[Pediatric consultations at the second-opinion level]. / Interconsultas de pediatría con el segundo nivel.

OBJECTIVE: To study the inter-consultations made with the second level by two out-patient paediatrics clinics, with regard to the reliability of the information system and the characteristics of the people referred in relation to the requested specialties. DESIGN: Descriptive. SETTING: Urban health centre. PATIENTS AND OTHER PARTICIPANTS: All children for whom a second level opinion was sought during 1993. MEASUREMENTS AND MAIN RESULTS: An inter-consultation was requested for 493 children, with an average age of 7.5. 65% were in the 6 to 14 age group, 33.3% in the 10-14 group. 45.4 of each 100 consultations were for ophthalmology, which, together with infant traumatology, dermatology, ENT and allergy, made up 87.8% of all the inter-consultations. Broken down by specialty, the most common reasons were: defects of refraction in ophthalmology; hip disorders in nursing children and feet problems, both in traumatology; changes in nevi, resistant eczemas and skin infections, all in dermatology; relapse cases of otitis and adenoiditis in ENT; and seasonal rhinoconjunctivitis (RCJ) in allergy. The result of the referral was known in writing in 31.6% of cases. The reason for the referral was recorded in the clinical notes in 92.7% of cases. CONCLUSIONS: The total number of referrals depends on the limit of paediatric age. By children's ages, the referrals most requested were: less than one month to cardiology, from 1 to 12 months to traumatology, from 2 to 3 years to ENT, over 9 to allergy and over 12 to ophthalmology, traumatology and endocrinology. Almost half the consultations are for ophthalmology, the main reasons being problems in refraction and the check-ups engendered by this problem. An internal channel to return information needs to be established.

[The demand for care at a health center according to the regional information system]. / La demanda asistencial en un centro de salud según el sistema de información regional.

OBJECTIVE: Our work is designed to find the level of demand for care in a health centre by studying data gathered with the system of regional information. DESIGN: This was a descriptive analysis of the health problems for which patients sought treatment, based on a sampling of these problems one week a month. SITE. The study, covering the whole of 1990, was carried out in an urban health centre in Valladolid. MAIN MEASUREMENTS AND RESULTS: 4.1 problems per person per year were recorded. Infants under a year old constitute the category with most problems (14.3 problems per year), followed by people over 65 (13 problems per year). The biggest group of problems concerned respiratory functions and social and administrative problems. CONCLUSIONS: In spite of the differences in methodology, there are a large number of similarities between several studies.

[Searching for the utility of an information system in primary care in Castilla and León]. / En busca de la utilidad del sistema de información de atención primaria de Castilla y León.

BACKGROUND: In Castille-Leon, there is an information system in primary health care. The target is to describe several operativity indicators in a primary health care center with the date collected with this system and indirectly, to initiate its evaluation. METHODS: The study was carried out in an urban primary health care center in Valladolid. A descriptive analysis of the data, related to the health problems demanded in 1990, collected in first sampling during a week of every month, is carried out. RESULTS: The global work load was 30-2 problems demanded to the doctor per day. The 5.7% of consult were home visits, and the prevailing problems were circulatory and respiratory. Per 100 problems, 10 laboratory test, 4.4 radiographies, 1.4 electrocardiograms and 5.25 other different tests were required. No adequate nor periodical informations was received from the administration to which data were sent. CONCLUSIONS: Insufficiency in the system to characterize in an adequate way, the health care activities complexity and lack of use of the provided data and of analysis.

[Reliability of the delayed reading of reactive strips of capillary blood glucose]. / Fiabilidad de la lectura diferida de las tiras reactivas de glucemia capilar.

To assess the realibility of delayed readings of the reactive strips for glycemia BM-test 20-8, obtained by patients at their home and read in the health center both according to the Boehringer color scale and by reflectometer Reflolux II, we assessed 100 strips. One half were stored in opaque tubes and the rest were exposed to the light, all at room temperature. They were read both visually and with reflectometer Reflolux II in a programmed fashion on the days 0, 1, 3, 5, 7, 10 and 14. The results showed that the accuracy of the color scale as compared with the reflectometer depended on the levels of glycemia (owing to the scale intervals), without significant differences. Regarding the delayed reading in the strips kept away from light, there was a statistically significant reduction of 7 mg/dl on the third day. According to the regression analysis, the strips lose 2 mg/dl each day. In the strips exposed to the light, the measurement loss on the 14th day is significantly greater than in strips removed from light.