The Role Of The Medical Institutions In The Prevention And Control Of Communicable Diseases

BackgroundThe frontline to discover and encounter infectious diseases and where they most occur, also the solid power to fight the infectious diseases on the first scene, health facilities have a bounden responsibility to the preventing and controlling of infectious diseases. While new kinds of infectious diseases keep emerging and spreading over the world, traditional kinds are reappearing and biological terrors are introducing new problems. Preventing and controlling of infectious diseases in our nation is threatened by both the old and new kinds of diseases and problems, making it a long and tough job. The outbreaks of diseases as SARS, H1N1 make the public to reconsider the negative impacts health problems bring to the economy, society, politics and the image of the nation. Rather than a minor problem of public health, infectious diseases have become a serious problem related with politics, economics and our daily life. To strengthen the management of infectious diseases, optimize the process health facilities take to prevent and control them, build up a scientific response system to the outbreak of public health problems and finally construct a long and effective system that integrate treatment and prevention of infectious diseases which is donated and used by all, it is necessary to give a systematic analysis of the role and effect of the health facilities to prevent and control infectious diseases as well as their responsibilities and current status.Objects1) To clear a functional framework in prevention and controlling of infectious diseases for healthcare facilities;2) To present the current functions of healthcare facilities by an analysis of a certain healthcare facility's cases about preventing and controlling of novel H1N1 influenza.3) To summarize the shortcomings of health facilities during the process they prevent and control infectious diseases and seek for solutions for them. Methods1) To clear a functional framework The relevant laws have made clearly definations about the tasks of prevention and control infectious diseases for healthcare facilities. The paper also summarizes the responsibilities and practices of healthcare facilities over the world and categorizes them, and,as a result, presents a framework of functions of healthcare facilities to prevent and control infectious diseases,2) Case studyTaking one hospital in Beijing as an example, the paper analysis its practice to prevent and control H1N1 influenza from 1,May,2009 to 30, Nov,2009, Survey and in-depth interviews are performed by some medical staff to find out the status-quo of preventive and control functions of the investigated hospital.3) To compare the clinical rules and practice between China and USABy research the guidelines on official websites of Ministry of Health of China and CDC,which provide credible health information about novel H1N1 influenza, we compare the clinical guidelines and practice of H1N1 influenza.Results and discussions1 Framework presentedThe framework of functions of healthcare facilities to prevent and control infectious diseases is presented that includes the following four parts:1) the surveillance of diseases 2) the treatment of diseases 3) the control of infections 4) the preventive services.2 Results and conclusions of case studyResults of the case study suggest that the investigated hospital performs well according to the functional framework,which are displayed that rules mature, the organization structure complete, the practice and the effect is positive,but we also could draw some conclusions that the rules are not strong enough in clinical guidance,medical staff is not sensitive and progressive to infectious diseases,and not eligible to cope with the complicated conditions such as the H1N1 pandemic. 1) Rules are mature,but is not strong in clinical guidanceThe investigated hospital has made a serious of rules about infectious diseases, contingency plan for the public health emergency, the special rules and working flows for H1N1, and these rules and plans are regularly checked and modified.Most of the guidelines are formulated by Ministry of Health,while the workflows.made up by the hospital.2) The organization structure is completeFollowing the rules of integrating the administrative and professional role,the investigated hospital has constructed a three-tier structure to prevent and control infectious diseases. Such a three-tired structure is stable and effective because it has a centralized leadership, clarifiess the responsibilities and is well-ordered. The expert team, composed by people of different expertise and administrative roles makes it easy to integrate the administration and operation which in turn helps much to more effectively prevent and control infectious diseases.3) The practice is goodThe investigated hospital could follow the related rules to prevent and control H1N1 influenza. It does well in surveillance and report, diagnose and treatment, infection control and preventive service.4) The effect is positiveFrom 1,May,2009 to 30, Nov,2009, no nosocomial infections, health care workers infection, death of H1N1 patients were reported in the investigated hospital. It fully realized the three-zero target set by Beijing Municipal Health Bureau on the prevention and control of H1N1 influenza.5) Knowledge should be enhanced and updated timelyThe investigation result of the frontline medical staff about the knowledge of and attitude towards the infectious diseases and H1N1 influenza shows that, although most staff know much knowledge, it is not updated timely. Most staff attended the trainings and rehearsals organized by the hospital that cover the diagnoseand treatment, disinfection and isolation of H1N1 cases. This may own to the fact that the medical staff is not sensitive and progressive to infectious diseases, not eligible to cope with the complicated conditions such as the H1N1 pandemic.3 Results and conclusions of rule comparisonOur rules guiding the practice of H1N1 influenza appear too general, lack of concrete and typical materials to guide clinical practice. Compared with USA,there are some difference in clinical practice.We has made up the triage rules for all the persons with a fever,also the selection of antivirus drug for H1N1 infection is different.Innovations about this studyIt is the first time in China that such a study has been conducted to investigate health facilities on their abilities and contributions to the prevention and control of infectious diseases. By the analysis of cases of a famous hospital in Beijing in preventing and controlling of H1N1 influenza, the paper studies the functioins of healthcare facilities in infectious diseases and find out the status-quo of preventive and control functions of the investigated hospital. This presentation may help the government make policies, the health facilities improve their prevention and control abilities, mitigate the pressure in case of infectious disease outbreaks as well as to resolve their current problems in preventing and controlling infectious diseases.