Objectives -To describe the first two years of a paediatric home care service.Design -Observational cross sectional study, 1989-91.Setting -One inner London health district.Patients -611 children referred to the service; 50 children selected from those referred during the first year, whose parents were interviewed and whose general practitioners were invited to complete a questionnaire.Main measures -Description and costs of service; views of parents and general practitioners of selected sample of children.Results -In its second year the team received 303 referrals and made 4004 visits at a salary cost of £98 000, an average of £323/referral and £24/visit. This represented a referral rate of 3.2% (258/7939) of inpatient-episodes from the main referring hospital between
New entrants to epidemiology or the other disciplines of community health, both in the United Kingdom and other countries, are most welcome to join our list of book reviewers.both with the place of birth and also the attendant. The demise of the power of the midwife, and the rise in control of the birth situation by the male obstetrician in hospital, complete with his (sic) increasing paraphernalia of technology and scientific arguments, is thoroughly reviewed.Tew is perhaps on less familiar territory with the historical data; for whatever reason, they lack the soundness of the analysis of the statistical and epidemiological data. The blunt analysis of simple careerism by obstetricians is not convincing enough to explain the complexity of events surrounding the increasing trend towards hospital delivery in earlier decades. As well as accepting motives of professional and territorial development, one would surely wish to examine (for example) contemporary social attitudes towards science and technology and to offer a closer analysis of the role of the hierarchy of midwifery. Tew's book presents us with a bit of a conundrum; while the second part of the book presents a rational critique of the obstetric claim to safer childbirth, the first, weaker, section which draws upon sociopolitical arguments, is in a curious way more accurate in that it acknowledges that the debate is not conducted only at a rational level.
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