RESUMEN
Outpatient clinic appointments are often not kept. There has been little study of the reasons for this, but failure to attend may affect future health. Our study was based on the children's outpatient department of a large inner city district general hospital. The parents of 34 children who had failed to keep appointments and of 12 who did attend were interviewed in depth and the appointment systems of the hospital and of a nearby regional referral centre for children were reviewed. At the district general hospital 23% of first appointments and 35% of subsequent appointments were not kept. We found that parents usually made a conscious decision about attending, balancing the perceived advantages and disadvantages of doing so. Their assessment of the severity of the child's illness was crucial in this. Twenty one of the 34 children who had not attended were assessed at the time of interview as still needing to attend. Of these, 16 subsequently kept an appointment and 11 underwent further investigation or treatment. We conclude that children who are not brought for outpatient appointments may be at risk of avoidable ill health and that ways of either ensuring attendance at outpatient clinics or providing alternative means of health supervision are needed.
Asunto(s)
Servicios de Salud del Niño/organización & administración , Servicio Ambulatorio en Hospital , Cooperación del Paciente , Adulto , Citas y Horarios , Niño , Estudios de Cohortes , Inglaterra , Hospitales de Distrito , Hospitales Generales , Humanos , Servicio Ambulatorio en Hospital/organización & administración , Padres/psicología , Factores de RiesgoRESUMEN
The visual evoked responses (VERs) to both flash and pattern stimulation were recorded in 44 children with migraine, with or without aura, and 8 with periodic syndrome. The controls were 50 age and sex matched children. VERs of 50 sex matched adults with migraine were also recorded. The fast wave amplitude in children with migraine was higher than that in controls. The amplitude was higher in younger children with migraine (under 13 years) than that in older children or adults with migraine. Children with periodic syndrome had VERs similar to those of children with migraine. The VER, especially in children, may prove to be a useful test in the diagnosis of migraine.