RESUMO
Annual patient consultation rates have been recorded continuously for 36 years in a stable National Health Service practice in a south-east London suburb. Four phases in consultation rates were noted: rising rates from 1950 to 1956; peak rates from 1957 to 1963; falling rates from 1964 to 1970 and low stable rates from 1971 to 1985. Thus workload fell by almost 50%, from a peak of 3.81 to a low of 1.93 consultations per patient per year. The reduction of 91% in home visits was much greater than the 43% reduction in surgery (office) consultations.CERTAIN QUESTIONS ARE RAISED BY THE STUDY: why are the consultation rates of this practice so low (one half the national rates); why have consultation rates in the practice fallen; and how many general practitioners are needed by the NHS? More studies are needed which compare practices, their processes and outcomes, and which analyse cost benefits in the health service.
Assuntos
Medicina de Família e Comunidade , Medicina de Família e Comunidade/tendências , Serviços de Assistência Domiciliar , Humanos , Londres , Encaminhamento e ConsultaRESUMO
A double-blind cross-over trial of emepronium bromide (Cetiprin) in nocturnal frequency of micturition in a group of elderly women living in their homes showed that the drug was superior to placebo in diminishing urinary frequency, though not every person benefited. It is suggested that the drug may alter the established habit of rising at night to pass urine. Side-effects were negligible.