The Alaska Health Surveillance Project was intended to improve the quality of the health care process by impacting on both the provider and the consumer using three tracer conditions. This evaluation of the Health Surveillance Project was conducted at four locations: the Alaska Native Medical Center (ANMC), Fairbanks Native Health Center (FNHC), Port Graham and Tanana. This study is the third phase of a larger study that began as an evaluation of existing conditions in health services at the four specified locations using three target conditions. This particular phase focuses on changes in diagnostic, treatment and follow-up protocols, and the employment of techniques designed to educate the consumer so that they may take an active part in their own health care.In each of the four study areas, protocols were established for screening and follow-up for three medical conditions - hypertension, iron deficiency anemia, and urinary tract infections. A Health Surveillance Report instrument was designed for distribution to patients. Health practitioners were instructed on how to use the surveillance instrument. Educational pamphlets were provided for distribution, and in some cases, house-to-house visits were conducted for the purpose of patient training. After a year, the number of patients served by the new system was tabulated and analyzed, and comparisons were made with earlier studies. The results are recorded in the form of tables by area and tracer condition.This phase of the study was primarily a feasibility and information gathering phase. It would be another year before any general conclusions could be drawn about the effectiveness of the Health Surveillance Report. There were some conclusions drawn on the experience with each tracer condition. For example, with hypertension, it was concluded that the new protocol has good potential for improving detection and follow-up, and that the health education and dietary counseling was deficient. For iron deficiency anemia, the emphasis was placed on consumer education so that potential patients could make themselves and their children available for screening. For urinary tract infection, it was clear that the consumer education program positively affected the follow-up rate.For the Health Surveillance Profile, it was recommended that its use should be continued and expanded to cover a broader cross section of the population; and that a one-year follow-up evaluation should be conducted to complete the current study. Dietary counseling and health education should be increased to improve the standard of health care from the providers and continue to promote consumer growth and awareness.
Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-08).
Lee JF. Munro PB. McMahon BJ. Fleshman CV. Evaluation of medical care provided to Alaskan Natives, Volume 4, a report of intervention methods to improve screening, detection, and follow-up. Indian Health Service, Staff Office of Planning, Evaluation and Research, Rockville, MD 20857 (E-08). 1980