La admisión a medicina vía Bachillerato en Ciencias: experiencia de 5 años / Admission to medical school of Bachelors of Science: experience of 5 years

BACKGROUND: In industrialized countries, most students are admitted to medical schools after obtaining a Bachelor degree. In 1993, the Catholic University of Chile instituted a program to obtain a Bachelor degree. These students can apply to Medical School. AIM: To compare the academic achievement of students admitted to medical school directly from high school or after obtaining a Bachelor degree. SUBJECTS AND METHODS: Cohorts of medical students coming directly from high school or after obtaining a Bachelor of Sciences degree, between 1997 and 2001, were studied. Social and demographic background, scores of the Academic Achieving test and grades obtained during high school and in medical school, were compared in both groups. RESULTS: The distribution of gender and the region of origin were similar in both groups of students. Thirty two percent of bachelors and 18 per cent of high school students admitted to medical school, came from public schools (p = 0.014). The Academic Achieving test score was 727 +/- 27 and 764 +/- 11 points in bachelor and high school students respectively (< 0.001). However the mean grades in Medical School were similar in both groups of students. CONCLUSIONS: Bachelor degrees are a good opportunity for students, that must be considered by Medical Schools in their admission systems.

Relación entre bronquiolitis aguda con factores climáticos y contaminación ambiental / Association of acute bronchiolitis with climate factors and environmental contamination

BACKGROUND: Annually, acute bronchiolitis (AB) occurrence peaks during winter and is probably associated with air pollution. AIM: To relate the number of ambulatory consultations, emergency and hospital admission due to AB with climatic factors and air pollution. PATIENTS AND METHODS: Patients of less than 1 year old with AB that consulted to outpatient clinics, the emergency room or were admitted to the Pediatrics ward of the Catholic University Hospital, were enrolled. Information about respiratory syncytial virus (RSV) was obtained from the Catholic University Medical Investigation Center. Indices of air pollution such as particulate matters of less than 10 microns/m3 (PM 10), of less than 2.5 microns/m3 (PM 2.5), CO, SO3 and O3 were obtained from the Metropolitan Environmental Service. Temperature, humidity and precipitations were obtained from the Chilean Meteorological Service. RESULTS: Ninety nine consultations in out patient clinics and 442 in emergency rooms were collected (55 per cent male, mean age 4.8 months). One hundred fifty two were admitted (34.4 per cent). Thirty percent of children consulting in emergency rooms were younger than 3 months and 43 per cent of them were hospitalized. The RSV study was made in 307 patients and 52 per cent were positive. There was a higher rate of hospital admissions among RSV positive than RSV negative patients (52.5 and 22 per cent respectively, p < 0.001). No association between environmental variables or air pollution and the number of consultations was observed. Young age and smoking inside the household were the main risk factors for hospital admission due to acute bronchiolitis. CONCLUSIONS: Environmental variables did not influence the number of cases of acute bronchiolitis. Young age and exposure to tobacco smoke were risk factors for hospital admission.

Equidad de género en el acceso a la atención de salud en Chile / Gender inequity in the access to health care in Chile

BACKGROUND: In the last two decades, Chile has experienced advances in economical development and global health indicators. However, gender inequities persist in particular related to access to health services and financing of health insurance. AIM: To examine gender inequities in the access to health care in Chile. MATERIAL AND METHODS: An analysis of data obtained from a serial national survey applied to assess social policies (CASEN) carried out by the Ministry of Planning. During the survey 45,379 and 48,107 dwellings were interviewed in 1994 and in 1998, respectively. RESULTS: Women use health services 1.5 times more often, their salaries are 30 per cent lower in all socioeconomic strata. Besides, in the private health sector, women pay higher insurance premiums than men. Men of less than two years of age have 2.5 times more preventive consultations than girls. This difference, although of lesser magnitude, is also observed in people over 60 years. Women of high income quintiles and users of private health insurance have a better access to preventive consultations but not to specialized care. CONCLUSIONS: An improvement in equitable access of women to health care and financing is recommended. Also, monitoring systems to survey these indicators for women should improve their efficiency.