Salud sexual y reproductiva en tiempos del COVID-19: accesibilidad de mujeres sordas y con discapacidad auditiva / Access of chilean deaf women to healthcare information and reproductive care

Background: The COVID-19 pandemic threatened the accessibility and response of healthcare systems worldwide. People with disabilities face specific access challenges to healthcare services and to healthcare information in accessible formats. Aim: To explore how deaf women acceded to information and sexual and reproductive health care during the first wave of COVID-19. Material and Methods: Sixty-one women with a median age of 32 years diagnosed with deafness and hearing loss were surveyed using an online questionnaire about access to healthcare information and midwifery care during the COVID-19 pandemic. Results: Forty-nine percent of respondents lived in the Metropolitan Region. Sixty-eight percent of respondents mentioned that information about COVID-19 was not accessible for them. The main source of information that they used to learn about the pandemic were videos made by deaf people available on the internet. Seventy-five percent of women reported that they had not received accessible information about sexual and reproductive health, and 70.0% of women requiring midwife care could not book an appointment. Conclusions: The pandemic generated a crisis in the Chilean healthcare system that demands a new strategy to ensure people's healthcare access. People with disabilities such as those herein studied are marginalized when these new policies are being discussed and implemented. Decision-makers and sexual and reproductive health services must improve their strategies to allow women with disabilities, particularly deaf women gain access.

Costo efectividad de un programa de rehabilitación cardiovascular modelo para personas post infarto agudo al miocardio en el Servicio de Salud Metropolitano Norte / Cost effectiveness of a theoretical cardiac rehabilitation program after myocardial infarction

Background: Secondary prevention programs are an essential part of comprehensive care of patients with cardiovascular disease (CVD), and its effectiveness in reducing morbidity or mortality has been proved. Aim: To determine the cost-effectiveness of a theoretical comprehensive cardiac rehabilitation (CCR) outpatient program after Myocardial Infarction, to be implemented in a Chilean Public Health System. Material and Methods: We designed a theoretical protocol of a CCR program based on recommendations of international guidelines, but adapted to local needs. A cost analysis was developed. Life years due to premature death were estimated with and without participation in CCR. The gained life-years and cost-effectiveness of the program were thus calculated. Results: The annual cost of cardiac rehabilitation center is $ 64,407,065 Chilean pesos (CLP). The Incremental Cost Effectiveness Ratio (ICER) considering a reduction of late mortality of 25%, is $ 475,209.7 CLP per year of life gained. Since this figure is lower than one unit of per capita gross domestic product, the intervention is considered very cost-effective. Conclusions: A comprehensive cardiac rehabilitation program after myocardial infarction is very cost-effective in the context of its implementation in a public health service.

Garantía de oportunidad, artrosis y autorreporte de salud en personas con artrosis en una comuna de la Región Metropolitana / Knowledge about health care rights among a group of Chilean patients with knee osteoarthritis

Background: Mild to moderate osteoarthritis of the knee in people over 55 years of age is one of the diseases whose management is covered by the explicit guaranties in health system (GES) in Chile. All beneficiaries with the disease should be informed about their rights to receive free treatment. Aim: To assess the degree of awareness about their rights among patients with knee osteoarthritis, admitted to GES. Material and Methods: Two hundred forty one patients aged 55 to 93 years (180 women) with knee osteoarthritis admitted to GES, answered at their homes a survey about their rights to receive health care, included in the GES system and about their disease. Results: Fifty percent of patients did not know what GES system was, 26% admitted to have a limited knowledge and 24%, a full knowledge. Sixty two percent were not informed about the nature of their disease and 42% perceived their health as less than optimal. There was a significant association between the level of knowledge about GES and osteoarthritis and their self-perception of health. Conclusions: Half of the patients with knee osteoarthritis surveyed, were not aware of their health care rights included in GES and received scanty information about their disease.