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1.  National surveillance for infection with Cryptosporidium parvum, 1995-1998: what have we learned? 
Public Health Reports  2000;115(4):358-363.
OBJECTIVE: Infection with Cryptosporidium parvum generally causes a self-limiting diarrheal illness. Symptoms can, however, last for weeks and can be severe, especially in immunocompromised individuals. In 1994, the Council of State and Territorial Epidemiologists (CSTE) recommended that cryptosporidiosis be a nationally notifiable disease. Forty-seven states have made infection with C. parvum notifiable to the Centers for Disease Control and Prevention (CDC), and laboratories in the three remaining states report cases to state health departments, which may report them to the CDC. To see what the data show about patterns of infection, the authors reviewed the first four years of reports to the CDC. METHODS: The authors analyzed reports of laboratory-confirmed cases of cryptosporidiosis for 1995-1998. RESULTS: During 1995-1998, 11,612 laboratory-confirmed cases of cryptosporidiosis were reported to the CDC. All ages and both sexes were affected. An increase in case reporting was observed in late summer during each year of surveillance for people <20 years of age. CONCLUSION: The first national data on laboratory-confirmed cryptosporidiosis cases, although incomplete, provide useful information on the burden of disease in the nation as well as provide baseline data for monitoring of future trends.
PMCID: PMC1308577  PMID: 11059430
2.  Converting a teaching hospital medical clinic to a group practice: patients vote with their feet. 
Public Health Reports  1986;101(1):76-82.
Traditional general medical clinics (GMCs) have been criticized as providing less than optimal primary care while losing money for the sponsoring teaching hospital. In addition, the GMC has become less attractive as a site for training house staff. In response, a number of teaching hospitals have sponsored the development of a primary care group practice as a more efficient alternative to the GMC. Under the new model, certain measures of patient care frequently improve, house staff receive better training, and the hospital may be able to trim financial losses. While the literature contains numerous descriptions of such conversions, very little information is available about the compliance of patients who are transferred to the new model with relatively little preparation or choice. Institutions that convert their GMCs may do so to attract new clientele. But they have a responsibility to their long-time patients and certainly should address the question of whom they expect to transfer successfully and what the dropout rate will be. New York City's Mount Sinai Hospital completed conversion of its GMC to a primary care group practice in 1983. A sampling of patients taken before the conversion, then followed up 6 months latter, revealed that 82 percent of the former GMC patients were successfully referred to the new model. Patients given specific appointments rather than instructions to call for their own appointment had a better "show" rate. Noncompliers were more likely to be female, Medicaid-covered, 46-65 years old, and living outside the hospital's immediate service area.(ABSTRACT TRUNCATED AT 250 WORDS)
PMCID: PMC1477654  PMID: 3080795

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