Public health and insurance: American addressesNewsholme, Arthur, Sir
History
Public health and insurance: American addresses
Newsholme, Arthur, Sir
Health insurance -- Great Britain; Public health; Public health -- Great Britain
(_a_) Skilled medical attendance and nursing as required while he is
treated at home;
(_b_) Institutional treatment when required;
(_c_) Supplementation of the convalescent patient’s funds, when
needed, to obviate the necessity for him at once to embark in
full-time work; to provide additional bedroom accommodation when
needed; and to ensure that the patient and his family are not
undernourished or overworked.
3. Remedial action for any insanitary conditions of the home, such as
uncleanliness, dampness, overcrowding; or of the patient’s workplace,
especially for dusty occupations.
4. Examination of home contacts with the patient.
The last named item may conveniently be considered further at this
point.
_Examination of Contacts_
This branch of tuberculosis work is most important. Often the first
notified case is not the first clinical case of tuberculosis in a
given family; and from the standpoint of prevention the detection of
such cases of longer standing is important. Examination of contacts
also frequently discovers patients in an earlier and more curable
stage of disease than the notified patient.
It is important that all home contacts of each notified case of
tuberculosis should be examined; and one of the most important
functions of the tuberculosis officer is to arrange for this. The
examination may be carried out by arrangement at the tuberculosis
dispensary; but otherwise, at the home of the invaded family. When
there is a medical practitioner in attendance his coöperation and
presence should as a rule be invited.
Such systematic examination of the household not only is more
efficient in discovering sources of continuing infection than the
desultory examination of a few contacts,—which often still represents
the extent of this important work,—but it has in addition a greater
educational effect on the public; and general recourse to such
systematic observations would rapidly improve the prospect of
satisfactory control of tuberculosis.
Even when examination of contacts is practised after notification
of a case of pulmonary tuberculosis, it is too often neglected
after notification of non-pulmonary cases. This represents a
great public-health loss; the majority of cases of non-pulmonary
tuberculosis are caused by infection of human source, and this source
often is an unrecognized case of pulmonary tuberculosis in the
patient’s family.
_Scope of Tuberculosis Schemes_
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