Estudo transversal sobre ausências de pacientes em consultas médicas agendadas em ambulatórios de hospital terciário / Cross-sectional Study On Patient Absences In Medical Consultations Scheduled In Outpatient Clinics Of Tertiary Hospital / Estudio Transversal Sobre Ausencias de Pacientes Em Citas Médicas Programadas Em Pacientes Ambulatorios de Hospitales Terciarios

Objetivo: Analisar variáveis relacionadas ao agendamento de consultas ambulatoriais que não se realizaram pela ausência dos pacientes. Métodos: Estudo transversal produzido em hospital público terciário de referência para o Sistema Único de Saúde. Foram sorteados aleatoriamente 493 pacientes, e a amostra final totalizou 317 pacientes que faltaram a consultas médicas. Variáveis investigadas: recebimento de mensagens via celular informando a data da consulta, intervalo entre a data do agendamento e da consulta e a realização de reagendamento. Os dados foram oriundos de relatórios informatizados de faltosos a consultas agendadas e entrevistas telefônicas. Análises estatísticas realizadas no programa SAS® for Windows, versão 9.3. Resultados: 49.8% dos pacientes informaram não terem recebido mensagem lembrando sobre a data da consulta. O tempo entre o agendamento e a data da consulta ficou entre 180 e 365 dias para 36,6% dos pacientes. Reagendaram a consulta 24,6% dos pacientes. Conclusão: É necessário ampliar procedimentos para prevenção de faltas às consultas, independentemente do tempo entre o agendamento e a consulta. (AU)

Objective: To analyze variables related to the scheduling of outpatient appointments that did not take place due to patient no-show. Methods: Cross-sectional study conducted in a tertiary public referral hospital providing services to the Brazilian Unified Health System. A total of 493 patients were randomly selected, and the final sample totaled 317 no-show patients. Variables investigated: receipt of messages via cell phones informing the appointment date, interval between the scheduling date and the appointment date, and rescheduling. Data were obtained from computerized reports regarding absenteeism from scheduled appointments and telephone interviews. Statistical analyses were performed using the SAS® for Windows software, version 9.3. Results: 49.8% of patients reported not having received a message reminding them of the appointment dates. The interval between scheduling and the appointment dates was from 180 to 365 days for 36.6% of patients. A total of 24.6% of patients rescheduled their appointments. Conclusion: It is necessary to expand procedures to prevent missed appointments regardless of the time between scheduling and the appointment. (AU)

Objetivo: Analizar variables relacionadas con la programación de consultas externas que no se realizaron por ausencia del paciente. Métodos: Estudio transversal realizado en un hospital público terciario de referencia del Sistema Único de Salud. Se seleccionó aleatoriamente a 493 pacientes y la muestra final fue de 317 pacientes que faltaron a las citas médicas. Variables investigadas: recepción de mensajes vía celular informando la fecha de la cita, intervalo entre la cita y la fecha de la cita y reprogramación. Los datos provienen de informes computarizados de ausencias n citas programadas y entrevistas telefónicas. Análisis estadísticos realizados en SAS® para Windows versión 9.3. Resultados: En el 49.8% de los pacientes informaron no haber recibido un mensaje recordando la fecha de la cita. Conclusión: Es necesario ampliar los procedimientos para evitar citas perdidas independientemente del tiempo entre citas y citas. (AU)

Facteurs associés au faible niveau de fréquentation du centre de santé intégré de Pondila en 2021 / Factors associated with low levels of attendance of the integrated health center of Pondila in 2021

Le système de santé de la République du Congo est caractérisé par un important gap dans l'offre des services de santé entre le milieu urbain et le milieu rural. La communauté rurale de Pondila, dans le département du Kouilou n'échappe pas à cette description, avec un faible taux de fréquentation du CSI de Pondila de 34,22%. Objectif: Cette étude avait pour objectif d'étudier les facteurs associés au faible taux de fréquentation du CSI de Pondila en 2021. Méthodologie : Il s'agit d'une étude transversale analytique qualitative et quantitative sur un échantillon probabiliste représentatif de 347 ménages dans toute l'aire de santé de Pondila. Un modèle de régression logistique a été construit par la méthode de sélection pas à pas descendante avec une probabilité d'entrée de 0,05 et IC à 95%. Résultats : 30,84% des enquêtés ont rapporté ne pas avoir consulté le CSI de Pondila dans les 03 mois précédant l'enquête dans de mauvaises conditions d'accès géographiques et financières. La régression logistique a permis d'établir le faible niveau de fréquentation du CSI et le chômage (OR=16,67 [14,67 à 18,67], p=0,000), le mauvais accueil des bénéficiaires par le personnel soignant (OR=3,15 [1,00 à 9,95], p=0,050) et l'absence de médicaments lors des consultations (OR=3,21 [0,26 à 39,24], p=0,000). Conclusion : Le faible niveau de fréquentation du CSI de Pondila est associé au chômage, au mauvais accueil et à la non disponibilité des médicaments au CSI, au coût élevé des soins et au mauvais état des routes.

Factores que Afectan la Duración de los Tratamientos de Ortodoncia en un Servicio Público de Salud / Factors that Affect the Duration of Orthodontic Treatment in Public Health Services

RESUMEN: La duración de los tratamientos de ortodoncia siempre ha sido una de las mayores preocupaciones, tanto en los pacientes como en los Ortodoncistas. El proposito de esta investigacion fue determinar la magnitud de las inasistencias a los controles por parte de los pacientes y como estas y otras variables, influyen en la duración de los tratamientos de Ortodoncia en el Centro de Salud Familiar (CESFAM) Dr. Victor Manuel Fernandez, Servicio de Salud de Concepcion, Chile. Se realizo un estudio descriptivo, de tipo transversal, retrospectivo, en el que se utilizaron las fichas clínicas de todos los pacientes que fueron dados de alta por los Ortodoncistas del CESFAM Dr. V. M. F. durante el año 2017. La tabulación se realizó en Microsoft Excel y el análisis estadístico se hizo en InfoStat 17. Se incluyeron 246 pacientes, con una edad de ingreso promedio de 13,6 años. La maloclusion predominante fue la Clase I de Angle (71 %). Estos pacientes tuvieron una duracion de tratamiento promedio de 33,9 meses. Se concluyó que a mayor cantidad de inasistencias, el tratamiento de ortodoncia tuvo una duración mayor.

ABSTRACT: The duration of orthodontic treatments has always been one of the biggest concerns, both in patients and for orthodontists. The purpose of this investigation was to determine the magnitude of the absences to the controls of the patients and how they influence the duration of the orthodontic treatments in the CESFAM Dr. Victor Manuel Fernandez, Concepcion, Chile. A descriptive, cross-sectional, retrospective study was carried out, in which the clinical records of all patients discharged by the Orthodontists of CESFAM Dr. V.M.F. during the year 2017 were analyzed. The tabulation was performed in Microsoft Excel and the statistical analysis was carried out in InfoStat 17. In total, 246 patients were included, with an average age of admission of 13.6 years. The predominant malocclusion was Class I of Angle (71 %). These patients had an average treatment duration of 33.9 months. It was further concluded that the length of orthodontic treatment, was also affected by the increased number of times patients failed to show for treatment.

No-shows at public secondary dental care for pediatric patients: a cross-sectional study in a large Brazilian city / Não comparecimento na atenção secundária pública em saúde bucal de pacientes pediátricos: estudo transversal em uma grande cidade brasileira

Abstract Missed appointments have a great economic, social and administrative impact on the management of public health services. This research aimed to study factors associated with non-attendance to the first appointments of pediatric patients in secondary dental care services in the city of Curitiba, Brazil. A cross-sectional study was performed using secondary data from the electronic health records of the Curitiba Municipal Secretary of Health. The study included all children (0-12 years) referred to secondary dental clinics in the years 2010 to 2013. Data were analyzed by the chi-square test and Pearson linear trend chi-square (α = 0.05). Binary logistic regression models were built. Data from 1,663 children were assessed and the prevalence of non-attendance was 28.3%. The variables associated with the non-attendance in inferential analysis (p < 0.05) and in the final model were the household income per capita (95% CI: 1.93-2.82) and the waiting time in virtual queue (95% CI: 1.000-1.002). Socioeconomic aspects and the waiting time in virtual queue, should be considered in the strategic planning of health services as they may influence the attendance of pediatric patients in secondary dental referral service.

Resumo O não comparecimento a consultas tem um grande impacto no gerenciamento dos serviços de saúde pública. O objetivo foi avaliar os fatores associados ao não comparecimento às primeiras consultas de pacientes pediátricos nos serviços de atenção secundária em saúde bucal na cidade de Curitiba, Brasil. Um estudo transversal foi desenvolvido com dados secundários obtidos de cadastros eletrônicos da Secretaria Municipal de Saúde de Curitiba. Participaram crianças de 0 a 12 anos de idade encaminhadas para atenção secundária nos anos de 2010 a 2013. Os dados foram analisados pelos testes de qui-quadrado de Pearson e qui-quadrado de tendência linear (α = 0,05). Foram constituídos modelos de regressão logística binária. Foram analisados os dados de 1.663 crianças. A prevalência de não comparecimento às primeiras consultas foi de 28,3%. As variáveis que estiveram associadas ao não comparecimento na análise inferencial (p < 0,05) e no modelo final foram a renda per capita familiar (95% CI: 1,93-2,82) e o tempo de espera em fila virtual (95% CI: 1,000-1,002). Aspectos econômicos e o tempo de espera em fila virtual devem ser considerados no planejamento estratégico dos serviços públicos de saúde bucal, pois podem influenciar o comparecimento de pacientes na atenção secundária.

Fatores associados às faltas em tratamentos ortodônticos em centro de especialidades odontológicas / Factors associated with absences from orthodontic treatment at a dental specialty center

Resumo O objetivo deste estudo foi identificar os fatores associados ao não comparecimento dos usuários ao tratamento ortodôntico, em três centros de especialidades odontológicas regionais (CEO-R) localizados no estado do Ceará. Metodologia: Os dados foram extraídos de prontuários de pacientes que concluíram o tratamento ortodôntico. Foi calculada a taxa de ausências, com o objetivo de estabelecer um coeficiente de faltas entre os municípios. A fim de descrever o padrão geográfico da ocorrência, foram construídos mapas temáticos baseados nas distribuições. Para as associações entre a variável desfecho (falta ao tratamento) e as independentes (sexo, idade, quebra de aparelho, mudança de profissional, renda e local de residência do usuário), utilizou-se a análise de regressão logística múltipla com p ≤ 0,05. Resultados: Foram examinados 237 prontuários em 20 municípios, com 8.283 consultas ortodônticas realizadas e 2.665 (32,17%) faltas. Apresentou diferença estatisticamente significativa a variável mudança de profissional. Conclusão: O maior número de faltas foi associado à mudança de profissional.

Abstract The aim of this study was to identify the factors associated with the users failing to keep orthodontic treatment appointments (absences), in three regional dental specialty centers (CEO-R) located in the State of Ceará. Methodology: This was a cross-sectional epidemiological study with secondary data source of 3 CEO-R, from which 237 medical records of complete orthodontic treatments were examined, with 8.283 appointments and 2.665 (32.17%) missing appointments. Data collection was standardized by an electronic questionnaire.. Factors associated with users missing appointments were calculated by means of absence rates and thematic maps were constructed based on distributions of the geographical pattern of occurrence. To evaluate the association between the outcome variable (absence from treatment) and the independent variables (sex, age, breakage of appliance, change of professional, income and place of user's residence) multiple logistic regression analysis was used with p ≤ 0.05. Results: There were high absence rates for both city headquarters and non-headquarter CEO-Rs. The variable change of professional showed statistical significance, in relation to the number of absences. Conclusion: The highest number of absences was associated with change of professional.

Déterminants et raisons de non vaccination complète des enfants hospitalisés dans deux hôpitaux de référence pédiatrique à Yaoundé

Introduction. Dans un contexte où les taux de couverture vaccinale sont faibles, les hospitalisations sont une occasion pour s'assurer de la vaccination des enfants. L'étude avait pour but de préciser les déterminants et raisons de non vaccination complète des enfants hospitalisés dans deux hôpitaux à Yaoundé. Méthodologie. Notre étude transversale a porté sur les enfants admis dans deux hôpitaux de référence de Yaoundé. Les connaissances des mères sur la vaccination ont été analysées, de même que le motif d'hospitalisation. La recherche des contacts antérieurs des enfants avec les formations sanitaires (FOSA) permettait d'explorer d'éventuelles occasions manquées de vaccination. Les facteurs associés et les raisons de la vaccination incomplète étaient également décrits. Résultats. Nous avons colligé les informations sur 205 sujets parmi lesquels 75,1% âgés de moins de 3 ans. Les principaux motifs d'hospitalisation étaient le paludisme (49,3%) et la pneumonie (14,1%). La plupart des parents connaissaient la vaccination (86,3%) ainsi que son rôle (92,1%) avec pour principale source d'information le personnel de santé (68,4%). La complétude vaccinale globale était de 40%, soit 65,9% et 50,3% pour les vaccins de routine (PEV) et hors PEV respectivement. Cette complétude n'était pas retrouvée chez 60% des patients bien que 90% aient fréquenté une FOSA. Les occasions manquées de vaccination s'élevaient à 65,7% et 61,8% pour le PEV et les vaccins hors PEV respectivement. Les raisons de non vaccination étaient dominées par l'ignorance (65,9%) et les ruptures en stock de vaccin (21,1%). Cependant, le niveau d'étude secondaire (p=0,020), la présence d'une pneumonie (p=0,020) et le fait d'être premier enfant influençaient négativement la vaccination (p=0,008). Conclusion. La complétude vaccinale était insuffisante malgré de bonnes connaissances des parents sur l'importance de la vaccination. Il est important d'agir sur les occasions manquées, surtout chez les ainés et les enfants des mères d'un faible niveau d'étude

Reasons for operation cancellations at a teaching hospital: prioritizing areas of improvement

PURPOSE: To report rates of and reasons for operation cancellation, and to prioritize areas of improvement. METHODS: Retrospective data were extracted from the monthly reports of cancelled listed operations. Data on 14 theatres were collected by the office of quality assurance at Jordan University Hospital from August 2012 to April 2016. Rates and reasons for operation cancellation were investigated. A Pareto chart was constructed to identify the reasons of highest priority. RESULTS: During the period of study, 6,431 cases (9.31%) were cancelled out of 69,066 listed cases. Patient no-shows accounted for 62.52% of cancellations. A Pareto analysis showed that around 80% of the known reasons for cancellation after admission were due to a lack of surgical theatre time (30%), incomplete preoperative assessment (21%), upper respiratory tract infection (19%), and high blood pressure (13%). CONCLUSION: This study identified the most common reasons for operation cancellation at a teaching hospital. Potential avoidable root causes and recommended interventions were suggested accordingly. Future research, available resources, hospital policies, and strategic measures directed to tackle these reasons should take priority.