Health trends
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This study was undertaken and completed in 1988, in an attempt to determine the reasons for admission to hospital, and the optimum care required for patients with Human Immunodeficiency Virus related illnesses. Approximately half of the total medical admissions stayed for less than a week, and patients admitted for terminal care and social care occupied a relatively small proportion of the beds. The single largest group of admissions were those for inpatient management of AIDS-related pneumonias. The results of this study provide a greater understanding of the resources currently required for such care, and suggest initiatives for meeting future needs.
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This paper describes an evaluation of the short-stay ward at Guy's Hospital Accident and Emergency Department. It includes an audit of the operational policy, the care provided to patients, and the impact of the short-stay ward on hospital admissions. The results indicate that by concentrating patients in a short-stay ward, the quality of care is improved, delays are reduced, and the pressure on inpatient beds is relieved.
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As part of an audit of clinical practice in an orthopaedic unit for elective surgery, a study was made of the causes of cancellation of operations. Despite careful liaison with general practitioners, and a booked admission policy, over 6% of patients were cancelled as unsuitable. The results of this study suggest that the number of cancellations on medical grounds would be reduced by closer liaison with general practitioners, and the establishment of preadmission clinics. Ensuring that only consultants book patients for surgery would also reduce the number of cancellations due to incorrect indications for surgery.
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The management of operating theatre time is a crucial element in the size of surgical waiting lists, and this paper reports a survey of causes of the cancellation of operations for orthopaedic surgery. The results show that, although the majority of cancellations were due to medical causes, others were the result of extended theatre schedules. These findings suggest that closer co-operation between surgical staff, general practitioners and theatre staff could help to reduce this problem.
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Nitrous oxide is now recognised as an important contributor to the 'greenhouse' effect. Each year the medical profession unwittingly adds a very small burden of this gas to the atmosphere. Unfortunately, the long lifetime of nitrous oxide means that all emissions into the atmosphere are significant. By making small changes in their practices, anaesthetists are well-placed to help reduce the potential environmental damage.