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A pilot study of tele-ophthalmology outreach services to primary care.

We have begun a randomized study of tele-ophthalmology. General practitioners in two participating health centres in the Negev region of Israel, serving a local population of 40,000, were invited to participate. The study group consisted of 50 consecutive patients attending the general eye outpatient clinic and 50 consecutive patients suffering from various retinal diseases attending a hospital outpatient clinic. The initial assessment was carried out via the tele-ophthalmology system. There was then a face-to-face re-examination of the same patients, in randomized order, by the same ophthalmologist on the same day, at an outpatient ophthalmology clinic.

Costs and Cost Analysis↗

Psychiatric referral and medical history of outpatients in a general hospital.

Outpatients of the Department of Internal Medicine with an early psychiatric referral (within twelve weeks), when compared with outpatients of the same department referred to the psychiatrist at a later stage or not at all, were found to be ten years younger when the complaints started, when they first visited the G.P. and (later) a medical specialist, and at the same time of the investigation. They had visited more medical specialists and had been admitted to hospital more frequently. Outpatients of the pain clinic with an early psychiatric referral (within six weeks), when compared without patients of the same department referred to the psychiatrist later or not at all were eleven years younger when the complaints started and eight years younger when they first visited the G.P. They were referred later to a medical specialist, visited more medical specialists, and belonged to a lower social class and income group. The results are discussed and compared with those of inpatient-studies.

Educational Status↗

[Functional evaluation of elderly patients with lower limb amputation followed at a university hospital].

We studied 40 elderly with lower limb amputation (above the malleolus), who attended a hospital outpatient clinic (Orthoses and Prostheses Unity, University Hospital, State University of Campinas), from June 1994 to June 1999. Our objectives were to evaluate the independence level according to the Barthel's Index and to identify relationships between the mentioned Index and the type and level of amputation, as well as the prosthetic use. The subjects had a high degree of independence, according to the Barthel's Index. We found statistical significance only for the relationship between the Barthel's Index and the type of amputation, suggesting that the elderly with unilateral amputation were more independent than those who had undergone bilateral amputation.

Activities of Daily Living↗