An exploration of the needs and goals of the health professional and patient in a medical consultation

This Study is the first phase of a three-phase study continuing over three years. Twent)' health professionals from different disciplinary backgrounds (medical doctors, nurses, allied health professionals) and 20 patients across a range of medical condidons, education, gender, and socio-economic backgrounds, pardcipated in one-on-one semi-structured interviews. Participants described their experiences and percepdons of both effecdve and sadsfying medical consultations and dissadsf)'ing and ineffecdve ones. They also discussed their individual goals and needs in the consultation process. Results indicated that while there were some similarides in consultation goals and needs between health professionals, there were also clear differences across the different discipUnes. In addition, there were clear differences in goals and needs across the twenty padents. These findings are discussed within the framework of communicadon accommodadon theor}' (CAT) and the linguisdc model of padent pardcipadon (LMOPP) and focus on understanding the different dynamics that underpin varying health professional and padent interacdons.

Cost of malaria control in China: Henan's consolidation programme from community and government perspectives

Objective To assist with strategic planning for the eradication,of malaria in Henan Province, China, which reached the consolidation phase of malaria control in 1992, when only 318 malaria cases were reported, Methods We conducted a prospective two-year study of the costs for Henan's malaria control programme. We used a cost model that could also be applied to other malaria programmes in-mainland China, and analysed the cost of the three components of Henan's malaria programme. suspected malaria case management,, vector surveillance,,and population blood surveys. Primary cost data were collected from the government, and data on suspected malaria patient's were collected in two malaria counties (population 2 093 100). We enlisted the help of 260 village doctors. in six-townships or former communities (population 247 762), and studied all 12 315 reported cases of suspected malaria in catchment areas in 1994 and 1995. Findings The average-annual government investment in malaria control was estimated to be US$ 111 516 (case-management 59%; active blood surveys 25%;vector surveillance 12%; and contingencies and special projects 4%). The average cost (direct and indirect) for-patients seeking-treatment for suspected malaria was US$ 3.48, equivalent,to 10 days' income for rural residents. Each suspected malaria case cost the government an, average of US$ 0.78. Conclusion Further cuts in government funding will increase future costs, when epidemic malaria returns; investment in malaria control should therefore continue at least at current levels,of US$ 0.03 per person a risk.