For a decade 324 patients with nephropathy have been admitted to a day hospital for obtaining more accurate data on nephropathy activity, on the role of hemodynamic and metabolic factor in the disease progression. The treatment group patients received repeated courses of high-dose cytostatics and corticosteroids. Pregnant women at risk of nephropathy were given small doses of aspirin and curantil.
Alternatives to inpatient care that improve quality of care and save money are desirable during periods of restraint on hospital budgets. One such alternative is the care-by-parent unit (CBPU) in which a parent's stay on the ward can reduce costs by resuming nursing tasks, limiting unnecessary procedures, and encouraging early discharge. This study measured costs per case treated in the CBPU compared with the costs for similar patients treated in the inpatient nursing unit (NU). Average costs per episode were lower in the CBPU--33 per cent for general pediatrics, 13.5 per cent for tonsils and adenoids and 29 per cent for other surgery. These savings are capable of considerable expansion because more than half of the admissions to NU meet the criteria for admission to CBPU. If CBPU facilities were expanded, however, the savings estimated above would not follow automatically. New CBPU facilities must substitute for NU, not add to total utilization.
This paper describes a shift in the focus of mental health services to remote Indian villages in Northwestern Ontario. Traditional indigenous counsellors are assuming control of this service, previously offered by non-Indian outsiders. The resources of the Federal Sioux Lookout Zone Hospital and psychiatrists from the University of Toronto are used in the ongoing training of the counsellors. Challenges encountered by outside non-Indian professionals providing relevant training and consultation to the area's natural helpers are described. This unique program has enjoyed enthusiastic acceptance by local people in helping positions.
The paper generalizes the experience of work of an optimized variant of the system of urgent aid and treatment of patients with eye traumas, an ophthalmological centre, organized on the basis of the Department of Urgent/Ophthalmological Aid and the Department of Vitreo-Retinal Surgery. The authors describe results after IOL implantation in removal of traumatic cataract and treatment of corneal wounds, diascleral removal of foreign bodies, localized paramacularly, from the posterior segment of the eye the usage of extracapsular transmembranous dialysis of antibiotics for treatment of intraocular infection. All this allowed to essentially improve outcomes after severe eye traumas.