[The decision to hospitalize. Apropos of a survey of 539 hospitalizations requested by general practitioners]. / La décision d'hospitaliser. A propos d'une enquête sur 539 hospitalisations demandées par des généralistes.

Reasons for hospitalization. A study about 539 hospitalizations decided by general practitioners. In this paper hospitalization is studied from the point of view of the general practitioner (GP) who is the most frequent supplier of in-patients. Five GP's practising in the southern suburbs of Paris have analysed their decision to hospitalize a total of 539 patients over one year. Owing to the number of hospital units available in that area and to the variety of diseases treated, it is understandable that these patients were referred to not less than 62 different units. Nevertheless, two-thirds of the patients were referred to 3 units: the Regional Hospital Centre (CHR) and 2 private hospitals. The majority of surgical patients were referred to the private sector, the choice of the unit in such cases being determined by the surgeon's skills as experienced or heard of by the GP. The CHR attracts GP's by its departments of internal medicine and specialties. The notoriety of a department as a whole or that of particular physicians working in the department explains the GP's choice. The degree of uncertainty surrounding the diagnosis, which varies with the nature of the disease requiring hospitalization, divides the departments into two categories: over one-half of the patients with a known diagnosis were referred to surgical departments, whereas 41 percent of those with unknown or uncertain diagnoses were sent to the internal medicine department.

[Who wants, in France, a healthier lifestyle?]. / Qui veut, en France, d'un mode de vie plus sain?

Changes in lifestyles are strongly suggested by Health Education. However, a major problem appears when these suggestions are transformed into actuality: is it possible to identify the groups which are convinced that a change is necessary? In France, an investigation about the rationality of administrative authorities, of physicians and of lay individuals shows the acuity of the question. The article first deals with administrative interests in lifestyle matters. It provides the evidence of incompatibility between Public Health Planning and short term management in the French social system. The second section sheds light on the concern of the medical profession with lifestyles. Physicians' attitudes seem to be dependent on the background of daily activities. Moreover, the problems of income and professional legitimacy faced by some sections of the profession in the Private Sector explain how and why they are in favour with prevention and Health Education. The final section focuses upon public awareness of changes in lifestyles. It provides a brief description of different ways of defining health among social classes, and of different health beliefs. Beyond this heterogeneity, the various conceptions of health are an expression of individual resources and social backgrounds; they are always related to actual working conditions and status.

An economic approach to the daily activities of private general practitioners.

The present crisis in general medicine centres around the contents of the health-care services provided by general practitioners. These services were examined in a survey, carried out in 1975, of GP's daily activities. Collected data have been used to describe the characteristics of the daily activities of a typical general practitioner. Variations from this model have been interpreted in terms of three factors that characterize the local situation under which primary medical care is delivered: the nature of the health-care market, GPs' relationships with potential clients and their relationships with the local medical profession and environment.