Year 2000 national health objectives

Article Abstract:

The first National Health Agenda was developed in the United States by the Surgeon General in Jul 1979. Five measurable goals were set for improved health care for all Americans, stressing the importance of disease prevention and health promotion. Some goals have been met, including those in the areas of high blood pressure, diseases of childhood, and injury prevention. Others have yet to be realized. In 1980, 226 more specific objectives were established to apply to unanticipated developments such as the dramatic increase in the prevalence of HIV infections. The Public Health Service (PHS) is currently in the process of establishing five new goals for the upcoming decade. "Year 2000 Objectives for the Nation", scheduled for publication in 1990, is currently being drafted and focuses on five new goals to be reached by 2000. These five goals are reducing infant mortality, minimizing disabilities caused by chronic conditions, increasing overall life expectancy, increasing the number of healthy years of life, and decreasing the current disparity which exists between life expectancies of minority and white populations. Additional objectives totalling 339 have thus far been developed to supplement these primary goals for 2000. Overall considerations for these goals were the prevention of deaths and disability, a concentration of effort to address groups at highest risk of premature death or disability, and an emphasis upon more screening to detect diseases or conditions having no symptoms in the early stages. A workbook is also being developed for use by state and local agencies which sets out suggested guidelines to enable various communities to meet their specific needs.

Forecasts and trends, 2000 AD, Health planning, Medical policy, Health policy, Institute of Medicine, United States. Public Health Service

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Increase in National Hospital Discharge Survey rates for septicemia - United States, 1979-1987

Article Abstract:

Septicemia, the presence of pathogenic bacteria in the blood, is the 13th major cause of death in the United States, accounting for up to $10 billion in health care expenses per year. A review of hospital discharge rates for septicemia showed that septicemia rates increased 139 percent from 1979 to 1987. The prevalence of septicemia increased in all geographic regions, particularly in the West, and for all age groups, especially among persons 65 years and older. Among persons 15 to 44 years, septicemia discharge rates increased in the West, Northeast, and North Central region, but decreased in the South, possibly reflecting the prevalence of human immunodeficiency virus (HIV) infection. The death rate for patients with a discharge diagnosis of septicemia decreased from 31 to 25 percent, although patients were at greater risk of death if septicemia was a discharge diagnosis. Factors responsible for the increased prevalence of septicemia include the following: (1) improved medical technology may have increased the number of immunocompromised patients who have weakened natural defense systems and who are susceptible to septicemia; (2) the increased use of invasive devices, such as catheters, may have increased the risk of hospital- or community-acquired septicemia; (3) the ability of physicians to diagnose septicemia has increased; and (4) the number of patients who have been immunocompromised or weakened by HIV infection and who develop community-acquired septicemia may have increased. These results show that septicemia continues to be a problem for the heath-care system. (Consumer Summary produced by Reliance Medical Information, Inc.)

United States, Statistics, Septicemia

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The National Health Service reforms

Article Abstract:

This article, written by a British physician, outlined and summarized the current state of the National Health Service, NHS, in Great Britain. Although Americans may think otherwise, most specialists and general practitioners like this system and consider the NHS a public property that is uninvolved with party politics. The present system divides and allocates funds into 21 regional authorities that fund district organizations and hospitals. The Family Practitioner Committees receive a separate distribution of funds and are compensated by a combination of sources. General practitioners play a key role, making any necessary patient referrals and function as the "gatekeepers" of the NHS. A white paper that was released in January 1989 outlined future government plans for NHS reform. Although much criticism has been received, the Thatcher administration has directed more money into the system than any previous government. The overall purpose of these reforms is to maximize patient choice and to provide the best quality of care for the money allotted. The new concept of "budget holding" is discussed; the general practitioner will operate for the first time under specific cash limitations. The escalating costs of prescription medications has also resulted in new monetary restrictions, and penalties may be imposed if physicians exceed their budgets. The proposed new contract for general practitioner's which includes increased levels of regulation and a restructuring of the payment system is explained. The author noted that the British Medical Association responded negatively to these new proposals and much debate is still underway.

United Kingdom, United Kingdom. National Health Service, Medical care, Cost of, Health care costs, Socialized medicine, Great Britain, letter to the editor

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