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Biomedical subjects

R E Lees

Publications and source records attributed to R E Lees.

At least 37 records · Page 2Linked to original sources

Primary care for nontraumatic illness at the emergency department and the family physician's office.

A total of 1117 visits by patients to two hospital emergency departments and 15 family physicians' offices for nontraumatic complaints over two 2-week periods were studied. Patients visiting the two settings fell into two distinct subgroups, and they appeared to select where to seek care by the acuteness and duration of the complaint. Several highly significant differences were noted between the two groups: those who visited an emergency department had complaints of shorter duration, underwent more investigations (which more often gave abnormal results), were more likely to undergo investigation for mental symptoms, had more consultations, received counselling and drug therapy less often (but intramuscular injections more often), were admitted to hospital more often, returned for further care for the same complaint less often, complied with disposal instructions less often, were more likely to receive fewer than 5 days' care and were less likely to receive more than 31 days' care; those without a family physician more often received additional care (were referred, admitted or asked to return).

Canada↗

Cost of primary health care services in the emergency department and the family physician's office.

An attempt has been made to determine the true cost of providing primary health care for nontraumatic conditions in the emergency departments of two hospitals in Ontario and in the offices of family physicians. A total of 1117 patients presenting with 1 of 10 common symptom/sign complexes at the emergency departments or the offices of 15 participating family physicians were studies with regard to number of visits made, type of assessment by the physician, investigations undertaken, management, therapy and outcome of the illness. Costs were calculated from the charges that would be made against the provincial health services insurance plan and from the system of hospital financing in effect in the province. The average true cost per illness episode of this type of care was $14.63 in hospital A, $14.20 in hospital B and $15.90 in the family physician's office.

Canada↗

Physician time-saving by employment of expanded-role nurses in family practice.

Registered nurses working in five family practices in Kingston, Ontario, were given a period of in-service training and supplementary formal instruction at Queen's University to expand their skills and enable them to undertake prescribed procedures in the physicians' offices. Operational data collected from the five practices before and after training was analysed to assess the saving of physician time effected by the expansion of the nurses' activities in providing primary medical care. Physician time was saved in all cases but the amount varied. The results are presented and discussed in relation to staff, physical premises and patterns of practice of the participating physicians. Under the most advantageous practice circumstances in this study, a 33.7% saving in original physician time was obtained. The mean time-saving for the five practices was 18.2%.

Education, Nursing↗

Intestinal parasite control in an institution for developmentally handicapped adults.

An intestinal parasite eradication program consisting of antiparasitic drug treatment and hygiene measures was conducted at an Ontario residential facility for developmentally handicapped adults from October, 1989 to August, 1990. The prevalence of intestinal parasites in general was initially over 90% while that of pathogenic species was 59%. Six months later, overall prevalence and that of pathogenic species were reduced to 32.9% and 11%. In one subgroup, the reduction in the prevalence of pathogenic parasites was sustained for at least one year. However, the prevalence of non-pathogenic species was similar to the baseline level. Simultaneous treatment and application of hygiene measures appeared to be effective in reducing pathogenic intestinal parasites.

Adult↗

Increasing the understanding of industrial accidents: an analysis of potential major injury records.

Understanding the causes of industrial accidents will be limited if only incidents which produce injury are studied. We examined the records of 514 Potential Major Injury events over a 20-year period in one plant. Injuries were sustained in 228 (44%) of them; 286 (56%) could be classed as "near-miss" incidents and were not associated with injury. Human error accounted for most incidents and was a more important factor among those with less experience on the job. Overall, third party injuries resulted from only 5% of incidents but from 11% of those caused by human error. Although the number of human error incidents fell by 19.5% between the first and second 10-year periods, their relative importance increased as the company managed to reduce incidents of equipment and structural failure even more. We suggest that the term Critical Incident is the most fitting for the first of a series of events in the spectrum of accidents.

Accidents, Occupational↗