Incidence and prevalence of treated mental disorders: HEALTH CARE PLANNING IN A SMALL-TOWN-RURAL REGION OF UPPER BAVARIA

An analysis of those to be cared for and those destined to provide the care is necessary, in order to develop an effective system of mental health care. Such an analysis is given here for a rural-small-town region of Upper Bavaria with 424,000 residents. The treated incidence and prevalence are presented according to sex, age and diagnosis. The morbidity rates for patients from communities of various sizes and distances from the institution of treatment are discussed as an example of ecological analysis. The future planning for the research area should be based on varied community-centred possibilities for psychiatric care.     

Meal patterns and meal quality in patients with leg ulcers

Background Wound healing is a complex process, which requires adequate energy sources, proteins, and specific minerals and vitamins. If an individual is unable to get or to eat the nutrients required, the wound healing process might be disrupted. The aim of this study was to investigate food-related factors, meal patterns and meal quality in relation to nutritional status in elderly out-patients with leg ulcers.
Methods Nutritional status was assessed by use of the Mini Nutritional Assessment in 70 patients living in their own homes. Fifty-six of the patients recorded actual meals and snacks over four consecutive days. Meal patterns and meal quality were evaluated with the help of a qualitative classification system, the Food Based Concept for Classification of Eating Episodes.
Results Thirty-six patients were classified as well-nourished, 32 were at risk of malnutrition and two were malnourished. More patients in the risk group for malnutrition did not buy their own food, and usually ate alone. Incomplete Meals and Low Quality Snacks were the most common eating types. The patients at risk of malnutrition had significantly fewer prepared Complete Meals than the well-nourished patients.
Conclusion The results show a diet and meal quality which hardly meets the requirements for nutrients that are important in wound healing, especially for those patients assessed at risk of malnutrition.     

Planning and managing research into day-surgery for cataract

Between 1995 and 1997, a randomized controlled study, funded by the Department of Health, was carried out into the management of patients with cataract attending a peripheral ophthalmic clinic and who had been assessed as suitable for day-surgery. The research took place in a clinical setting and it was accepted from the outset that, while such studies have the power to give information about the real clinical world, this also means that the research is potentially at the mercy of events within that world. The purpose of this paper is to report how the study was set up and integrated into the clinic. First, a literature review was undertaken in order to focus the aims of the study more clearly. Second, drawing on principles of action research, clinical and research staff worked together to implement the study. This strategy allowed a flexible approach to the research which enabled problems to be handled as they arose.     

佛山市中医院开展品管圈活动缩短门诊患者候药时间的实践

目的探讨品管圈在提高门诊中药房调剂效率,缩短患者候药时间中的应用效果。方法分析造成门诊中药房患者候药时间延长的原因,制订并实施相应对策,统计开展品管圈活动前、后患者的候药时间,评估品管圈活动成效。结果活动开展后,患者平均候药时间14.47 min,比开展前缩短了2.45 min;开展后在15 min内完成取药的患者占总数的67.78%,较前上升了10.61%;圈员的品管手法、解决问题的能力、积极性等方面均有进步。结论在门诊中药房开展品管圈活动能提高调剂效率,有效缩短患者候药时间,提升中药房的核心竞争力。     

A nation-wide census of psychiatric out-patients in Denmark

A nation-wide census of Danish psychiatric out-patient clinics has been undertaken with a two-fold purpose, firstly to categorize psychiatric out-patients, secondly to compare them with psychiatric in- and day-patients. On January 1st, 1977, Denmark had a population of 5,079,879, of which 3,947,383 were 15 years or older. On census day, a total of 3,161 patients, 1,366 males and 1,795 females corresponding to 0.89 males and 0.80 females respectively per 1,000 were in outpatient treatment. On April lst, 1976, 10,335 patients, 4,378 males and 5,947 females, corresponding to 2.26 males and 2.95 females respectively per 1,000 were psychiatric in-patients and 1,624 patients, 874 males and 750 females corresponding to 0.43 males and 0.37 females, respectively per 1,OOO were psychiatric day-patients. The overall prevalence rate increased with increasing age in both sexes. Peak prevalence in out-patients was between 25-44 years in males and 45-64 years in females. In males, schizophrenia was the prevailing diagnosis in all three therapeutic groups, accounting for 38.1%. In females no single diagnostic group was prevailing in all types of treatment, but in the total group schizophrenia was the most common diagnosis, amounting to 37.7%. Analysis of contact pattern showed that 74.4% of the patients were former in-patients. Only 8% were referred from the general practitioner.     

妇幼保健院内科门诊五年就诊情况分析

目的：了解妇幼保健院内科门诊五年的就诊情况变化，为防治疾病提供依据.方法：就内科门诊五年的就诊病人资料8718例，按ICD－10统计分析。结果：疾病按系统构成前四位依次为呼吸系统疾病，消化系统疾病，泌尿系统疾病，传染性疾病，妇幼保健院就诊病人呈年轻化趋势，结论：重视妊娠期保健，加强疾病防治意识，提高常见病的诊断和治愈率是提高妇幼保健院医疗质量的关系。     

内蒙古自治区基层医疗卫生机构2010年门诊处方用药情况的调查分析

目的:了解内蒙古自治区社区基层医疗卫生机构门诊患者用药情况。方法:调查内蒙古自治区54个旗县(市、区),对抽样处方逐一审查,进行统计、分析。结果:共抽取2010年门诊处方5293张,每张处方平均用药品种数为3.17种,每张处方平均用药金额为49.19元。其中,40.68%的处方使用了注射剂,51.92%的处方使用了抗菌药物,40.75%的处方使用了输液。结论:处方抽查发现内蒙古自治区基层医疗卫生机构存在较多不合理用药问题,应加强处方管理和推进新处方管理办法的正确实施,促进合理用药。     

广西县级综合性医院门诊患者满意度及其影响因素分析

目的 调查广西县级综合性医院门诊患者的满意度并分析其影响因素.方法 采用随机抽样方法对在广西壮族自治区武鸣县人民医院就诊的450名门诊患者进行满意度调查;问卷内容包括患者的基本信息如性别、年龄、户籍、工作状况、文化程度、经济收入和参加医疗保险等情况,满意度评价涉及就医方便程度、候诊时间、就医环境、医疗设备、医疗技术水平、医务人员服务态度、解释交流情况、费用水平和治疗效果等9个维度;采用描述性分析、t检验和方差分析、非条件logistic回归分析患者的满意度及其影响因素.结果 该县级医院门诊患者对所接受医疗服务的总体满意度为3.74分,满意率为96.3％,属于比较满意.年龄＜ 60岁、就业、失业、高中及中专学历、参加城镇基本医疗保险是门诊患者满意度总体评价的负面影响因素.非农业户籍和失业人群与其他群体比较差异有统计学意义(P＜0.05).结论 该县级医院门诊患者对医疗服务的总体评价是满意的,对候诊时间和治疗费用的满意度偏低.建议根据不同科室的特点,采用适宜有效的措施来减少患者的候诊时间;引入成本核算理念,借助信息化技术,从根本上降低医院的运营成本,建立透明的价格管理体系.