Variabilidad de la práctica médica: a 80 años del efecto Glover / Variability of medical practice: at 80 years since the Glover effect

At this moment, it seems to be clear, that the application of the epidemiological logic to the sanitary administration, by one side, to specify which are the diseases or the needs that have a greater importance in a determined population to identify which individuals are at risk situation or with unnoticed requeriments to focuse resources mainly in them, and on the other side, to planify politics at macro level or logistic to supply resources and at level meso or micro through the analysis of the configuratiion of the employement of services or their polinomic terms: patient, providers and mediating organizations. Rarefieds, however a little the atmosphere of the called variability phenomen in the medical practice, prefigurted by Glover in the decade of the 30 th. It has been however a fundational basis the study of Allison Glover on the amigdalectomies in the British school districts, chronologically the first call for attention on the wide variation over the poblational rates of the interventions (Glover 1938), to such an extent that it was coined the concept "Glover effect" to refer to this fact. These facts showd that there was in England and Wale a rate of tonsillectomies between 50% and 70%, and indication 3 times more frequent in children from more accommodated class, a higher incidence in boys than in girls, an age of higher incidence between 5 to 7 years of age, and the absence of correlatively with the so called impersonal facts as accumulation , powerty, deficient dwelling or clime. In our analysis it was proved that in the practice the Glover effect continues producing fullness. These aspects are anayzed in the study

Epidemiología y salud comunitaria

Contenido: Historia y crónica de la epidemiología, con especial referencia a la Argentina y la América Latina: evolución de paradigmas y marco conceptual. Áreas de conocimiento epidemiológico. La epidemiología aplicada a los servicios de atención primaria de salud y la salud comunitaria. La epidemiología como instrumento para la adopción de decisiones en el nivel local y la comunidad. Diseños en la investigación epidemiológica. Instrumentos epidemiológicos. Actividades epidemiológicas y función del epidemiólogo en el hospital. Infecciones asociadas al cuidado de la salud. La epidemiología en los sistemas locales de información. Investigación epidemiológica. La epidemiología aplicada en la evaluación de resultados en salud. Epidemiología social. Capacitación del personal en epidemiología. Inferencia causal, multicausalidad, causalidad compleja. Epidemiología y medicina preventiva. Bioética en epidemiología y salud comunitaria. Técnicas cualitativas y de consenso aplicadas a la investigación en salud. Fronteras en epidemiología: epidemiología genómica molecular y bioinformática.

Variabilidad de la práctica médica: a casi 70 años del efecto Glover / Variability of the medical practice: almost 70 years of the Glover's effect

Knowledge about the financing efficiency and organization of health services requires continual updating.Clinical epidemiology is the science of making predictions that can guide the management of individual patients by the careful study of groups. It is clear at the present that the application of the logical epidemiology to the health administration should permit the identification of which diseases have importance to determinate populations to identify people in risk situation. These situations are considered in detail in the article