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BMJ 2011; 343 doi: (Published 20 July 2011) Cite this as: BMJ 2011;343:d4432

Rates of hospital admission for chronic obstructive pulmonary disease (COPD) among Medicare beneficiaries differ widely across the United States. A study used almost 3.8m inpatient records from Medicare claims for 1995-2006, along with the total numbers of eligible Medicare beneficiaries, to calculate rates of admission for COPD by region. Excess risk of admission was concentrated in Appalachia, the southern Great Lakes, the Mississippi Delta, the Deep South, and west Texas. Geographic comparisons provide insights for better public health practice, policies, and programmes for COPD prevention (International Journal of Chronic Obstructive Pulmonary Disease 2011;6:321-8, doi:10.2147/COPD.S19945).

Paracetamol pack sizes were restricted in the UK in 1998, and even more so in Ireland in 2001, in an effort to reduce intentional overdoses. But a study of admissions for non-fatal self harm using data from England and Ireland reports that overall rates of overdose did not differ significantly between the two countries. However, significantly more pack equivalents (based on maximum non-pharmacy pack sizes) were used in overdoses in Ireland compared with those in England. The authors suggest that differences in access …

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