Introducción de Neurología en un hospital comarcal / Introducing a neurology department at a local hospital

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[The long-term treatment card from the user's viewpoint]. / La tarjeta de largo tratamiento desde el punto de vista del usuario.

OBJECTIVE: To find the user's opinion of the long-term treatment card (LTC) as against repeat prescriptions from a medical clinic, the time employed on administration and information received on the use of the LTC. Criticisms and suggestions were gathered. DESIGN: Crossover, by means of questionnaires filled in by the subjects. SETTING: Almozara Health Centre, Zaragoza. PATIENTS AND OTHER PARTICIPANTS: 397 valid questionnaires given out to LTC users. The Primary Care team. MEASUREMENTS AND MAIN RESULTS: The LTC was preferred to a clinical prescription by 88% of those surveyed. 79% considered that they needed less time to obtain their prescriptions by using the LTC. 10% had difficulties in obtaining their treatment; 36% of them due to problems involving the collection/delivery timetable. 38% demanded the right to have medication included in the LTC: either at their own wish (18%), in the view of other INSALUD doctors (11%) or of any other medical officer (9%). 25% did not feel they were sufficiently informed. CONCLUSIONS: The LTC is very widely accepted. Information on its use and functioning should be improved, with special emphasis on the inclusion of medication solely by the General Practitioner concerned. The criticisms collected, such as insufficient control of lengthy treatments or adverse side-effects, support the view that quality controls of the LTC are needed.

[The appropriateness of emergency referrals sent from primary care to a general hospital]. / Adecuación de los volantes urgentes remitidos desde atención primaria a un hospital general.

OBJECTIVE: Study of the degree of completeness of slips sent to forward patients from primary medical care to emergency units of the corresponding general hospital. DESIGN: This is a statistical descriptive and inferential study. SITE. The study was carried out in the general hospital allocated to Zaragoza Health Area III. PATIENTS: Included in the study are all patients sent by primary medical care for evaluation by the urgency unit in the internal medicine section. MAIN MEASUREMENTS AND RESULTS: 415 urgent treatment slips were analysed, evaluating the completion rate and the degree of correctness in relation to their source as either rural or urban. With regards the degree of completion (clinical history, antecedents, examination) and correct functioning at the visit to family doctor stage, there are highly significant differences between those sent from all other such centres (p less than 0.01). Only in the case of 8 slips were physical examinations completed for the presenting ailment: 7 came from urban health centres and 1 from rural health centres. Diagnostic impressions and observations were absent from 62.2% of the slips. CONCLUSIONS: While overall there is no difference between those sent from rural and urban centres, there were differences when those sent from urban health centres were compared with those sent by all other health centres.