Reform of child immunization service delivery in Israel

Article Abstract:

Israel may decide to restrict government control of its child immunization program because of budgetary constraints and procedural conflicts. Israel's immunization rate for 2-year-olds is over 90%, largely due to its tracking and follow-up procedures. In 1992, the Ministry of Health was not able to recommend quickly a new vaccine mostly because of financial problems, but a pediatric association issued its own approval. To get the new vaccine, parents had to go to their sick fund physician, instead of the usual Tipat Halav clinic. Public health nurses in Israel's Tipat Halav system are responsible for administering immunizations in neighborhood clinics. Separate funds are now provided for preventive care and for sick care, and individual records are also kept for each function. The new proposal is to use sick funds to pay for both preventive and curative care. However, the immunization rate could slip if tracking and outreach, so successful in the Tipat Halav system, are abandoned.

Evaluation, Israel, Finance, Children, Preventive medicine, Immunization of children, Immunization, Preventive health services for children

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Reestimating date of delivery in multifetal pregnancies

Article Abstract:

It may be better to estimate the delivery date of a women with a multiple pregnancy as being 37 to 38 weeks from the last menstrual period rather than 39 or 40 weeks. Researchers used data on all live and stillborn births after 26 weeks gestation in Japan between 1989 and 1993 to estimate delivery dates for women with multiple fetuses. During this time there were 6,020,542 single births and 88,936 infants born from a multiple pregnancy. Almost 40% of the women with multiple fetuses gave birth before 37 weeks compared to 4% of those with a single fetus. By 38 weeks, 61% of the women with multiple fetuses had delivered. Among women with a single fetus, the risk of delivering a stillborn infant was lowest at 39 weeks. But among the women with multiple fetuses, this risk was lowest at 37 to 38 weeks. The risk of stillbirth was more than 6 times higher in women with multiple fetuses delivering at 37 weeks or later than in women with a single fetus delivering at 40 weeks or later.

Physiological aspects, Childbirth, Delivery (Childbirth), Pregnancy, Multiple, Multiple pregnancy

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Medical care delivery at the 1996 Olympic Games

Article Abstract:

Data from the 1996 Olympic Games can be used to plan medical services for other mass gatherings in the future. During the Atlanta games, one large multipurpose clinic and 128 medical aid stations were in operation. Thirty-five percent of all medical visits were for injuries, which were more common in the athletes. Heat-related illness was more common among visitors and spectators, accounting for 89% of all heat-related illness. Among the 5 million athletes, visitors and spectators attending the 17-day event, the overall treatment rate was 4.2 per 10,000 people.

Medical care, Statistics, Olympics

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