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At least 19 recordsLinked to original sources
PubMed1995

[Confidentiality in HIV-infection/AIDS--a comment on the Communicable Disease Control Act].

The new Communicable Diseases Control Act has come into force in Norway. It makes it compulsory for a physician to warn a third party if it is obvious that a HIV-positive patient, with a high degree of certainty, puts the third party at risk of being infected with HIV. Some philosophers characterize medical confidentiality as an intransigent and absolute obligation, others as a prima facie duty. This article supports the latter view, but the author still argues that strict conditions have to be fulfilled before a physician should consider breaking medical confidentiality: The doctor must try repeatedly to gain the consent or co-operation of the patient involved. Possible negative long-term consequences for the preventive HIV-work support strict medical confidentiality.

Acquired Immunodeficiency Syndrome↗
PubMed1995

The Abrams report--communicable disease control; how do Health Districts measure up to the recommendations?

BACKGROUND: The aims of the study were to examine whether Health Districts in the North Western Region complied with the recommendations in the Abrams report regarding the control of communicable disease [incorporated into the Annex to Circular HSG(93)56], and to identify areas that need further attention. METHODS: The recommendations were extracted and arranged in questionnaire form. Further items were included dealing with the use of Epinet in communicating with the profession. A compliance score was derived from affirmative and qualified affirmative responses. RESULTS: Many recommendations were met by all or most Districts. Compliance was 90 percent or over for 58 percent of the questions where an assessment was appropriate. Of the 16 Districts in consortia, 75 percent did not have a consortium plan. Day-to-day plans were informal in 21 percent of Districts. In 63 percent of Districts the Family Health Services Authority (FHSA) was not involved to the extent that it should be. The Consultant in Communicable Disease Control (CCDC) had insufficient District Health Authority support in 42 percent of Districts and insufficient Local Authority support in 16 percent of Districts. In 58 percent of Districts there was lack of inclusion of matters relating to the control of infectious disease in contractual statements between purchaser and provider. There was a lack of audit in 47 percent of Districts. CONCLUSIONS: One plan or a compatible series of plans are required across each District. Informal day-to-day plans should be formalized. The FHSA should be fully involved in infectious disease control plans. Certain Districts require a Community Infection Control Nurse, accountable to the CCDC and/or administrative support to input and scan surveillance data. Contractual statements between purchaser and provider should include appropriate infection control requirements when this is not already the case. Communicable disease control audit should be a regular part of CCDC duties.

Communicable Disease Control↗
PubMed1999

Public health physicians who contribute to on-call communicable disease control duties: national comparative clinical audit by questionnaire survey.

BACKGROUND: In most health authorities in the UK, general public health physicians provide out-of-hours cover for specialists in communicable disease control. Although communicable disease control was part of their specialist training, there is no current formal mechanism to enable these doctors to keep up to date. The Faculty of Public Health Medicine has an active Continuing Professional Development Programme. A new initiative aimed to assess the knowledge of general public health physicians who take part in on-call communicable disease control rotas, or may do so in the future, by means of an educational clinical audit exercise. METHODS: Experts in communicable disease control developed a questionnaire containing a selection of scenarios, covering six different situations that might arise on-call. This was circulated to all members of the Faculty, but participation was voluntary. Answers were marked against model answers agreed by the experts. Results were analysed by positions held by participants. RESULTS: Response was unacceptably low. Overall scores ranged from 15 per cent to 89 per cent with a mean of 63 per cent. There was a trend of improvement in marks from those not normally involved in on-call (mean score 56.1 per cent (95 per cent confidence interval 51.6-60.7 per cent)) through Directors of Public Health (58.4 (54.9-62.0) per cent), Consultants (62.8 (60-65.6) per cent), and specialist registrars (67.9 (65.2-70.6) per cent), to Consultants in Communicable Disease Control (70.9 (68.1-73.6) per cent). CONCLUSION: The public health physicians who took part in this audit appear to be competent in their knowledge of communicable disease control, and particularly good at dealing with meningitis and salmonella, which are frequently encountered out of hours.

Clinical Competence↗
PubMed1999

Control of diphtheria: guidance for consultants in communicable disease control. World Health Organization.

These guidelines for the control and management of diphtheria are intended for consultants in communicable disease control and regional epidemiologists in England and Wales. They are intended to complement existing guidance from the World Health Organization. The guidelines cover the immediate steps to be taken following identification of a case, what is required to confirm the diagnosis, steps to be taken to minimise the likelihood of further linked cases, and what should be done to disseminate information after a case.

Anti-Bacterial Agents↗
PubMed1998

Public health, communicable diseases, and managed care: Will managed care improve or weaken communicable disease control?

BACKGROUND: Several changes can be anticipated in the practice of communicable disease control as a result of the health care delivery system's transition from a predominantly fee-for-service system to a predominantly managed care system. These changes will clearly involve clinical services provided by public health agencies, such as immunizations and diagnosis and treatment of tuberculosis and sexually transmitted diseases, as well as those that do not involve direct patient care, such as public health surveillance, disease investigation, outbreak control, contact tracing, public health laboratory services, and health education. METHODS: In this paper I review the potential impact of managed care on each of these areas of communicable disease control and suggest strategies for minimizing adverse effects and maximizing potential areas of cooperation. RESULTS: Examples of successful strategies include California's Medi-Cal managed care expansion, which allows local public health agencies to bill managed care organizations for the sexually transmitted disease, immunization, and confidential HIV services they provide to managed care beneficiaries. A different strategy is illustrated by the Pacific Business Group on Health, an employer-based purchasing group, that uses purchasing power to standardize the clinical preventive services benefit across all plans with which it contracts and to promote immunization goals. CONCLUSION: This analysis and these examples suggest that the emergence of managed care as the predominant form of health care financing and delivery in the United States offers an important opportunity for public health.

California↗