ABSTRACT
OBJECTIVE: To analyse the urgent consultations sent by doctors to a Dermatology Department for origin, reason for referral, clinical compliance, suspected diagnosis, concordance with the dermatologist's diagnosis and justification of the urgent referral. DESIGN: Descriptive study. SETTING: The information was gathered in the tertiary specialist Dermatology service of Navarra, which covers the whole population. PARTICIPANTS: Of the total (595) number of urgent forms received by the service in 1995, 505 were analysed and contrasted with the dermatological clinical history. Each patient corresponded to a form. MEASUREMENTS AND MAIN RESULTS: The following was analysed: age, sex, origin of referral, reason for referral, clinical compliance, suspected diagnosis, concordance with the dermatologist's diagnosis and justification of the urgent referral. Most letters came from Health Centres (48.5%). The most commonly alleged reason for referral was diagnostic help (51.2%). There was good clinical compliance only in the notes coming from hospital Casualty Departments (78.7%). CONCLUSIONS: There were major deficiencies in all the points under analysis, with no significant differences as to origin, except for hospital Casualty, which had better clinical compliance and whose referrals were more justified.
Subject(s)
Referral and Consultation , Skin Diseases , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Data Interpretation, Statistical , Emergencies , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Patient Compliance , Skin Diseases/diagnosis , SpainABSTRACT
OBJECTIVE: To find out the quality of extended treatments as recorded on the long-treatment medical record cards of the users of Chantrea Health Centre (Pamplona). DESIGN: This was a descriptive crossover study. SITE. An urban Primary Care centre. PATIENTS OR OTHERS PARTICIPANTS: The record cards filled in by registered nurses and physicians during one week in May 1990 were chosen. No prior notice was given to the rest of the team. Overall, 370 record cards were studied. MAIN MEASUREMENTS AND RESULTS: The average of drugs per person is 2.93 + 1.81, with significant differences for those over 65 years old (p less than 0.01). Regarding the quality indicators used: 78% of the medicines are included in the Primary Care Guide; 79.5% of those studied only took one drug; drugs were administered orally in 83% of cases; occasional concomitant medication was detected on 22.7% of the record cards and potential interactions existed on 35% of the cards. CONCLUSIONS: A therapeutic level, which was acceptable in terms of the indicators used, was supposed. For the Primary Care team to reflect jointly on prescriptions was thought to be important. The question was posed of a training programme for all doctors working in the area.
Subject(s)
Drug Therapy , Drug Utilization , Medical Records , Aged , Female , Humans , Middle Aged , Time FactorsABSTRACT
BACKGROUND: Colorectal cancer constitutes a serious health care problem in the Western world due to its frequency and mortality. Early detection and strict follow up of disease with risk of degeneration may increase survival. The guaiac test for fecal occult blood detection (one of the first signs of cancer) may contribute to the aforementiokned. METHODS: The guaiac test was randomly offered to patients consulting in general medicine. Those who accepted were taken to group meeting in general information and the test. Patients with positive tests underwent colonoscopy. Patients delaying the conclusion of the study were remained by telephone. Participation and the lesions detected were evaluated. RESULTS: The test was offered to 1,605 subjects, of whom 1,334 attended the meetings and 1,166 completed the test. Sixty patients were found to be positive and 52 underwent colonoscopy. The most significant diagnosis were 5 carcinomas at different stages and 25 neoplastic polyps. One hundred seventy-eight people were recouperated from 481 telephoned. CONCLUSIONS: The high participation in this study concerning early detection and follow up of disease with risk of degeneration to colorectal carcinoma is emphasized, in addition to the good response to the use of the telephone. Moreover, the low rejection to colonoscopy and the important lesions detected during this study are also of note.
