Constitution and monitoring of an epidemiological surveillance network with sentinel general practitioners (original) (raw)
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An exploratory study of disease surveillance systems in Norway
Journal of telemedicine and telecare, 2008
We conducted a qualitative study of the system for contagious disease surveillance in Norway. Semi-structured interviews were held with five general practitioners (GPs), including one person responsible for informing GPs in their region about potentially serious disease outbreaks. The interviews suggested that the existing system had several limitations, making it of little relevance to local epidemics or daily medical practice. Specifically, it was difficult and time-consuming for physicians to locate relevant information, and there was a substantial delay between reported diagnoses and eventual feedback about outbreaks. This resulted in information that was too old to be of value. The interviews also investigated design matters related to future realtime disease surveillance systems. The GPs expressed interest in a distributed system for realtime extraction and presentation of data from electronic record systems. They required that any such system be customizable to the specific n...
Studies in Health Technology and Informatics, 2009
In this paper we have investigated "to what degree patients trust their regular doctor to be fully informed about the prevalence of infectious diseases in their neighbourhood", and what general practitioners (GPs) actually know. A representative sample of one thousand Norwegians (potential patients) was interviewed by telephone, and 13 GPs were interviewed individually or in focus groups. Nearly half of the patients trusted their GP to be more or less "fully informed" about the prevalence of infectious diseases in their neighbourhoods, while the GPs in reality were not well informed. We conclude that new surveillance solutions are needed. One promising approach is electronic retrieval of symptom data directly from patients.
Global Health Action, 2015
Background: Participation of private practitioners in routine disease surveillance in India is minimal despite the fact that they account for over 70% of the primary healthcare provision. We aimed to investigate the knowledge, attitudes, and practices of private practitioners in the city of Pune toward disease surveillance. Our goal was to identify what barriers and facilitators determine their participation in current and future surveillance efforts. Design: A questionnaire-based survey was conducted among 258 practitioners (response rate 86%). Data were processed using SPSS TM Inc., Chicago, IL, USA, version 17.0.1. Results: Knowledge regarding surveillance, although limited, was better among allopathy practitioners. Surveillance practices did not differ significantly between allopathy and alternate medicine practitioners. Multivariable logistic regression suggested practicing allopathy [odds ratio (OR) 3.125, 95% confidence interval (CI) 1.234Á7.915, p 00.016] and availability of a computer (OR 3.670, 95% CI 1.237Á10.889, p 00.019) as significant determinants and the presence of a laboratory (OR 3.792, 95% CI 0.998Á14.557, p 00.052) as a marginal determinant of the practitioner's willingness to participate in routine disease surveillance systems. Lack of time (137, 55%) was identified as the main barrier at the individual level alongside inadequately trained subordinate staff (14, 6%). Main extrinsic barriers included lack of cooperation between government and the private sector (27, 11%) and legal issues involved in reporting data (15, 6%). There was a general agreement among respondents (239, 94%) that current surveillance efforts need strengthening. Over a third suggested that availability of detailed information and training about surveillance processes (70, 33%) would facilitate reporting. Conclusions: The high response rate and the practitioners' willingness to participate in a proposed pilot noncommunicable disease surveillance system indicate that there is a general interest from the private sector in cooperating. Keeping reporting systems simple, preferably in electronic formats that minimize infrastructure and time requirements on behalf of the private practitioners, will go a long way in consolidating disease surveillance efforts in the state. Organizing training sessions, providing timely feedback, and awarding continuing medical education points for routine data reporting seem feasible options and should be piloted.
Population Medicine
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Journal of Epidemiology & Community Health
Background and objective: Assuming the hypothesis that the general practitioner (GP) can and should be a key player in making end-of-life decisions for hospitalised patients, perceptions of GPs' role assigned to them by hospital doctors in making withdrawal decisions for such patients were surveyed. Design: Questionnaire survey. Setting: Urban (districts located near Paris) and rural (southern France) areas. Participants: GPs. Results: The response rate was 32.2% (161/500), and it was observed that 70.8% of respondents believed that their participation in withdrawal decisions for their hospitalised patients was essential, whereas 42.1% believed that the hospital doctors were sufficiently skilled to make withdrawal decisions without input from the GPs. Most respondents were found to believe that they had the necessary skills (91.9%) and enough time (87.6%) to participate in withdrawal decisions. The last case of treatment withdrawal in hospital for one of their patients was described by 40% (65/161) of respondents, of whom only 40.0% (26/65) believed that they had participated actively in the decision process. The major factors in the multivariate analysis were the GP's strong belief that his or her participation was essential (p = 0.01), information on admission of the patient given to the GP by the hospital department (p = 0.007), rural practice (p = 0.03), visit to the patient dying in hospital (p = 0.02) and a request by the family to be kept informed about the patient (p = 0.003). Conclusion: Strong interest was evinced among GPs regarding end-of-life issues, as well as considerable experience of patients dying at home. As GPs are more closely corrected to patients' families, they may be a good choice for third-party intervention in making end-of-life decisions for hospitalised patients.