The list system can reduce the waiting time and number of consultations in a centralized primary care centre that provides out of hours medical care.

OBJECTIVE: To study the waiting time and number of consultations of the patients who required out of hours medical care from a centralized primary care centre before and after the introduction of a list system. DESIGN: Non-controlled intervention study. A questionnaire, completed by receptionists, concerning all out of hours general practice consultations for one week each month during two separate years (in 1990 with no list system and in 1993 with list system in operation). SETTING: One health centre in central Finland in a region with 39495 inhabitants. SUBJECTS: All patients contacting the health centre to request medical help during out of hours work. OUTCOME MEASURES: Consultation rates by age and sex of the patients and their waiting time before seeing the GP. RESULTS: In 1990, the average out of hours consultation rate per 1000 inhabitants per year was 826 for women and 819 for men. These figures were reduced by 271 for women (95% CI 262-280) and 305 for men (95% CI 297-314) in 1993. The mean waiting time was 55 min in 1990 and 32 min in 1993 (p < 0.001). CONCLUSION: The introduction of a list system leads to more effective primary care services.

Absorption of erythromycin. A cross-over study in healthy volunteers.

The absorptions of 6 erythromycin preparations were compared in a cross-over study in healthy humans. In a single-dose study, 500 mg of each preparation was, after an overnight fast, given to 10 volunteers. The two enterosoluble preparations of erythromycin base studied were absorbed slowly, and the peak serum concentration (1.5-2 mg/l) was achieved only at 4 h. The absorption of the stearates was quick, but especially one of them was poorly absorbed, the serum concentration being always below 1 mg/l. Both of the two estolates gave highest apparent concentrations, and the maximum serum level (2-2.5 mg/l) was achieved at 2 h, but the concentration of active erythromycin remains unknown. In the second part of the study, two erythromycin stearates and one base preparation were given at 6-h interval in a cross-over fashion, each for 4 days. On the 4th day, blood samples were analyzed. The erythromycin base gave higher serum concentrations than did the two stearates, which were equivalent. It seems doubtful that the erythromycin stearate at the dose of 250 mg every 6th hour would give satisfactory serum levels of erythromycin which would be effective against most bacteria during the whole treatment.