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Biomedical subjects

A H Macmillan

Publications and source records attributed to A H Macmillan.

6 recordsLinked to original sources
PubMed1998

J95 health surveillance in Multinational Division South West (Bosnia): July-November 1996.

A modified version of the J95 morbidity reporting system, called J95a, was used in the Multinational Division South West (MND SW) during Operation Resolute 2. The broad scope of the 'Other Diseases' and 'Other Injuries' event codes were reduced, with codes being added for specific areas of interest which were 'ENT Problems', 'Sports Injuries' and 'Training Injuries'. Designated medical centres from all nations in the division reported on a monthly basis to HQ MND SW, enabling the morbidity profile to be monitored. The first attendance rates in MND SW were twice as high as those experienced by the whole of the British Army, though the rate of working days lost was only a third. Almost half (49%) of the working time lost in the division was due to injuries and orthopaedic problems. The disease and injury distribution showed considerable differences compared to the SHAPE planning figures, with the disease rates experienced being between half and two thirds of those predicted, whilst the injury rates experienced were between four and six times as high as those predicted. This evidence suggests that the planning figures need to be re-assessed for operations other than war. Further investigation into the aetiology of injuries causing loss of working time is recommended, particularly sports injuries and orthopaedic problems.

Bosnia and Herzegovina↗
PubMed1998

A pilot study of J95 in secondary care in Bosnia.

The Army's morbidity reporting system J95 was fashioned into a secondary care variant and a pilot study conducted in Multinational Division South West (MND SW) during Operation Resolute 2. Some codes were modified, in keeping with the concurrent primary care J95a amendment, which included separating 'Other Injury' event codes further into 'Sports Injuries' and 'Other Injuries'. The collection system encompassed both out-patient and in-patient data and appropriate disposal categories such as 'admit' and 'length of stay' were introduced. Participating units included the Hospital Squadron at Sipovo, the Hospital facility at Tomislavgrad and, via a liaison officer, UK admissions and referrals to the Force Hospital near Split. A four month period of compatible data was found. Over this period 1,410 personnel (42.2/1,000/month) first attended out-patients with 337 requiring subsequent attendances (10.1/1000/month) and there were 425 admissions (12.7/1,000/month) from an average force level of 8,340 personnel. Nearly half the patients seen (49%) had orthopaedic problems and this group provided over half of the admissions (54%) and the bed occupancy (53%). There was a sizeable out-patient work load for the physician (28%). The pilot study showed that a J95 surveillance mechanism in secondary care was possible and informative. It gave indications of the impact of morbidity on the medical services and could help shape medical manning for future operations. It would be possible to adopt such a system in both the peacetime setting and in an international operational setting--in keeping with its primary care partner. It is recommended that J95 secondary variant should be continued on operations.

Ambulatory Care↗
PubMed1996

Pilot study of the introduction of the J95 health data collection system.

J95 is a health data collection system aimed at gathering information on the weight of health problems facing the Army in order to allow rational and effective prioritization. Before implementing the system Army-wide, a pilot study has been undertaken to validate the J95 ICD 9-based classification system, to test the practical problems encountered with operating the system and its practical value to decision-makers. Both internal and external coding validity were tested in terms of agreement with a "gold standard' and in terms of repeatability and they scored highly. A number of problems were identified analysing discordances and using the comments raised by the participants. A final shortened version of the classification was developed accordingly. The report also contains a number of examples of the potential of the system which is due to be implemented by 1 January 1996.

Humans↗