Centralización en la elaboración y bancos solidarios de drogas oncológicas, una estrategia para mejorar la accesibilidad a los tratamientos / Centralization in the development and solidarity banks of oncological drugs, a strategy to improve accessibility to treatments

El objetivo del estudio es determinar los tratamientos que se generan fruto de la centralización y medir el impacto económico. El proceso de utilización de citostáticos inicia con la confección del protocolo por parte del médico, la validación por el farmacéutico con la confección de la orden de elaboración, y la ejecución por el técnico realizando la preparación en cabina de seguridad biológica. Culmina con la administración por parte de enfermería y seguimiento médico. La centralización disminuye el riesgo de exposición, ofrece protección del producto, paciente, operador, ambiente. Al mismo tiempo disminuye los costos provocando un ahorro significativo si se coordina la programación del protocolo y prescripción médica, la preparación en el servicio de farmacia y la administración en hospital de día agrupando por tratamiento a los pacientes.

The objective of the study is to determine the treatments that are generated by centralization and to measure the economic impact. The process of using cytostatics starts with the preparation of the protocol by the physician, the validation by the pharmacist with the writingof the preparation order, and the execution by the technician carrying out the preparation in the biological safety cabinet. It culminates with nursing administration and medical follow-up. Centralization reduces the risk of exposure, offers protection to the product, the patient, the operator, and the environment. At the same time, it reduces costs, with significant savings if the programming of the protocol and medical prescription, the preparation in the pharmacy service and the administration in the day hospital are coordinated grouping by treatment to the patients.

O tempo de percurso a cidades polos regionais influencia na mortalidade em pequenos municípios gaúchos? / Does time spent traveling to regional hub cities to receive healthcare influence mortality in small towns in Rio Grande do Sul State, Brazil? / ¿El tiempo de desplazamiento a ciudades que son polos regionales tiene influencia en la mortalidad en los municipios pequeños del Rio Grande do Sul, Brasil?

Resumo: O presente estudo objetiva responder se o tempo de viagem a municípios polos regionais possui efeito na taxa de óbitos por causas evitáveis (TOCE) e na taxa bruta de mortalidade padronizada (TBMP) em municípios com até 5 mil habitantes do Rio Grande do Sul, Brasil. Sem a utilização de variáveis controles, o maior tempo de percurso até municípios com 100 mil habitantes ou mais está associado com um aumento de ambas as taxas. No entanto, enquanto que o comportamento da TOCE permanece similar após a inserção dos controles, a TBMP inverte seu sinal, sugerindo que, mantendo as demais características socioeconômicas e de atendimento de saúde constantes, a distância a municípios polos está associada, ao mesmo tempo, a uma redução dos óbitos por causas evitáveis e a um aumento nas demais causas de morte.

Abstract: The current study aims to determine whether the time spent travelling to regional hub cities to receive healthcare affects mortality from avoidable causes and the standardized crude mortality rate in towns with up to 5,000 inhabitants in Rio Grande do Sul State, Brazil. Without adjusting for control variables, the longest time spent to reach cities with 100,000 inhabitants or more was associated with an increase in both rates. However, while the pattern in the avoidable mortality rate was similar after including controls, the standardized crude mortality rate reversed its signal. This suggests that if other socioeconomic and healthcare characteristics are kept constant, the distance to reference cities is associated with both a reduction in deaths from avoidable causes and an increase in other causes of death.

Resumen: El objetivo del presente estudio es responder si el tiempo de viaje a municipios que son polos regionales posee un efecto en la tasa de óbitos por causas evitables y en la tasa bruta de mortalidad estandarizada en municipios con hasta 5.000 habitantes del estado de Rio Grande do Sul, Brasil. Sin la utilización de variables de control, el mayor tiempo de desplazamiento -hasta municipios con 100 mil habitantes o más- está asociado con un aumento de ambas tasas. No obstante, mientras que el comportamiento de la tasa de óbitos evitables permanece similar tras la inclusión de los controles, la tasa bruta de mortalidad estandarizada invierte su señal, sugiriendo que manteniendo constantes las demás características socioeconómicas y de atención de salud, la distancia a municipios polos regionales está asociada simultáneamente a una reducción de los óbitos por causas evitables y a un aumento en las demás causas de muerte.

A preliminary analysis of the reduction of chemotherapy waste in the treatment of cancer with centralization of drug preparation / Uma análise preliminar da redução do resíduo de quimioterapia no tratamento do câncer com a centralização no preparo da medicação

SummaryIntroduction:chemotherapy is essential to treat most types of cancer. Often, there is chemotherapy waste in the preparation of drugs prescribed to the patient. Leftover doses result in toxic waste production.Objective:the aim of the study was to analyze chemotherapy waste reduction at a centralized drug preparation unit.Methods:the study was cross-sectional, observational and descriptive, conducted between 2010 and 2012. The data were obtained from chemotherapy prescriptions made by oncologists linked to a health insurance plan in Curitiba, capital of the state of Paraná, in southern Brazil. Dose and the cost of chemotherapy waste were calculated in each application, considering the dose prescribed by the doctor and the drug dosages available for sale. The variables were then calculated considering a hypothetical centralized drug preparation unit.Results:there were 176 patients with a cancer diagnosis, 106 of which underwent treatment with intravenous chemotherapy. There were 1,284 applications for intravenous anticancer medications. There was a total of 63,824mg in chemotherapy waste, the cost of which was BRL 448,397.00. The average cost of chemotherapy waste per patient was BRL 4,607.00. In the centralized model, there was 971.80mg of chemotherapy waste, costing BRL 13,991.64. The average cost of chemotherapy waste per patient was BRL 132.00.Conclusion:the use of centralized drug preparation units may be a strategy to reduce chemotherapy waste.

ResumoIntrodução:a quimioterapia é essencial no tratamento da maioria dos tipos de câncer. No processo de preparo da quimioterapia, com frequência, parte da medicação precisa ser descartada para se atingir a dose prescrita pelo médico. A dose excedente da medicação resulta na produção de resíduo tóxico.Objetivo:analisar a redução do resíduo de quimioterapia obtida por meio da centralização do preparo da medicação.Metodologia:foi realizado um estudo transversal observacional e descritivo entre 2010 e 2012, a partir da análise das prescrições de quimioterapia, pela auditoria médica de um plano de saúde, no estado do Paraná. Foi calculada a dose de quimioterapia desprezada e o seu custo, em cada aplicação, considerando a dose prescrita pelo médico e as apresentações comerciais das drogas. A mesma análise foi realizada em um modelo hipotético centralizado de preparo de quimioterapia.Resultados:foram identificados 176 pacientes, com diagnóstico de câncer, sendo que 106 pacientes realizaram um total de 1.284 aplicações endovenosas. Houve um total de 63.824 mg de resíduo de quimioterapia com custo de R$ 448.397,00. O custo médio de quimioterapia desprezada por paciente foi de R$ 4.607,00. No modelo centralizado de preparo houve 971,80 mg de resíduo com custo de R$ 13.991,64. Nesse modelo, o custo médio de quimioterapia desprezada por paciente seria de R$ 132,00.Conclusão:conclui-se que a centralização no preparo da medicação para o tratamento do câncer pode ser uma estratégia para reduzir os resíduos de quimioterapia.

Development and application of hospital customer service center platform / 中国医疗器械杂志

This paper introduces the construction and application of the platform of client service center in the general hospital and discusses how to provide patients with an entire service including service before clinic, on clinic and after clinic. It can also provide references for a new service mode for clinic service.

An experience of health services provided by a peripheral government teaching hospital in India: Patients' perspective.

Background: Patients' satisfaction has now become the most important and measurable aspect for assessing the quality of patient care services. For improvement of performance of any health system there is a need to assess patients' satisfaction as often as possible. Objectives: 1) To assess the level of patients' satisfaction as well as dissatisfaction regarding the services provided in the outdoor and indoor of different departments of a tertiary care hospital. 2) To find out the relation of some socio-demographic variables and different departments with the level of satisfaction if any. Materials and Methods: Two predesigned pretested interview schedule (separate for outdoor and indoor) was developed covering certain domains of patients care. Overall satisfaction level was determined by using summated Likert's score. Results: For outdoor, a little excess of half of the patients were satisfied in doctor-patient communication(51.0%),consultation room(53.5%), and overall(59.9%).The unsatisfied area was waiting place and time(38.6%).In the Indoor, 58.6% patients were satisfied with admission procedure,53.2% for clinical care,57.1% for nursing care and 45.3% with food services and the areas where more patients were not satisfied were cleanliness(40.4%),comfort(20.2%) and food services.G&O patients were less satisfied both in indoor and outdoor. Satisfaction level significantly increased with increase in age (P<0.01),male patients (P<0.01),lower education(P<.05) and surgical patients(P<0.01). Conclusion: The level of patients' satisfaction showed deficiencies in different issues of hospital services, which should be given utmost importance by the hospital management authority for betterment.

Analysis of Maternal and Neonatal Transport by the 1339 Emergency Medical Information Center in Busan Area

PURPOSE: In relation to perinatal healthcare, medical institutions and resources are limitative and also are in a state of flux due to the therapeutic specialty. We analyzed requests for interhospital transfers received by Busan 1339 Emergency Medical Information Center (EMIC) to grasp the state of perinatal healthcare delivery system. METHODS: This study was conducted on the basis of data inputted into the computing system of Busan 1339 EMIC, between January 1 and December 31, 2009. In connection with 378 pregnant women and 136 newborns who were required to transfer, retrospective analyses were made of the success rate of transfer (SR), the number of contacted hospitals, the time required for transfer and the reason of transfer and refusal. RESULTS: In the case of pregnant women, the SR were 65.5%. They came in contact with 2.7 hospitals, and it took 24.4 minutes. As for the reason of transfer, preterm labor accounted for the highest proportion. In the case of newborns, the SR were 71.3%. They came in contact with 2.4 hospitals, and it took 15.6 minutes. The most common reason of transfer were respiratory symptoms. In the reason of refusal with pregnant women and newborn, the lack of medical staff, medical equipments and wards accounted for great. CONCLUSION: Many pregnant women and newborns have been transferred to hospitals by EMIC, but the SR has not been higher yet. Accordingly, there is a need to evaluate the propriety of perinatal treatment system, as well as to set up effective perinatal healthcare delivery system.

Papel del hospital dentro de la red de instituciones de salud / The hospital role within health institutions network

Se realiza una descripción de los antecedentes de las unidades hospitalarias y el cambio de su función de acuerdo a las transformaciones demográficas, epidemiológicas, políticas, económicas y sociales. Se analiza los retos que enfrentan los sistemas de salud en el nuevo siglo y la necesidad de la reorientación de las instituciones hospitalarias dentro de la red de servicios de salud para lograr una mayor eficiencia y accesibilidad de la atención médica. Por último se analiza como está conformada la red de servicios de salud en nuestro país...

Propuesta de ampliacion de servicios de salud en la Clinica Policial Virgen de Copacabana / sss

La ampliacion de servicios de salud en la clinica policial Virgen de Copacabana, se justifica por el incremento de efectivos tanto activos como pasivos, resultando nuestra infraestructura insufiente a los requerimientos, lo que amerita una reestructuracion administrativa y que sea implementada financieramente, para asi ampliar la cobertura el entorno familiar de los beneficiarios para lluego llegar a los particulares. La oferta actual de servicios de medicina general, ginecologia, pediatria, dermatologia, cardiologia, neurologia, cirugia general, traumatologia, oftalmologia, gastroenterologia y odontologia. Cabe señalar que el financiamiento proviene un 30 por ciento del Comando General en un a 30 por ciento de MUSEPOL...

Manual de organización del Hospital "Dr. Jaime Mendoza" / Manual of organization of hospital \"Dr. Jaime Mendoza\"

Garantizar la ejecución de los programas y proyectos del Hospital a través de la coordinación, supervisión, control y evaluación del desarrollo de los mismos, con el fin de mejorar la calidad de atención

Manual de organización manual de funciones reglamento interno: Coroico / Manual of organization of functions. inter regulations: Coroico

El manual de organización del Hospital General de los Yungas es un instrumento interno de identificación de recursos para el ordenamiento de actividades y tareas, delimitando deberes y responsabilidades en las diferentes áreas que conforman el Hospital

Manual de normas generales y procedimientos / Manual of general regulations and procedures

Las normas son el conjunto de reglas, medidas de ordenamiento, guías de función y manejo de diferentes servicios, principios éticos, compartiendo y desenvolvimiento dentro y fuera de los servicios. Son instrumentos administrativos: guía para los trabajadores; son de igual valor tanto para el administrador como para el empleado en particular