RESUMO
The implementation of statutory aftercare for psychiatric inpatients, as outlined in Section 117 of the Mental Health Act 1983 (England and Wales), was studied by examining current practice in an inner city psychiatric service. Seventy-seven per cent of patients received Section 117 aftercare; 56% of patients did not have an identified key worker. A significant proportion of those receiving statutory aftercare did not have evidence of adequate forward planning. General practitioners did not attend any meetings. Patients who had Section 117 aftercare were compared with those who did not. Using the Cox regression model, it was found there was no significant difference between these two groups in terms of time between discharge and first readmission, readmission rate, and length of first readmission.
Assuntos
Assistência ao Convalescente/normas , Psiquiatria Comunitária/normas , Adolescente , Adulto , Assistência ao Convalescente/organização & administração , Psiquiatria Comunitária/organização & administração , Feminino , Humanos , Londres , Masculino , Pessoa de Meia-Idade , Readmissão do Paciente , Análise de Regressão , Estudos RetrospectivosRESUMO
A survey of emergency department visits was conducted over a 56-week period between November 1980 and November 1981. Inappropriate ambulance use and unmet ambulance need were compared between two cities (one large and one small) with paramedic ambulance services and two cities (one large and one small) with nonparamedic ambulance services. A total of 6,405 visits was evaluated, resulting in overall rates of inappropriate use and unmet need of 42% and 58%, respectively. When paramedic ambulance services were compared to nonparamedic services, the results indicated less inappropriate use in cities with paramedic services (34% vs 49%, P less than .001) as well as less unmet need in cities with paramedic services (48% vs 67%, P less than .001). These results remain consistent within most sample subgroups based on age, sex, time of arrival at ED, and disposition, except that no differences were found for small cities or for patients 50 years and older. The results indicate that paramedic ambulance systems are beneficial to the general population of emergency department users.
Assuntos
Pessoal Técnico de Saúde , Ambulâncias/estatística & dados numéricos , Auxiliares de Emergência , Mau Uso de Serviços de Saúde , Necessidades e Demandas de Serviços de Saúde , Pesquisa sobre Serviços de Saúde , Serviços de Saúde , Adolescente , Adulto , Fatores Etários , Alberta , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Erros Inatos do Metabolismo dos Aminoácidos , Doenças do Prematuro , Tirosina/sangue , Peso ao Nascer , Estatura , Peso Corporal , Pré-Escolar , Feminino , Seguimentos , Idade Gestacional , Crescimento , Humanos , Lactente , Recém-Nascido , Deficiência Intelectual/etiologia , Testes de Inteligência , MasculinoRESUMO
During the past year the Department of Pediatrics at Queen's University has supplied a pediatric consulting service to the James Bay Zone of the Indian and Northern Health Services. Five pediatricians and three pediatric residents have visited the area for periods of two weeks. The organization of the program, the educational opportunities inherent in the scheme, the health problems encountered and the special character and challenge of the work are briefly described.
