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Canada must update patient records
Indian medical institute strikes for better pay he All India Institute of Medical Sciences (AIIMS), New Delhi, went on strike in a demand for higher wages and wage parity with government civil servants, on Feb 8. Problems in the medical education and research centre, which have arisen in the past few months, are associated with the delay in implementing new pay scales, as recommended by a government panel, chaired by the union health secretary Kalyan Kumar Baksi. In response to the strike, Prime Minister Atal Bihari Vajpayee has selected a committee of ministers to examine the issue, but the Institute’s faculty association insists on implementation of the Baksi panel recommendations. The association accuses finance ministry bureaucrats of “insensitive and arrogant handling” of the issue. “It is not just a question of a pay hike, but a question of the recognition AIIMS deserves”, said Anoop Saraya, an association spokesperson. Saraya pointed to “vast inequities” between salaries and the promotional advantages available to civil servants.
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The average age of entry into AIIMS is 32, because of the number of years in training. “By this time, people in other services would have had already put 7 to 8 years of service and got two promotions. This peculiar situation of AIIMS faculty has never been understood and corrected. It needs to be done now”, the association said in a letter to the prime minister. Saraya added that while the government is deliberating over a pay rise for AIIMS staff, which would cost an additional 5 million rupees per year, it is giving concessions worth several billion rupees to private corporate hospitals. “These hospitals get government land virtually free and enjoy tax concessions on imports, but do not give free services to the poor, as required.” Most AIIMS services are free to the poor. The problems are causing many specialists to leave the institute to work, in many cases, in private hospitals. In the past 5 years, about 35 Institute members have left.
ndigenous Australians are about twice as likely as non-indigenous people to report poor health according to an Australian Bureau of Statistics analysis, released on Jan 27. The conclusions were drawn from a 1995 National Health Survey, which directly compared indigenous and non-indigenous Australians. The results are based on interviews with more than 50 000 Australians living in predominantly urban or densely populated rural areas. The survey included questions on health status, actions people took for their health, and lifestyle factors, such as smoking. People excluded from the survey included the mentally ill, hospital inpatients, nursing home residents, and those living in remote areas. One in three indigenous people aged 45–54 years took medication for heart problems or high blood pressure compared to one in eight non-indigenous people. In this age-group 15% of indigenous people and 2% of nonindigenous people took medication for diabetes.
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More than half the indigenous adults were current smokers compared with 23% of non-indigenous adults. Indigenous adults were less likely to report alcohol consumption in the week before the study interview. Among those reporting recent alcohol use, 21% of indigenous males were classified as high-risk drinkers compared with 8% of non-indigenous males. High-risk drinking was less common among females with 9% of indigenous and 3% on non-indigenous females in the high-risk category. With the exception of the 18–24 year group, 22% of indigenous males versus 12% of non-indigenous males were classified as being obese. More indigenous women (18%) were also overweight compared with their non-indigeous counterparts (12%). The survey found that only 11% of indigenous adults had private health insurance, compared with almost four times as many non-indigenous adults.
lectronic patient records (EPR) are stuck in the “dinosaur age” said the Canadian Advisory Council on Health Infrastructure on Feb 3. In their report, entitled Canada Health Infoway, the panel recom mended that federal and provincial authorities should create a national health database to store EPRs. Access to up-to-date, reliable medical information could aid diag nosis, improve treatment for patients, and reduce costs by preventing duplication of tests. Such a system could also be used as a “report card” on the national health system providing compara tive assessments data on the efficacy of alternative forms of treatment. “We’re back in the dinosaur age compared to information manage ment and technology in many other industries”, said Tom Noseworthy, the advisory council co-chairperson and professor of public-health sciences, University of Alberta. The 24-member panel was established in Aug 1997 to investi gate new technologies to improve the Canadian healthcare system. The group recommended the creation of a national health data base, which doctors could access from anywhere in the country, but avoided questions of which govern ment departments would pay for it and how much the system would cost. The report suggested the federal government should allocate a portion of its healthcare payments to provinces for infostructure devel opment. But panel ignored the fact that Ottawa can not make such demands because such health care payments are unconditional. Canada’s provinces have already spent a total of Can $1 billion on EPR. But as each province has its own healthcare priorities, their efforts have been quite wide-rang ing. Noseworthy said that the panel envisioned a “network of networks” rather than a single system. The report concludes that all levels of government should provide financial support for EPR, includ ing the provision of unspecified funds to the Canadian Institute for Health Information to develop common standards in health informatics and telematics.
Bebe Loff, Stephen Cordner
Wayne Kondro
Dinesh C Sharma
Indigenous Australian health survey
I
Canada must update patient records
THE LANCET • Vol 353 • February 13, 1999
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The average age of entry into AIIMS is 32, because of the number of years in training. “By this time, people in other services would have had already put 7 to 8 years of service and got two promotions. This peculiar situation of AIIMS faculty has never been understood and corrected. It needs to be done now”, the association said in a letter to the prime minister. Saraya added that while the government is deliberating over a pay rise for AIIMS staff, which would cost an additional 5 million rupees per year, it is giving concessions worth several billion rupees to private corporate hospitals. “These hospitals get government land virtually free and enjoy tax concessions on imports, but do not give free services to the poor, as required.” Most AIIMS services are free to the poor. The problems are causing many specialists to leave the institute to work, in many cases, in private hospitals. In the past 5 years, about 35 Institute members have left.
ndigenous Australians are about twice as likely as non-indigenous people to report poor health according to an Australian Bureau of Statistics analysis, released on Jan 27. The conclusions were drawn from a 1995 National Health Survey, which directly compared indigenous and non-indigenous Australians. The results are based on interviews with more than 50 000 Australians living in predominantly urban or densely populated rural areas. The survey included questions on health status, actions people took for their health, and lifestyle factors, such as smoking. People excluded from the survey included the mentally ill, hospital inpatients, nursing home residents, and those living in remote areas. One in three indigenous people aged 45–54 years took medication for heart problems or high blood pressure compared to one in eight non-indigenous people. In this age-group 15% of indigenous people and 2% of nonindigenous people took medication for diabetes.
568
E
More than half the indigenous adults were current smokers compared with 23% of non-indigenous adults. Indigenous adults were less likely to report alcohol consumption in the week before the study interview. Among those reporting recent alcohol use, 21% of indigenous males were classified as high-risk drinkers compared with 8% of non-indigenous males. High-risk drinking was less common among females with 9% of indigenous and 3% on non-indigenous females in the high-risk category. With the exception of the 18–24 year group, 22% of indigenous males versus 12% of non-indigenous males were classified as being obese. More indigenous women (18%) were also overweight compared with their non-indigeous counterparts (12%). The survey found that only 11% of indigenous adults had private health insurance, compared with almost four times as many non-indigenous adults.
lectronic patient records (EPR) are stuck in the “dinosaur age” said the Canadian Advisory Council on Health Infrastructure on Feb 3. In their report, entitled Canada Health Infoway, the panel recom mended that federal and provincial authorities should create a national health database to store EPRs. Access to up-to-date, reliable medical information could aid diag nosis, improve treatment for patients, and reduce costs by preventing duplication of tests. Such a system could also be used as a “report card” on the national health system providing compara tive assessments data on the efficacy of alternative forms of treatment. “We’re back in the dinosaur age compared to information manage ment and technology in many other industries”, said Tom Noseworthy, the advisory council co-chairperson and professor of public-health sciences, University of Alberta. The 24-member panel was established in Aug 1997 to investi gate new technologies to improve the Canadian healthcare system. The group recommended the creation of a national health data base, which doctors could access from anywhere in the country, but avoided questions of which govern ment departments would pay for it and how much the system would cost. The report suggested the federal government should allocate a portion of its healthcare payments to provinces for infostructure devel opment. But panel ignored the fact that Ottawa can not make such demands because such health care payments are unconditional. Canada’s provinces have already spent a total of Can $1 billion on EPR. But as each province has its own healthcare priorities, their efforts have been quite wide-rang ing. Noseworthy said that the panel envisioned a “network of networks” rather than a single system. The report concludes that all levels of government should provide financial support for EPR, includ ing the provision of unspecified funds to the Canadian Institute for Health Information to develop common standards in health informatics and telematics.
Bebe Loff, Stephen Cordner
Wayne Kondro
Dinesh C Sharma
Indigenous Australian health survey
I
Canada must update patient records
THE LANCET • Vol 353 • February 13, 1999