Seasonal Variation of Adrenal Cortex Activity

Two hundred patients, under long-term care in an urban hospital outpatient clinic, were re-evaluated with complete history, physical examination, and selected diagnostic procedures. The history and physical examinations were performed in the first and third years of study and the diagnostic procedures were done in each of the three years. New diagnoses were elucidated for 116 different patients throughout the study period. In many cases, the reevaluation affected the physicians’ management of the patients. Numerous problems arose in the processing of patients in the program. Costs are discussed, but cost effectiveness of the program cannot be determined without data to indicate whether disability and hospitalization are decreased for patients in periodic evaluation programs. The several factors mentioned and others must all be weighed 10 fully assess the value of the periodic health examination.