Análisis del cumplimiento de la atención fonoaudiológica de la guía clínica GES, en pacientes con enfermedad de Parkinson en centros de atención primaria de salud de Talca / Analysis of compliance phonoaudiologic care of clinical guide GES in patients with Parkinson's disease in primary care centers health Talca

Since 2010 the Chile's Ministry of Health includes Parkinson's disease (PD) pathology in AUGE. Accordingly, this unit produced a clinical guideline wherein stipulates a specific procedure for assessment and intervention in Primary Care Health Centers. In that guideline, the speech therapy intervention is indicated as fundamental, applicable in a given amount of annual sessions depending on the phase of the disease for each person. Currently there are 518 cases in control in the province of Talca. Therefore, the present investigation aims to establish the level of accomplishment of speech therapy services in Parkinson's disease as required by GES law in Primary Care Health centers of the city of Talca...

Desde el año 2010 el Ministerio de Salud incorpora la Enfermedad de Parkinson (EP) en las patologías AUGE . Para ello elaboró una Guía Clínica en donde se estipula un determinado procedimiento de evaluación e intervención para Centros de Atención Primaria de Salud. En ella, se indica la intervención fonoaudiológica como fundamental, aplicable en una determinada cantidad de sesiones anuales según el estadio de la patología en que se encuentra el sujeto. Actualmente en la provincia de Talca se encuentran 518 casos en control. Por consiguiente, la presente investigación tiene como objetivo establecer el nivel de cumplimiento de la atención fonoaudiológica en la Enfermedad de Parkinson según lo establecido por la ley GES en Centros de Atención Primaria de Salud de la ciudad de Talca...

Cobertura de programas preventivos en Chile / Coverage with preventive programs in Chile

Introducción: Los Programas de Medicina Preventiva para que tengan un impacto en el nivel de salud deben tener una alta cobertura poblacional. Objetivo: Estudiar la cobertura de los programas preventivos que se realizaron en el Sistema de Salud Público Chileno el año 2007. Material y Métodos: Se revisó la cobertura de los programas preventivos en las bases de datos del Departamento de Estadísticas e Información en Salud del Ministerio de Salud de Chile del año 2007. Resultados: La cobertura global de los programas preventivos medido a través del Índice de Medicina Preventiva fue de0.202. El programa de salud dirigido a los < de 6 años (infantil) fue el que registró una mayor cobertura (0.84), un nivel de cobertura intermedio se observó en los programas de la mujer (0.34) y del adulto mayor (0.29), por su parte los programas dirigidos a la población escolar, adolescente y adulto fueron los que presentaron menores coberturas (<0.1). Discusión: La alta cobertura observada en el programa preventivo dirigido a la población infantil, ha sido un factor que ha favorecido la mejoría en el nivel de salud de este grupo poblacional, particularmente ha contribuido a reducirla mortalidad infantil en Chile. El país debe crear estrategias que permitan incrementar la cobertura en programas preventivos dirigidos a la población escolar, adolescente y adulta, solo de esta forma podrá seguir avanzando en la senda de mejorar el nivel de salud poblacional.

Introduction: In order to have an impact on the level of health, Preventive Medicine Programs should have high population coverage. Objective: To study the coverage of preventive programs which were conducted in the Chilean Public Health System in 2007. Material and Methods: The coverage of preventive programs in the databases of the Department of Health Statistics and Information of the Chilean Ministry of Health in the year 2007 were reviewed. Results: The overall coverage of preventive programs as measured by the index of Preventive Medicine was 0.202. The health program aimed at < 6 years (children) was the one that recorded a greatest coverage (0.84). An intermediate level of coverage was observed in the women’s program (0.34) and in that of elderly (0.29). Programs conducted for school children, teenagers, and adults presented a low coverage (<0.1). Discussion: The high coverage observed in the child health preventive program, has been a factor that has led to the improvement of the health status of this population group. Particularly, it has contributed to reduce the infant mortality in Chile. The country must create strategies to increase the coverage of preventive programs aimed at schoolchildren, teenagers and adults. Only in this way we can go on improving the level of population health.

Índice de medicina preventiva: Una medida integradora de la cobertura de los programas preventivos / Coverage of preventive health activities in a Chilean region, calculated using the preventive medicine index

Background: Preventive activities of the public health system in Chile are not integrated and there is no parameter assessing the whole population that is benefited with these activities. Aim: To develop and implement a mathematical measure of the coverage of preventive health activities, provided to different age groups. Material and methods: Data was gathered from the monthly statistical reports of the women, children, teenager, adult and elderly health programs in 30 communities of the Seventh Chilean Region. The preventive medicine index (PMI) was calculated as the ratio between the population that was ascribed to each program and the population that was a potential beneficiary of such program. Results: In the studied region, the global coverage of preventive medicine, calculated using the PMI, increased from 0.229 in 1999 to 0.370 in 2003. This represents a 61 percent increment. However, there are important inequalities in the access to preventive health in the different communities of the region. Conclusions: The PMI revealed a substantial increment in preventive health activities in the studied region.

Prevalencia de diabetes mellitus en la VII Región de Chile / Prevalence of diabetes in the seventh Region of Chile

Background: The prevalence of diabetes mellitus in Latin America is not well known. Aim: To study the real prevalence of diabetes mellitus (DM) and its associated risk factors in the VII region of Chile. Material and Methods: A probabilistic sample of 1,325 subjects over the age of 20, stratified by age and differentiated by place of residence was studied. The criteria of the World Panel of Experts convened by the World Health Organization in 1997, was used to define the presence of diabetes (two fasting blood glucose values over 126 mg/dl or a blood glucose over 200 mg/dl, 2 hours after a 75 g carbohydrate oral load). Results: The global prevalence estimated for DM in this population was 5.39 percent. The calculated prevalence in subjects between 20 and 44 years was 1.88 percent (CI 0.39-3.37); between 45 and 64 years, 10.75 percent (CI 8.35-13.14); 65 years or older 11.30 percent (CI 8.00-14.60), p <0.05. The prevalence was 5.8 percent in urban areas and 4.5 percent in rural areas. Forty five percent of diabetics were not aware of their condition. Forty eight percent of diabetics and 31 percent of non diabetics were hypertensive (p <0.01), whereas 47.8 percent of diabetics and 24.6 percent of non diabetics had at least one diabetic parent (p <0.01). Smoking was less frequent in diabetics than in non diabetics (15.7 and 24.3 percent respectively, p <0.05). Ninety percent of both diabetics and non diabetics were sedentary. Discussion: Health care systems require an epidemiological monitoring system to provide information about the prevalence of diabetes mellitus and to control the evolution of patients

Prevalencia del cáncer de próstata en la comuna de Talca, VII región Chile / Prevalence of prostate cancer in the seventh region of Chile

Background: In 1998, there were 1,218 deaths in Chile caused by prostate cancer. This figure results in a death rate of 16.6 per 100,000 males for this disease. Aim: To assess the prevalence of prostate cancer in the Seventh Region of Chile. Material and methods: A probabilistic sample of 327 males aged 40 to 59 years old was studied. In all, a codified questionnaire was applied, a digital rectal examination was performed and a blood sample was drawn to measure prostate specific antigen. All digital rectal examinations were performed by the same observer. Patients with an abnormal rectal examination or prostate specific antigen were subjected to a prostatic biopsy under ultrasound guidance. Results: In 14 subjects, the digital rectal examination was considered abnormal and in seven, prostate specific antigen was over 4 ng/ml. All subjects with elevated prostate specific antigen had an abnormal rectal examination. In three of the 14 subjects, the biopsy showed a well differentiated adenocarcinoma. All three were aged over 50 years old. The resulting calculated prevalence of prostate cancer was 9.2 per 1,000 males (CI 4.2-14.1). Conclusions: the cost effectiveness of screening for early diagnosis of prostate cancer must be calculated, to decide its incorporation in preventive medical examinations