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CMAJ • May 2, 2000; 162 (9)
© 2000 Canadian Medical Association or its licensors

Letters
Correspondance

Out of province, out of sight

John M. Tallon

Department of Emergency Medicine; QE II Health Sciences Centre; Halifax, NS

Linda D. Van Til and Lamont E. Sweet have written an interesting paper on blood recipient notification for hepatitis C in Prince Edward Island.1 However, their simple yet complete provincial analysis says more, perhaps, about Canada's national health care system than they initially intended. The statement that 91.2% of blood recipients in PEI "were identified as tested, dead or moved out of province" [italics mine] is ominous in the setting of the Canada Health Act of 1984,2 which mandates portability and universality as 2 of its 5 basic tenets.

The "out of province" group constituted 469 of 2977 (15.8%) live recipients during the look-back period of 1984 to 1990. "Dead or moved out of province" strikes one as a poor way to definitively identify Canadians with universal health care coverage who may have been exposed to hepatitis C through blood products. The authors state that information was forwarded to the appropriate non-PEI provincial health authority but no data on follow-up are given and no data on new patients with hepatitis C who might have moved to PEI are given, implying a further lack of provincial notification reciprocity.

Therefore, while the paper is laud-able as a provincial monitoring report, the basic recommendations of the National Task Force on Health Information in 19913 and the final report of the National Forum on Health4 in 1997, calling for comprehensive national databases to track health indices such as the one described in this article, have not been achieved. One would hope that in the near future the descriptor "dead or moved out of province" will not appear in Canadian health surveillance studies.

References

  1. Van Til LD, Sweet LE. Blood recipient notification for hepatitis C in Prince Edward Island. CMAJ 2000;162(2):199-202.[Abstract/Free Full Text]
  2. www.hc-sc.ge.ca/english/archives/releases/agebk4.htm
  3. National Health Information Council. Health information for Canada 1991: report of the Task Force on Health Information. Ottawa: Health and Welfare Canada; 1991.
  4. National Forum on Health. Canada health action: building on the legacy. The final report of the National Forum on Health. Ottawa: Health Canada; 1997. Available: wwwnfh.hc-sc.gc.ca (accessed 2000 Apr 4).




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