RESUMO
Background: In Mexico there is an important gap of information regarding the quality of care for neonates with necrotizing enterocolitis (NEC). This study aimed at evaluating the quality of care for neonates with NEC affiliated with the program Medical Insurance Century XXI (MIC-XXI), which is a branch of Seguro Popular. Methods: From December 2011 to March 2012, a cross-sectional study took place in 61 hospitals of the Ministry of Health located in 22 Mexican states. A set of 16 quality indicators based on a literature review served for the evaluation. Results: We reviewed 262 medical records of neonates with NEC. More than half were male and born by caesarean section; 55.8% were premature, 55.3% had low birth weight and 12.2% died. Regarding the quality of care, 72.5% were breastfed before being diagnosed with NEC. Most cases had abdominal radiography (90%), 75.0% had diagnosis of NEC according to Bell's criteria, but only 30% had reported symptoms that met the criteria for the recorded stage. Suspension of enteral feeding and administration of antibiotics reached 95.8% and 93.9%, respectively. Twenty six neonates underwent surgery, of which 34% had reported radiographic findings. Conclusion: A wide margin exists to improve the quality of care of neonates with NEC in Mexican Hospitals.
RESUMO
OBJETIVO: Evaluar la autopercepción del estado de salud positivo (APES +) o negativo (APES -) de mujeres climatéricas e identificar los factores relacionados con la APES-. MATERIAL Y MÉTODOS: Se analizó la información de 9 248 mujeres de 40 a 59 años. Las variables dependientes fueron la APES y las independientes las características generales, antecedentes ginecoobstétricos, enfermedades crónicas, actividad física, participación en programas de detección y educación. Se realizó un análisis descriptivo, bivariado y multivariado. RESULTADOS: Una proporción de 42 por ciento de las mujeres refirió APES+ y 58 por ciento APES-. Los factores vinculados con APES- fueron primaria completa o menos (RM=1.78; IC95 por ciento 1.62-1.95), no tener trabajo remunerado (RM=1.20; IC95 por ciento 1.09-1.33), menopausia (RM=1.22; IC95 por ciento 1.11-1.33), diabetes (RM=1.88; IC95 por ciento 1.65-2.13), hipertensión (RM=2.01; IC95 por ciento 1.82-2.22), actividad física irregular (RM=1.30; IC95 por ciento 1.12-1.50), sedentarismo (RM=1.395; IC95 por ciento 1.23-1.57), falta de integridad de detección (RM=0.82; IC95 por ciento 0.75-0.89) y de información sobre el climaterio por parte de los servicios de salud (RM=1.17; IC95 por ciento 1.07-1.28). CONCLUSIÓN: Los factores relacionados con APES- son múltiples y algunos, como la información acerca del climaterio y la actividad física, deben fortalecerse.
OBJECTIVE: To evaluate self-rated health (SRH) in climacteric women and to identify the factors associated with negative SRH. MATERIAL AND METHODS: Information from 9 248 women aged 40 to 59 years was analyzed. SRH was the dependent variable. Independent variables were demographic characteristics, history of reproductive and chronic diseases, physical activity, and participation in screening and health education programs. Data were analyzed using descriptive statistics, bivariate analysis, and logistic regression modeling. RESULTS: Forty-two percent of women reported positive SRH and 58 percent reported negative SRH. Factors associated with negative SRH were: low literacy level (OR 1.78, CI95 percent 1.62-1.95), unemployment (OR 1.20, CI95 percent 1.09-1.33), menopause (OR 1.22, CI95 percent 1.11-1.33), type 2 diabetes (OR 1.88, CI95 percent 1.65-2.13) hypertension (OR 2.01, CI95 percent 1.82-2.22), irregular physical exercise (OR 1.30, CI95 percent 1.12-1.50), sedentarism (OR 1.395, CI95 percent 1.23-1.57), lack of information about climacteric (OR 1.17, CI95 percent 1.07-1.28) and lack of screening for chronic diseases (OR 0.82, CI95 percent 0.75-0.89). CONCLUSIONS: Factors associated with negative SRH such as lack of information and physical activity should be strengthened.