H—3l

PART Y. —MISCELLANEOUS NOTES From the time-table analysis the following facts emerge which it is considered are worth recording (see Appendix No. IX). Delay in Calling the Doctor Data on this score is available in 59 cases. This is set out in the following table :

It will be noted that subsequent to '23 rd September, on which day the public were informed of the nature of the outbreak and were advised to seek medical advice early in all cases of sickness, the delay fell from 7to 3 days on the average. This may be construed to indicate that attempts to educate the public on matters of health does occasionally pay some dividends. The fact that 34 patients ill with typhoid waited on the average 7 days before calling in medical aid is hardly in accordance with the often made statement that the present system of medical service in New Zealand results in patients calling the doctor unnecessarily. Delay in Notification and Admission The average delay between the first visit to the doctor and notification for 59 cases is 7-36 days. The delay in the early part of the epidemic was in excess of this figure and made it extremely difficult to assess the probable requirement of hospital beds. This figure had to be twice revised upwards. Over the same 59 cases the delay from first visit of the doctor to admission to hospital was 944 days. The average number of visits paid each patient during this period was 7-4. Over the whole 78 cases the average delay between onset and admission is 13-7 days, the extremes being 0 and 59. Eighteen had a delay of 20 days or more. Of the 78 patients, 25 were notified before admission with an average delay of 7-8 days between the two events, 38 were notified on admission, and 15 after being admitted with an average delay of 1-9 days. Of 7 capitation patients included in the above list, 6 were notified on admission and 1 admitted the day after notification. The number of visits paid these patients prior to notification is not known. The date of notification has been taken as the date on which the notification was signed, not the day on which it was received. Some cases were notified by the general practitioner attending the case, others by the hospital authorities, some by both. The earliest notification received has been taken in all cases. Duration of Illness As to the Ist April, 1948, 77 of the 78 patients had been discharged. The average stay in hospital was 45-8 days. The average period from date of onset to the day of discharge from hospital was 60 days. It is known that the discharge of some patients was delayed on account of their becoming temporary carriers.

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— Days of Delay. All Oases. 1 | Before 23rd October, 1947. After 23rd October, 1947. Number of cases Total delay Average delay per case 59 318 5-39 34 241 7-09 25 77 3-08