| TITLE: |
Sentinel Health Events (Occupational): A Basis for Physician Recognition and Public Health Surveillance |
| AUTHORS: |
Rutstein DD, Mullan RJ, Frazier TM, Halperin WE, Melius JM, Sestito JP |
| SOURCE: |
Am J Public Health Sept;73(9):1054-62 (1983) |
| ABSTRACT: |
A Sentinel Health Event (SHE) is a preventable disease, disability, or untimely death whose occurrence serves as a warning signal that the quality of preventive and/or therapeutic medical care may need to be improved. A SHE (Occupational) is a disease, disability, or untimely death which is occupationally related and whose occurrence may: 1) provide the impetus for epidemiologic or industrial hygiene studies; or 2) serve as a warning signal that materials substitution, engineering control, personal protection, or medical care may be required. The present SHE(O) list encompasses 50 disease conditions that are linked to the workplace. Only those conditions are included for which objective documentation of an associated agent, industry, and occupation exists in the scientific literature. The list will serve as a framework for developing a national system for occupational health surveillance that may be applied at the state and local level, and as a guide for practicing physicians caring for patients with occupational illnesses. We expect to update the list periodically to accommodate new occupational disease events which meet the criteria for inclusion. |
| TITLE: |
Measuring the Quality of Medical Care (Second Revision of Tables, May 1980)—A Clinical Method |
| AUTHORS: |
Rutstein DD, Berenberg W, Chalmers TC, Child DG, Fishman AP, Perrin EB |
| SOURCE: |
New Engl J Med 294:582-588 (1976) |
| ABSTRACT: |
We outline the implementation of a new method of measuring the quality of medical care that counts cases of unnecessary disease and disability and unnecessary untimely deaths. First of all, conditions are listed in which the occurrence of a single case of disease or disability or a single untimely death would justify asking, "Why did it happen?" Secondly, we have selected conditions in which critical increases in rates of disease, disability, or untimely death could serve as indexes of the quality of care. Finally, broad categories of illness are noted in which redefinition and intensive study might reveal characteristics that could serve as indexes of health. We describe how these inth of the general population and the effects of economic, political, and other environmental factors upon it, and to evaluate the quality of medical care provided both within and without the hospital to maintain health and to prevent and treat disease. |
| TITLE: |
Occupational Sentinel Health Effects: An Up-Dated List for Physician Recognition and Public Health Surveillance |
| AUTHORS: |
Mullan RJ, Murthy LI |
| SOURCE: |
Am J Ind Med 19:775-799 (1991) |
| ABSTRACT: |
An occupational sentinel health event (SHE[O]) is a disease, disability, or untimely death, which is occupationally related and whose occurrence may: 1) provide the impetus for epidemiologic or industrial hygiene studies; or 2) serve as a warning signal that materials substitution, engineering control, personal protection, or medical care may be required. Following survey of scientific literature, a list of 50 disease conditions linked to the workplace was presented in 1983; these were codable within the framework of the International Classification of Diseases system (ICD-9). Three criteria were used for inclusion: documentation of associated agent(s), of involved industries, and of involved occupations. The up-dated list contains 64 diseases or conditions and a bibliography of literature citations. The list is useful for the practicing physician in occupational disease recognition, for occupational morbidity and mortality surveillance, and as a periodically up-dated database of occupationally related diseases. |
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