ABSTRACT
Introduction: Today, health system, like any other event dependent to social conditions, requires effective evaluations for promoting condition and function improvement. The present study aims to examine the impact of health evolution plan on between- hospital dispatches of orthopedic service in Shiraz Medical Sciences Universities in 2013-2014. Methodology: This study was performed with descriptive- analytical method in time period of 2013 and 2014. The research population included all orthopedic service dispatches which have been accomplished from hospitals of Fars province cities to hospitals settled in Shiraz. The research sample was coincident with the mentioned statistical population. The research information was received from Shiraz Medical Sciences University, medical care monitoring center and included data relating to dispatches such as non-existence presence of specialized physician in the hospital. Statistical analysis was performed using descriptive statistics and Chi-square, Mann-Whitney test and Z-test and by SPSS 22 software. Results: The number of dispatches with average age of 41 years (SD=22/78) before health evolution plan has been 209 cases and after evolution plan it has reached 279 cases with average age of 43 years (SD=22/38). The results showed that there is a significant difference between before and after health evolution plan based on non- existence of specialist and also need to operation room (p<0.05). also, the results revealed that there is no significant difference between before and after evolution plan based on specialist presence, empty bed, department or respective service, tendency to private hospital, the patient financial problem, time of getting admission and time of admission registration (p<0.05). Conclusion: Health evolution plan has been successful in the field of specialist existence in cities while, in the field of reducing dispatches from cities to center of province hasn’t performed successfully. Regarding the importance of between- hospital dispatch issue and expectations envisaged from evolution plan, it seems that despite the obtained changes, fundamental amendments are necessary to achieve the optimal result.
ABSTRACT
La migraña es una entidad neurológica de carácter crónico con manifestaciones episódicas y una de las principales causas de discapacidad. Se ha descrito que hasta el 14% de los individuos afectados por patrones episódicos pueden virar a un patrón crónico y frecuente, denominado migraña crónica. La cronificación de esta entidad se ha asociado con mayor disfunción en las esferas familiar y social, menor rendimiento laboral y académico, así como una mayor comorbilidad psiquiátrica, lo que causa deterioro de la calidad de vida. Se han descrito algunos factores de riesgo para la cronificación de la migraña como el sexo femenino, el bajo nivel educativo y la depresión, sin embargo es posible que existan algunos factores específicos de cada población que contribuyan a la transformación migrañosa. Los aspectos culturales y posiblemente su baja letalidad entre otros elementos aminoran el impacto de la migraña entre los pacientes, el personal de salud y los sistemas de salud pública.
Migraine is a neurological manifestations of episodic and repetitive nature and considered as one of leading causes of disability. It has been reported that up to 14% of persons who is affected by an episodic patterns can turn to chronic pattern, called chronic migraine. The chronic pattern has been associated with greater dysfunction in the family and social spheres, less labor and academic performance, with an increased psychiatric morbidity, resulting in further deterioration of quality of life. Have been previously described risk factors for chronification such as female gender, low educational level and depression, however there may be some specific factors that contribute to migraine transformation populations. Some cultural facts and its low lethality among other things, lessen the impact of migraine among patients, health personnel and public heath systems.