How does the UK NHS compare with European standards? A review of EU health care systems using hierarchical cluster analysis

Objectives: To undertake a review of the EU member states’ health care systems in relation to a framework of health-related variables, and to determine the position of the UK with respect to all other EU countries in the light of recent remarks by Tony Blair in arguing for the UK to move towards European standards. Methods Hierarchical cluster analysis, in conjunction with scatter plots, was used firstly to formulate country-cluster groups for pairs of OECD Health Data variables within the chosen framework, namely health expenditure as a share of GDP and per capita health expenditure; infant mortality and life expectancy (males and females); number of physicians and number of beds per head of population; average length of in-patient stay and in-patient admission rate. Following this a composite cluster analysis was performed using all nine variables to gain an overall country-cluster solution. Results The solutions reveal a strong association between the cluster country-membership and the health care mode of organisation, namely Social Insurance or NHS. The results obtained further reveal that although the UK achieves comparable health outcomes, its health care system is comparatively under-funded and under-resourced. However, the type of health care system employed needs to be taken into account when making cross-European comparisons. Conclusions Tony Blair is justified in seeking to increase health spending for the UK NHS which should address the problems of relative under-funding and under-resourcing and lead to a situation more in line with European standards. Hierarchical cluster analysis is a useful tool in the study of health care systems, and has a high number of potential applications in the field of health economics and other related subjects in determining criteria-specific groups.health expenditure, health outcomes

Convergence of health care spending and health outcomes in the EUropean Union, 1960-95

Convergence in health expenditure in the countries of the European Union (EU) has been demonstrated to be occurring in previous studies. The aim of this paper is to identify and discuss the reasons for this finding and to present new evidence confirming convergence in health outcomes, as represented by life expectancy and infant mortality rates. The statistical methods used, s and b-convergence analysis, are well established in macro-economic growth analyses and based on the neo-classical growth model which predicts convergence in income for homogenous countries such as those forming the EU. The analyses reveal a common trend in that Southern Mediterranean countries have generally exhibited upward convergence towards the mean in health expenditure, and convergence towards the EU mean in improving directions for health outcomes. In contrast, EU countries of the North, particularly those of Scandinavia, exhibit downward convergence towards the EU mean or below it in health expenditure, whilst their health outcome measures have generally been displaying a decreasing advantage over the EU mean over the periods of analysis. The results are briefly considered in relation to the factors that help to explain the results, including the question of whether a causal relationship between health expenditure and health outcomes exists, the nature and impact of health care reforms throughout the 1970s, 80s and 90s in countries contributing most to the observed convergence, and the predictions of the neoclassical growth model which underpin the results.convergence, divergence, health expenditure, health outcomes, causal relationship

A characterisation of generically rigid frameworks on surfaces of revolution

A foundational theorem of Laman provides a counting characterisation of the finite simple graphs whose generic bar-joint frameworks in two dimensions are infinitesimally rigid. Recently a Laman-type characterisation was obtained for frameworks in three dimensions whose vertices are constrained to concentric spheres or to concentric cylinders. Noting that the plane and the sphere have 3 independent locally tangential infinitesimal motions while the cylinder has 2, we obtain here a Laman-Henneberg theorem for frameworks on algebraic surfaces with a 1-dimensional space of tangential motions. Such surfaces include the torus, helicoids and surfaces of revolution. The relevant class of graphs are the (2,1)-tight graphs, in contrast to (2,3)-tightness for the plane/sphere and (2,2)-tightness for the cylinder. The proof uses a new characterisation of simple (2,1)-tight graphs and an inductive construction requiring generic rigidity preservation for 5 graph moves, including the two Henneberg moves, an edge joining move and various vertex surgery moves.Comment: 23 pages, 5 figures. Minor revisions - most importantly, the new version has a different titl

Model-based approaches for predicting gait changes over time

Interest in automated biometrics continues to increase, but has little consideration of time which are especially important in surveillance and scan control. This paper deals with a problem of recognition by gait when time-dependent covariates are added, i.e. when $6$ or $12$ months have passed between recording of the gallery and the probe sets. Moreover, in some cases some extra covariates present as well. We have shown previously how recognition rates fall significantly when data is captured between lengthy time intervals. Under the assumption that it is possible to have some subjects from the probe for training and that similar subjects have similar changes in gait over time, we suggest predictive models of changes in gait due both to time and now to time-invariant covariates. Our extended time-dependent predictive model derives high recognition rates when time-dependent or subject-dependent covariates are added. However it is not able to cope with time-invariant covariates, therefore a new time-invariant predictive model is suggested to accommodate extra covariates. These are combined to achieve a predictive model which takes into consideration all types of covariates. A considerable improvement in recognition capability is demonstrated, showing that changes can be modelled successfully by the new approach

On gait as a biometric: progress and prospects

There is increasing interest in automatic recognition by gait given its unique capability to recognize people at a distance when other biometrics are obscured. Application domains are those of any noninvasive biometric, but with particular advantage in surveillance scenarios. Its recognition capability is supported by studies in other domains such as medicine (biomechanics), mathematics and psychology which also suggest that gait is unique. Further, examples of recognition by gait can be found in literature, with early reference by Shakespeare concerning recognition by the way people walk. Many of the current approaches confirm the early results that suggested gait could be used for identification, and now on much larger databases. This has been especially influenced by DARPA’s Human ID at a Distance research program with its wide scenario of data and approaches. Gait has benefited from the developments in other biometrics and has led to new insight particularly in view of covariates. Equally, gait-recognition approaches concern extraction and description of moving articulated shapes and this has wider implications than just in biometrics

Texture Segmentation by Evidence Gathering

A new approach to texture segmentation is presented which uses Local Binary Pattern data to provide evidence from which pixels can be classified into texture classes. The proposed algorithm, which we contend to be the first use of evidence gathering in the field of texture classification, uses Generalised Hough Transform style R-tables as unique descriptors for each texture class and an accumulator is used to store votes for each texture class. Tests on the Brodatz database and Berkeley Segmentation Dataset have shown that our algorithm provides excellent results; an average of 86.9% was achieved over 50 tests on 27 Brodatz textures compared with 80.3% achieved by segmentation by histogram comparison centred on each pixel. In addition, our results provide noticeably smoother texture boundaries and reduced noise within texture regions. The concept is also a "higher order" texture descriptor, whereby the arrangement of texture elements is used for classification as well as the frequency of occurrence that is featured in standard texture operators. This results in a unique descriptor for each texture class based on the structure of texture elements within the image, which leads to a homogeneous segmentation, in boundary and area, of texture by this new technique

The way we walk

Mark Nixon and John Carter reveal how developments in biometrics could mean the increasing use of biometric evidence such ear shape and gait to identify defendants