Apuntes históricos sobre del proceso de formación del médico general integral en Cuba / Historical notes on the training process of the comprehensive general doctor in Cuba

La salud pública cubana se sustenta en la Atención Primaria de Salud y, con ello, la instauración de la especialidad de medicina general integral en 1985, con cambios sustanciales hasta la actualidad, ha dado un importante paso de avance en la accesibilidad y calidad en los servicios médicos; transformación necesaria en el Sistema Nacional de Salud. Teniendo en cuenta lo anterior se realizó el presente estudio con vistas a profundizar en las tendencias históricas por las que ha transitado el proceso de formación del médico general integral en Cuba. Se concluye que dicho proceso ha tenido transformaciones que obedecen a las necesidades nacionales e internacionales, donde todas las versiones del programa consideran la educación en el trabajo como protagonista en los servicios de salud.

The Cuban public health is sustained in the Primary Health Care which improvement has been favored with the establishment of the comprehensive general medicine specialty in 1985, with substantial changes until the present time that have propitiated a step of important advance in the accessibility and quality in the medical services. Taking into account the above-mentioned the present study was carried out aimed at deepening in the historical tendencies that the training process of the comprehensive general doctor in Cuba has gone through. It was concluded that this process has had transformations that obey the national and international necessities, where all the versions of the program consider the education at work as main character in health services.

A Comparative Study of Health Checkup Results between Early and Late Elderly / General Medicine

<b>OBJECTIVE</b>: The present study assessed the validity of the benchmark, 75 years old, that divides elderly people into an early and a late stage, based on health checkup results for two consecutive years. We also investigated prevalent health problems and improvement trends.<br><b>METHODS</b>: This retrospective study was conducted on 1,416 subjects (1,007 early and 409 late elderly subjects) who received health checkups at the Health Care Center of the St. Marianna University School of Medicine Hospital between April 2006 and March 2007. The survey consisted of blood pressure, required blood test results, diagnoses according to the criteria defined by Kawasaki city, outcomes, and the presence or absence of a primary care doctor.<br><b>RESULTS</b>: The number of subjects with anemia and/or renal dysfunction was significantly greater in the late elderly than the early elderly (p<0.01). The results of the survey demonstrated that 79.6% of the early elderly and 87.4% of the late elderly had primary care doctors (p<0.01). In the early elderly, 57.0% of the subjects with primary care doctors and 43.2% of those without primary care doctors showed improvement; the subjects with primary care doctors showed significant improvement compared to those without primary care doctors (p<0.05). In the late elderly, 50.2% of the subjects with primary care doctors and 54.2% of those without primary care doctors showed improvement, resulting in no significant difference between the subjects with and without primary care doctors.<br><b>CONCLUSIONS</b>: We found differences in the detected health problems and outcomes between the early and late elderly. These results support the appropriateness of the current age segmentation and future prospects for medical care in detecting and managing health problems in the elderly.