggregate clinical features or health deficits into a single score. While simple and interpretable, this approach may overlook the complexity of frailty and not capture the full range of variation between individuals. METHODS: Exploratory factor analysis was used to infer lat…
Using Video-Reflexive Ethnography on an Acute Medical Unit: Methodological Challenges, Solutions and Opportunities within a Complex and Busy Clinical Setting
Video-Reflexive Ethnography (VRE) is an innovative and participatory research and improvement methodology that involves videoing in-situ work practices and collaboratively analysing this footage with participants during reflexive sessions. This involves participants 'slowing down', engaging reflexively with their everyday working practices, and taking time out to discuss issues collectively. VRE has increasingly been used across a range of differ…
Can Topic Modeling of Local Newspaper Texts Enhance Understanding of Neighborhood Effects on Health
Social attributes of neighborhoods, like heritage, and low‐level social disorder, are not reflected in official metrics such as deprivation indices. However, research suggests these attributes are important for understanding spatial variations in health and social outcomes. This exploratory study investigated whether recurring themes in local newspaper articles capture meaningful social characteristics that help explain neighborhood health resili…
Excluded by design: A qualitative study of inequalities in health and social care innovation
Innovations, especially those involving digital technologies, are expanding rapidly in health and social care in many countries around the world, but the extent to which the needs of underserved populations are considered is unclear. The aim of this study was to explore if and how socioeconomic health inequalities are considered in the design and delivery of health and social care innovations in the United Kingdom. A qualitative study using 23 se…
Medicine (17 works) · Health care (10 works) · Nursing (10 works) · Chronic Disease Management Strategies (9 works) · Political science (9 works) · Sociology (8 works) · Primary Care and Health Outcomes (7 works) · Computer Science (6 works) · Environmental health (6 works) · Psychology (6 works)