Biomedical subjects

J McAnaney

Publications and source records attributed to J McAnaney.

4 recordsLinked to original sources

PubMed1993

Laboratory-based reporting of AIDS.

To improve the speed and completeness of AIDS reporting, the Philadelphia Board of Health adopted regulations requiring medical laboratories to report directly to the Department of Public Health all results indicative of AIDS-defining diagnoses. Reports were used to focus active AIDS surveillance on physicians who had requested laboratory reports whose results were likely to have diagnosed AIDS recently. One year after implementation, laboratories provided the first lead to 20% of all AIDS reports. Reports originating with laboratories reach our data base sooner after diagnosis and ascertain a slightly higher proportion of women than do other reports. Laboratory-based reporting offers a practical way to focus the limited resources available for active surveillance on health providers likely to have an AIDS diagnosis to report.

Acquired Immunodeficiency Syndrome↗

PubMed1993

Private medical insurance among Philadelphia residents diagnosed with AIDS.

We used medical insurance information gathered on each Philadelphia resident with AIDS to examine time trends in private medical insurance at the time of diagnosis. The proportion of AIDS patients with private medical insurance decreased from 51.9% in July-December 1988 to 28.6% in July-December 1991. During the same time period, an increasing proportion of people diagnosed with AIDS were female, poor, members of minority groups, or abusers of injection drugs. A discrete multivariate model showed that the (point) prevalence of private medical insurance at AIDS diagnosis decreased significantly with time, even after adjustment for changes with time in the age, gender, race, estimated income, history of injection drug use, and history of homosexual contact of those who were affected with AIDS. Thus the decreasing prevalence of private medical insurance among people newly diagnosed with AIDS does not simply reflect changes in the demographic and behavioral characteristics of the people affected.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Changes in AIDS case reporting after hospital site visits.

In an effort to improve AIDS case reporting, site visits (meetings with hospital staff to encourage reporting) were made to all Philadelphia hospitals. Comparisons of hospitals visited during a 7-week period with hospitals not visited during that period indicated that the site visits were followed by a marked increase in case reports. No similar increase was observed at the comparison hospitals. The increased reporting was accompanied by an increased lag time from diagnosis to report, suggesting that the additional reports at visited hospitals were the result of the identification of previously missed cases rather than a speedup of reporting. Cases reported after the visits were more likely to have white-collar occupations or private medical insurance than were those reported before the visits.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Limitations of AIDS reporting under favorable circumstances.

To assess completeness of acquired immunodeficiency syndrome (AIDS) reporting by a consortium of Philadelphia physicians, we compared the consortium's patient data base to AIDS case reports received by the Philadelphia Department of Public Health (PDPH). Several circumstances favored better than ordinary reporting. Consortium physicians were highly motivated, specialized in the care of patients with human immunodeficiency virus disease, had worked with PDPH physicians for years, and knew beforehand about the plan to compare data bases. Of 295 patients in the consortium data base diagnosed with AIDS at least nine months prior to this study, 267 (90.5%) had been reported to the PDPH and 28 (9.5%) had not. Only two of the missed reports were deliberately withheld, each in response to the patient's request. Reporting completeness increased with the time elapsed since diagnosis, varied by practice from 70% to 100%, and was unrelated to patient demographic, insurance status, or occupational characteristics. AIDS reporting for patients in health care occupations (11/13 = 85% reported) was not significantly different from reporting for patients in other occupations (256/282 = 91% reported). We conclude that, under conditions favorable to reporting, approximately 10% of AIDS patients are not reported; the only patient characteristic that predicts reporting is the time elapsed since diagnosis; and nearly all reporting failures are inadvertent.

Acquired Immunodeficiency Syndrome↗