Institutional outpatient clinics: a case study in unmet needs.

An outpatient clinic of a charity hospital, managed by a medical school of a large Latin American country, was studied to assess the characteristics of the patients and the management of their conditions. All medical records of registered patients of the clinic were abstracted for identification, demographic and clinical data, for two periods of one month each, yielding 2,153 patient observations. The study period represented 18 per cent of the total days of operation of the clinic in 1975. A 20 per cent stratified sample of all cases was studied in depth to characterize the management of patients. Up to 40 per cent of all patients were rejected by the clinic, a result of the system of selection and handling of the patients. Only 36 per cent of all patients received minimally satisfactory care when treated. These results are analyzed within the framework of the conflict between professional and academic values of the medical profession and the medical and social needs of the patients.