Randomised controlled trial of early discharge for inguinal hernia and varicose veins.

A randomised controlled trial has been conducted into the effects of discharging patients from hospital either 48 hours or six to seven days after operations for inguinal hernia and varicose veins. There was no statistically significant difference in major postoperative complications between the two lengths of stay for either of the two conditions. Similarly there was no difference between the two groups of hernia patients in relation to eventual recurrences. There was no significant difference in length of convalescence between long-stay and short-stay patients in full-time occupations. The savings to the statutory services of discharging patients early were estimated at 25.72 pounds per patient. Patients appeared to approve of the type of care they experienced, regardless of length of stay. However, the families of short-stay patients were significantly less enthusiastic in their attitudes towards the policy of early discharge than the families of long-stay patients.

Why do women consult doctors? Social factors and the use of the general practitioner.

This study was designed to investigate personal and social factors associated with demand for care by women aged between 20 and 44 years, a group unlikely to suffer from chronic illness. A random sample of women was drawn from the age-sex register of a south London group practice, and information was obtained concerning their daily symptom perception, anxiety level, social and health characteristics, and their consultations for one year. Social class, family involvement, number of children in household, satisfaction with the housing, and use of other health and social services were not associated with demand for general practitioner care. Absence of basic housing amenities, difficulties in running the household, brevity of stay in the house or neighbourhood, and lack of attachment of the neighbourhood were related to a high patient-initiated consultation rate. Some of the possible interpretations of these results are discussed together with their implications for social policy planning.

Factors influencing demand for primary medical care in women aged 20-44 years: a preliminary report.

This paper reports on a study designed to relate certain social and psychological variables to demand for medical care in a random sample of female patients aged between 20 and 44 years, in a National Health Service General Practice in the United Kingdom. Women selected for study completed questionnaires on anxiety and on their social characteristics. They also completed a health diary for four weeks, and over 12 months their demand for general practitioner care was recorded. This paper summarizes some of the literature on the subject of utilization behaviour, describes the objectives and methodology, and gives some preliminary results suggesting associations between anxiety, perception of symptoms and demand for primary care.