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Aim & objectives: Females who engage in high levels of sports have a high prevalence of menstrual cycle disorders and bone stress injuries (BSI). In this study, we determined the prevalence of menstrual disorders and fractures in female athletes and their association with bone mineral density (BMD) parameters. Material & methods: Cross-Sectional Study. Forty-one female athletes from a public High-Performance Regional Centre; 24 high-endurance athletes (HEA) and 17 other athletes, were included. To form the control group, we invited medical students from a public University. Twenty-nine non-athletes (NA) were included. A health surveys and a dual-energy X-ray absorptiometry (DXA) were conducted for all participants. Results: Among the participants (median age, 24 years; body mass index, 21 kg/m2), the percentage of long-term amenorrhoea was 42 % in HEA vs. 0 % in NHEA (OR 25.35; 95 % CI 1.37-470.50, p = 0.008) or 10 % in NA (OR 6.20; 95 % CI 1.46-26.24, p = 0.022), and the percentage of BSI was 29 % in HEA vs. 0 % in NHEA or NA. Both groups of female athletes (HEA and NHEA) showed higher Z-scores than those of NA in the femur; however, only NHEA had a significant increase in the BMD on lumbar spine than that of NA. Conclusion: The prevalence of long-term amenorrhoea and/or BSI was significantly higher in the HEA than in the NHEA or NA females. In contrast, HEA, like NHEA, had higher BMD values in the femur than those of controls. It is unlikely that DXA parameters can be used to estimate cortical BSI risk in this population.
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Antecedentes: La prevalencia de malnutrición es elevada entre la población mayor. El ingreso hospitalario es una ventana de oportunidad para su detección. Objetivo: Valorar la concordancia de distintas escalas nutricionales en pacientes hospitalizados.Método: Estudio prospectivo en pacientes mayores de 65años no institucionalizados ingresados en un servicio de Medicina Interna. Se compararon 5 encuestas de cribado de malnutrición (MNA, MST, MUST, NRS-2000 y CONUT) y 3 encuestas de cribado de riesgo nutricional (SCREEN3, 8 y 14). Como patrón de referencia se utilizó la definición de malnutrición de la Iniciativa Global para el Liderazgo en Malnutrición (GLIM). Resultados: Se incluyeron 85 pacientes (37% mujeres, mediana de edad 83años). El 48% (IC95%: 38-59%) de los pacientes fueron clasificados como malnutridos según criterios GLIM. La escala SCREEN3 fue la más sensible (93%; IC95%: 87-98) y MUST la más específica (91%; IC95%: 85-99). La escala más eficaz para excluir la sospecha de malnutrición fue SCREEN3 (LR− 0,17; IC95%: 0,05-0,53) y la mejor para confirmarla fue MST (LR+ 7,08; IC95%: 3,06-16,39). La concordancia entre las distintas escalas fue baja o muy baja, con índices kappa entre 0,082 y 0,465.Conclusiones: Se precisa un abordaje integral para detectar la malnutrición en adultos mayores ingresados. Las escalas más sensibles son más útiles en el cribado inicial. Las herramientas de riesgo nutricional podrían ser eficaces en esta etapa. En un segundo paso se debe confirmar la malnutrición de acuerdo con criterios establecidos como los de la GLIM.(AU)
Background: The prevalence of malnutrition is high among the elderly population. Hospital admission is a window of opportunity for its detection. Objective: To assess the concordance of different nutritional scales in hospitalized patients. Methods: Prospective study in non-institutionalized patients over 65years of age admitted to an internal medicine department. Five malnutrition screening surveys (MNA, MST, MUST, NRS-2000 and CONUT) and three nutritional risk screening surveys (SCREEN3, 8 and 14) were compared. As gold standard we use the Global Leadership Initiative for Malnutrition (GLIM) definition of malnutrition. Results: Eighty-five patients (37% female, median age 83years) were included. Forty-eight percent (95%CI: 38-59%) of patients were classified as malnourished according to GLIM criteria. The SCREEN3 scale was the most sensitive (93%; 95%CI: 87-98) and MUST the most specific (91%; 95%CI: 85-99). The most effective scale for excluding suspected malnutrition was SCREEN3 (LR− 0.17; 95%CI: 0.05-0.53) and the best for confirming it was MST (LR+ 7.08; 95%CI: 3.06-16.39). Concordance between the different scales was low or very low with kappa indices between 0.082 and 0.465. Conclusions: A comprehensive approach is needed to detect malnutrition in hospitalized patients. More sensitive scales are more useful in initial screening. Nutritional risk tools could be effective at this stage. In a second step, malnutrition should be confirmed according to established criteria such as GLIM.(AU)
Subject(s)
Humans , Male , Female , Middle Aged , Aged , Malnutrition , Health of Institutionalized Elderly , Sarcopenia , Sensitivity and Specificity , Nutrition Assessment , Prospective Studies , Surveys and Questionnaires , Health of the ElderlyABSTRACT
BACKGROUND: The prevalence of malnutrition is high among the elderly population. Hospital admission is a window of opportunity for its detection. OBJECTIVE: To assess the concordance of different nutritional scales in hospitalized patients. METHODS: Prospective study in non-institutionalized patients over 65 years of age admitted to an internal medicine department. Five malnutrition screening surveys (MNA, MST, MUST, NRS-2000 and CONUT) and three nutritional risk screening surveys (SCREEN 3, 8 and 14) were compared. As gold standard we use the Global Malnutrition Leadership Initiative for Malnutrition (GLIM) definition of malnutrition. RESULTS: Eighty-five patients (37% female, median age 83 years) were included. Forty-eight percent (95% CI 38-59%) of patients were classified as malnourished according to GLIM criteria. The SCREEN 3 scale was the most sensitive (93%; 95% CI 87-98) and MUST the most specific (91%; CI 85-99). The most effective scale for excluding suspected malnutrition was SCREEN 3 (LR- 0.17; 95% CI 0.05-0.53) and the best for confirming it was MST (LR+ 7.08; 95% CI 3.06-16.39). Concordance between the different scales was low or very low with kappa indices between 0.082 and 0.465. CONCLUSIONS: A comprehensive approach is needed to detect malnutrition in hospitalized patients. More sensitive scales are more useful in initial screening. Nutritional risk tools could be effective at this stage. In a second step, malnutrition should be confirmed according to established criteria such as GLIM.
Subject(s)
Malnutrition , Nutrition Assessment , Humans , Female , Aged , Aged, 80 and over , Male , Prospective Studies , Malnutrition/diagnosis , Malnutrition/epidemiology , Hospitalization , Mass Screening , LeadershipABSTRACT
La relación entre ética e inteligencia artificial en medicina es un tema crucial y complejo y se encuadra en su contexto más amplio. Así, la ética en inteligencia artificial médica implica asegurar que las tecnologías sean seguras, justas y respeten la privacidad de los pacientes. Esto incluye preocuparse de la precisión de los diagnósticos proporcionados por la inteligencia artificial, la equidad en el tratamiento de pacientes y la protección de los datos personales de salud. Los avances en inteligencia artificial pueden mejorar significativamente la atención médica, desde diagnósticos más precisos hasta tratamientos personalizados. Sin embargo, es esencial que los desarrollos en inteligencia artificial médica se realicen con una consideración ética fuerte, involucrando a los pacientes, profesionales de la salud e inteligencia artificial y especialistas en ética para guiar y supervisar su implementación. Por último, es fundamental la transparencia en los algoritmos de inteligencia artificial y la formación continua para los profesionales médicos. (AU)
The relationship between ethics and artificial intelligence in medicine is a crucial and complex topic that falls within its broader context. Ethics in medical artificial intelligence involves ensuring that technologies are safe, fair, and respect patient privacy. This includes concerns about the accuracy of diagnoses provided by artificial intelligence, fairness in patient treatment, and protection of personal health data. Advances in artificial intelligence can significantly improve healthcare, from more accurate diagnoses to personalized treatments. However, it is essential that developments in medical artificial intelligence are carried out with strong ethical consideration, involving healthcare professionals, artificial intelligence experts, patients, and ethics specialists to guide and oversee their implementation. Finally, transparency in artificial intelligence algorithms and ongoing training for medical professionals are fundamental. (AU)
Subject(s)
Artificial Intelligence/ethics , Artificial Intelligence/trends , Ethics, MedicalABSTRACT
The relationship between ethics and artificial intelligence in medicine is a crucial and complex topic that falls within its broader context. Ethics in medical artificial intelligence (AI) involves ensuring that technologies are safe, fair, and respect patient privacy. This includes concerns about the accuracy of diagnoses provided by artificial intelligence, fairness in patient treatment, and protection of personal health data. Advances in artificial intelligence can significantly improve healthcare, from more accurate diagnoses to personalized treatments. However, it is essential that developments in medical artificial intelligence are carried out with strong ethical consideration, involving healthcare professionals, artificial intelligence experts, patients, and ethics specialists to guide and oversee their implementation. Finally, transparency in artificial intelligence algorithms and ongoing training for medical professionals are fundamental.
Subject(s)
Artificial Intelligence , Medicine , Humans , Algorithms , Health Facilities , Health PersonnelABSTRACT
Introduction: social media is increasingly used in medical education, but its real educational effectiveness is unclear. In this study we assess the effectiveness of Twitter threads (TTS) in improving electrocardiogram (ECG) basic reading skills (ECGBRS). Materials and Methods: Seven TTS describing ECGBRS were published from October 28, 2021, to November 24, 2021. Tests were used to assess medical students ECGBRS pre and post intervention. All third and sixth-year medical students were invited to participate. Sixty-three students were enrolled (33 third year and 30 sixth year). Nine (14.3%) participants dropped out. Results: Sixth year medical students had higher ECGBRS at baseline. The number of correct items increased after the Twitter intervention; median correct pre-test items were 20 out of 56, (interquartile range (IQR) 14-23), and median post-test were 29 out of 56, (IQR 21-36) (p < 0.001). The improvement in sixth year students was greater than for third year students; 10 more correct items (IQR 4-14) vs. 7 (IQR 1-14) items (p = 0.045). The more TTS followed, the greater the improvement in ECGBRS (p = 0.004). The QRS axis calculation was the ECG reading skill with the lowest scores. Most medical students were definitely (35%) or very probably (46%) interested in repeating another on-line learning experience and found the TTS extremely (39%) or very (46%) interesting. Conclusions: The use of specifically designed TTS was associated with improvement in medical students' interpretation of ECGs. The effectiveness of the threads was higher in the final years of medical school when basic skills had already been acquired. Supplementary Information: The online version contains supplementary material available at 10.1007/s40670-023-01885-x.
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No disponible
Subject(s)
Humans , Coronavirus Infections/drug therapy , Severe Acute Respiratory Syndrome/drug therapy , Pneumonia, Viral/drug therapy , Severe acute respiratory syndrome-related coronavirus/pathogenicity , Pandemics , Antiviral Agents/therapeutic use , Communicable Disease Control/methods , Disease Outbreaks/prevention & control , Anti-Inflammatory Agents/therapeutic use , Compassionate Use Trials/trendsABSTRACT
Introducción: La integración asistencial es una prioridad para la mayoría de los sistemas de salud. En este estudio evaluamos cuales son las expectativas y los conocimientos de los profesionales. Material y métodos: Entre marzo y junio de 2017 los profesionales de la Gerencia de Asistencia Sanitaria del Bierzo fueron invitados a participar en 2 cuestionarios sobre integración (405 y 211 participantes, respectivamente, sobre el total de 1.854 profesionales). Resultados: Tres de cada cuatro señalaron la comunicación como el factor más importante para conseguir la integración. Los informes médicos, la educación y la conciliación de la medicación también fueron priorizados. Las rutas asistenciales (98%), las enfermeras de enlace (93%) o los protocolos de cuidado compartidos (92%) fueron ampliamente aceptados. Como nexo de unión se prefirió a todo el servicio hospitalario (55%), frente a la figura del enlace-consultor por centros (29%) o común para el área (16%). No hubo diferencias entre la valoración de los profesionales de primaria u hospital en la mayoría de las herramientas analizadas. Conclusiones: De acuerdo con la opinión de los profesionales, las herramientas que favorezcan la comunicación son la clave para conseguir una integración exitosa
Introduction: Integrated care is a top priority for most of the National Health Services. In this study, an evaluation is made on the professional's beliefs and expectations regarding integration. Material and methods: Between March and June 2017, Health Professionals from El Bierzo, León, Spain, were invited to complete 2 questionnaires on health integration process, including an online questionnaire on patient care integration (405 and 211 participants, respectively out of the total 1854 professionals). Results: Three out of four professionals pointed at communication as the most important factor to achieve integration. Medical records, Health Care Education and medication reconciliation were the other prioritised factors. Care pathways (98%), nurse navigator (93%) or shared care protocols (92%) were highly recommended. The entire Hospital Service (55%) was the preferred link, with Primary Care versus a single consultant for every Primary Care Centre (29%), or for all the whole area (16%).There were no differences between primary and hospital services in most of the tools assessed. Conclusions: Communication tools are the cornerstone to achieve a successful integration of the care services according to Health Professionals
Subject(s)
Humans , Male , Female , Adult , Attitude of Health Personnel , Delivery of Health Care, Integrated/organization & administration , Health Personnel/organization & administration , Patient Care , Communication , Health Care Surveys , Health Personnel/psychology , Primary Health Care/organization & administration , SpainABSTRACT
INTRODUCTION: Integrated care is a top priority for most of the National Health Services. In this study, an evaluation is made on the professional's beliefs and expectations regarding integration. MATERIAL AND METHODS: Between March and June 2017, Health Professionals from El Bierzo, León, Spain, were invited to complete 2 questionnaires on health integration process, including an online questionnaire on patient care integration (405 and 211 participants, respectively out of the total 1854 professionals). RESULTS: Three out of four professionals pointed at communication as the most important factor to achieve integration. Medical records, Health Care Education and medication reconciliation were the other prioritised factors. Care pathways (98%), nurse navigator (93%) or shared care protocols (92%) were highly recommended. The entire Hospital Service (55%) was the preferred link, with Primary Care versus a single consultant for every Primary Care Centre (29%), or for all the whole area (16%).There were no differences between primary and hospital services in most of the tools assessed. CONCLUSIONS: Communication tools are the cornerstone to achieve a successful integration of the care services according to Health Professionals.
Subject(s)
Attitude of Health Personnel , Delivery of Health Care, Integrated/organization & administration , Health Personnel/organization & administration , Patient Care/methods , Adult , Communication , Female , Health Care Surveys , Health Personnel/psychology , Humans , Male , Middle Aged , Primary Health Care/organization & administration , SpainABSTRACT
BACKGROUND: Health services are moving towards a complete integration to try and reduce fragmentation, increase efficiencies and improve health outcomes. Estimates the effectiveness in of different tools for integrated care in Spain. METHODS: We performed a systematic review of articles using MEDLINE (last search July31st, 2017). Randomized clinical trials reporting health outcomes of tools for integrated care used in Spain were included. Studies were appraised for quality using the Cochrane Risk of Bias assessment. RESULTS: Twenty studies met the criteria for the systematic review. Interventions included were hospital-at home (four studies, 455 patients), outpatient clinic by videoconference (three studies, 2438 patients), nurse navigator (four studies, 1051 patients), self-care improvement (four studies, 1291 patients), at-home health monitoring (three, 162), health apps (two, 225) and medical reconciliation (one, 172). Hospital-at-home, nurse navigator or self-care improvement reduced readmission rate in older patients, heart failure (HF) or chronic obstructive pulmonary disease (COPD). Self-care improvement and nurse navigator reduced mortality rate in HF. Hospital-at-home reduced hospital stay in COPD. Self-care improvement reduced outpatient visits in asthma patients. Outpatient video by videoconference reduced time to diagnosis and treatment in rural areas. The quality of the evidence ranged from low to very low for all the outcomes because it was based in double or triple downgraded randomized trials. CONCLUSION: The implementation of tools for integrated care in Spain improved some outcomes of relevance in patients with chronic conditions, although evidence is low. Self-care improvement stood out due to the improvements made.
Subject(s)
Delivery of Health Care, Integrated/organization & administration , Hospitalization , Primary Health Care , Humans , SpainABSTRACT
Fundamento: Los servicios de salud evolucionan hacia la integración, con el fin de reducir la fragmentación de la atención, mejorando la eficiencia y los resultados en salud. Este trabajo valora la efectividad de distintas herramientas para la integración en España. Método: Revisión en MEDLINE (última búsqueda: 31 de julio de 2017) de ensayos clínicos realizados en España. El riesgo de sesgo se valoró utilizando la propuesta de la colaboración Cochrane. Resultados: Se incluyeron veintiún estudios: hospitalización a domicilio (cuatro estudios, 455 pacientes), consultas externas mediante videoconferencia (tres, 2438), enfermeras de enlace (cuatro, 1051), mejora del autocuidado (cuatro, 1219), monitorización de parámetros biomédicos en domicilio (tres, 162), uso de aplicaciones informáticas (dos, 225) y conciliación de la medicación (uno, 172). La hospitalización a domicilio, las enfermeras de enlace y la mejora del autocuidado redujeron los reingresos en pacientes ancianos, con insuficiencia cardiaca (IC) o enfermedad pulmonar obstructiva crónica (EPOC). La mejora del autocuidado y las enfermeras de enlace disminuyeron la mortalidad en IC. La hospitalización a domicilio disminuyó los días de hospitalización en EPOC. La mejora del autocuidado redujo el número de visitas a consulta en asma. La consulta externa mediante videoconferencia disminuyó el tiempo hasta el diagnóstico y el tratamiento en áreas rurales. La calidad de la evidencia fue baja o muy baja ya que los estudios tenían dos o más riesgos de sesgo. Conclusiones: La aplicación de herramientas para la integración mejoró algunos resultados en salud en pacientes con enfermedades crónicas, aunque la evidencia es escasa. De todas las herramientas cabe destacar la mejoría en los resultados conseguida con el autocuidado (AU)
Background: Health services are moving towards a complete integration to try and reduce fragmentation, increase efficiencies and improve health outcomes. This study estimates the effectiveness in of different tools for integrated care in Spain. Methods: We performed a systematic review of articles using MEDLINE (last search July31st, 2017). Randomized clinical trials reporting health outcomes of tools for integrated care used in Spain were included. Studies were appraised for quality using the Cochrane Risk of Bias assessment. Results: Twenty studies met the criteria for the systematic review. Interventions included were hospital-at-home (four studies, 455 patients), outpatient clinic by videoconference (three studies, 2438 patients), nurse navigator (four studies, 1051 patients), self-care improvement (four studies, 1291 patients), at-home health monitoring (three, 162), health apps (two, 225) and medical reconciliation (one, 172). Hospital-at-home, nurse navigator or self-care improvement reduced readmission rate in older patients, heart failure (HF) or chronic obstructive pulmonary disease (COPD). Self-care improvement and nurse navigator reduced mortality rate in HF. Hospital-at-home reduced hospital stay in COPD. Self-care improvement reduced outpatient visits in asthma patients. Outpatient video by videoconference reduced time to diagnosis and treatment in rural areas. The quality of the evidence ranged from low to very low for all the outcomes because it was based in double or triple downgraded randomized trials. Conclusion: The implementation of tools for integrated care in Spain improved some outcomes of relevance in patients with chronic conditions, although evidence is low. Self-care improvement stood out due to the improvements made (AU)
Subject(s)
Humans , Referral and Consultation/organization & administration , Hospitalization/trends , Primary Health Care/trends , Systems Integration , Continuity of Patient Care/organization & administration , Home Care Services, Hospital-Based/organization & administration , Self CareABSTRACT
No disponible
Subject(s)
Humans , Female , Aged, 80 and over , Liver Failure, Acute/complications , Liver Failure, Acute/drug therapy , Liver Failure, Acute , Abdominal Pain/etiology , Abdominal Pain/therapy , Pleural Effusion , Paracentesis/instrumentation , Paracentesis , Hemolysis , Hemolysis/physiology , Malnutrition/therapy , Pancytopenia/complications , Pancytopenia/diagnosis , Hodgkin Disease/diagnosis , Hodgkin Disease/pathologyABSTRACT
SUMMARY: We studied the changes in the number of new referrals with Paget's disease of bone (PDB) and severity of PDB in a high prevalence focus and its neighboring region. Referral of patients changed only in the high prevalence focus. The severity of PDB decreased in both regions. These results could suggest the effects of an environmental influence on disease activity. INTRODUCTION: The prevalence and severity of PDB have decreased in several countries over recent years. We previously reported a high radiological prevalence of PDB in Vitigudino. Here we sought to determine if secular changes in the number of new referrals and severity of PDB had occurred over recent years. METHODS: We studied 280 patients with clinically diagnosed PDB who were evaluated at a regional referral center for metabolic bone disease between 1986 and 2009. Changes in the number of new referrals were calculated by relating these data to the number of subjects at risk as determined by population registers. Trends in disease severity were analyzed with alkaline phosphatase (ALP) activity and disease extent on scan. RESULTS: Referrals from the Vitigudino region increased substantially between 1986 and 2003 but fell markedly between 2004 and 2009, although by this time there had been depopulation of the region due to emigration. No significant changes in the rates of referral occurred in the remainder of Salamanca. ALP activity and disease extent decreased in Salamanca, but only ALP activity decreased in Vitigudino. Referrals rate and severity of PDB in Vitigudino were greater than in the remainder of Salamanca. CONCLUSIONS: Referral of patients with clinically diagnosed PDB has remained stable for most of Salamanca during the past 24 years, but substantial changes have been observed in Vitigudino. In agreement with other reports, the severity of PDB has decreased in both regions consistent with the effects of an environmental influence on disease activity.
Subject(s)
Osteitis Deformans/epidemiology , Age Factors , Aged , Alkaline Phosphatase/blood , Biomarkers/blood , Clinical Enzyme Tests/methods , Female , Humans , Male , Middle Aged , Osteitis Deformans/diagnosis , Prevalence , Referral and Consultation/statistics & numerical data , Severity of Illness Index , Spain/epidemiologyABSTRACT
ObjetivoValorar la calidad percibida por los usuarios del Servicio de Medicina Interna de Los Montalvos (Salamanca) durante los 5 primeros años de funcionamiento de este.Material y métodosEstudio transversal, realizado desde febrero de 2004 hasta enero de 2009. A todos los pacientes hospitalizados (6.997) se les entregó al alta una encuesta modelo SERVQHOS de cumplimentación anónima y voluntaria.ResultadosSe recogieron 2.435 encuestas. La participación fue del 34,8%. Excepto en lo relativo a la accesibilidad, las cuestiones planteadas en la encuesta se percibieron como se esperaba o por encima de las expectativas por parte de más del 85% de los encuestados. El 90,6% de los pacientes estuvo satisfecho con la atención recibida y el 83,9% recomendaría el hospital a otras personas. Las variables con mayor capacidad predictiva, en relación con la satisfacción global, fueron el trato personalizado y el interés del personal por solucionar problemas. El 33,6% valoró la facilidad para llegar al hospital por debajo de lo esperado. Tras implantar medidas de mejora, el porcentaje de insatisfacción respecto a la accesibilidad se situó en el 24,8% (p=0,02).ConclusionesNueve de cada 10 pacientes encuestados estaban satisfechos o muy satisfechos con la atención recibida y recomendarían el hospital a otras personas. Las variables más vinculadas con la satisfacción global fueron las relacionadas con el personal del servicio. Tras detectar deficiencias e implantar medidas de mejora, la encuesta detectó mejoría en el nivel de satisfacción(AU9
ObjectiveTo evaluate the quality perceived by users of the Los Montalvos Internal Medicine Service (Salamanca, Spain), over its first five years of operation.MethodsA cross-sectional study was carried out from February 2004 to January 2009. All in-patients (6,997) were given a survey model SERVQHOS at the time of discharge, which was anonymous and voluntary.ResultsWe collected 2,435 surveys. Participation was 34.8%. Except for the item regarding accessibility, the other questions of the survey were perceived as expected or above expectations by over 85% of the users. A total of 90.6% of patients who completed the survey were satisfied with the care received, and 83.9% would recommend the hospital to others. The variables with higher predictive capability, in relation to overall satisfaction, were personalised care, and the interests of staff to solve problems. The easy access to the hospital was seen by 33.6% as below expectations. After introducing several improvement measures, the percentage of dissatisfaction regarding accessibility was 24.8% (p=0.02).ConclusionsNine out of ten patients surveyed were satisfied or very satisfied with the care received, and would recommend the hospital to others. The variables more strongly associated with overall satisfaction were those related to service personnel. After identifying deficiencies and implementing measures to improve, the survey detected an increase in the level of satisfaction(AU)
Subject(s)
Humans , Patient Satisfaction/statistics & numerical data , Health Care Surveys/statistics & numerical data , Internal Medicine/trends , Cross-Sectional Studies , Biomedical EnhancementABSTRACT
OBJECTIVE: To evaluate the quality perceived by users of the 'Los Montalvos' Internal Medicine Service (Salamanca, Spain), over its first five years of operation. METHODS: A cross-sectional study was carried out from February 2004 to January 2009. All in-patients (6,997) were given a survey model SERVQHOS at the time of discharge, which was anonymous and voluntary. RESULTS: We collected 2,435 surveys. Participation was 34.8%. Except for the item regarding accessibility, the other questions of the survey were perceived "as expected" or above expectations by over 85% of the users. A total of 90.6% of patients who completed the survey were satisfied with the care received, and 83.9% would recommend the hospital to others. The variables with higher predictive capability, in relation to overall satisfaction, were "personalised care', and the interests of staff to solve problems. The easy access to the hospital' was seen by 33.6% as below expectations. After introducing several improvement measures, the percentage of dissatisfaction regarding accessibility was 24.8% (p=0.02). CONCLUSIONS: Nine out of ten patients surveyed were satisfied or very satisfied with the care received, and would recommend the hospital to others. The variables more strongly associated with overall satisfaction were those related to service personnel. After identifying deficiencies and implementing measures to improve, the survey detected an increase in the level of satisfaction.
