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1.
Gac. sanit. (Barc., Ed. impr.) ; 34(6): 561-566, nov.-dic. 2020. tab
Article in Spanish | IBECS | ID: ibc-200247

ABSTRACT

OBJETIVO: Describir los casos de violencia de odio atendidos en servicios de urgencias. MÉTODO: Estudio transversal de una serie de casos de agresión atendidos en los servicios de urgencias de dos hospitales de Madrid, entre abril de 2015 y marzo de 2018. Se describen los casos de violencia de odio en cuanto a características sociodemográficas, clínico-epidemiológicas y del incidente, y se comparan con las de otros tipos de violencia dentro del estudio. RESULTADOS: Se incluyeron 147 pacientes. El 49% refirieron haber sido víctimas de la violencia de odio. El 61% eran hombres, la media de edad fue de 36 años y un 48% tenían un nivel de estudios medio-alto. Las motivaciones más frecuentes son el aspecto físico, la nacionalidad y el origen étnico. El lugar de la agresión es la calle en un 50% de los casos, y en el 61% la agresión fue perpetrada por más de una persona (el 83% por hombres). La lesión más común fue la contusión (71%) y las localizaciones más frecuentes fueron la cabeza y el cuello (71%). El 8% de las víctimas requirieron ingreso. CONCLUSIONES: La vigilancia de la violencia de odio permitiría conocer con mayor exactitud la magnitud real y las características de este problema de salud, así como mejorar la calidad de la atención a las víctimas


OBJECTIVE: To describe the cases of hate violence attended in emergency services. METHOD: A cross-sectional study of a series of cases of aggression treated in the emergency rooms of two hospitals in Madrid, between April 2015 and March 2018. The cases of hate violence are described in terms of their sociodemographic, clinical-epidemiological and incident data and compared with other types of violence within the study. RESULTS: A total of 147 patients were included and 49% reported having been victims of hate violence. Among the victims, 61% were men, the average age was 36 years and 48% had a medium-high level of education. The most frequent motivations were physical appearance, nationality and ethnic origin. The place of aggression was the street in 50%, and in 61% of the cases it was perpetrated by more than one person (83% by men). The most common injury was contusion (71%) and the most frequent location the head and neck (71%). Only 8% required admission. CONCLUSIONS: The surveillance of hate violence would foster more accurate knowledge of the real magnitude and characteristics of this health problem and improve the quality of care for victims


Subject(s)
Humans , Violence/statistics & numerical data , Crime Victims/statistics & numerical data , Emergency Treatment/methods , Aggression/classification , Hate , Spain/epidemiology , Emergency Medical Services/statistics & numerical data , Exposure to Violence/statistics & numerical data , Cross-Sectional Studies
2.
Gac. sanit. (Barc., Ed. impr.) ; 34(2): 166-170, mar.-abr. 2020. tab
Article in Spanish | IBECS | ID: ibc-196053

ABSTRACT

OBJETIVO: En el marco del proyecto SIVIVO se propuso la elaboración de una herramienta que facilitase la detección, el registro y la descripción de casos de violencia de odio y sus consecuencias sobre la salud. MÉTODO: Se utilizó el método Delphi a dos vueltas con personas expertas pertenecientes a los ámbitos clínico-asistencial, salud pública, investigación epidemiológica, académico, administración y organizaciones no gubernamentales para evaluar la pertinencia de diferentes ítems mediante una escala Likert de 1 a 5, y los resultados se presentan como medianas y coeficientes de variación. RESULTADOS: Las preguntas mejor valoradas, con puntaciones ≥4, y que componen la versión final del cuestionario, son las relativas a las características sociodemográficas de la víctima, el tipo de lesiones, la descripción del incidente, las motivaciones percibidas por la persona agredida, posibles evidencias de odio, la intención de denunciar y la percepción del personal sanitario del motivo de la agresión. El pilotaje mostró la adecuación de las preguntas finalmente seleccionadas. CONCLUSIONES: La incorporación sistemática de esta herramienta puede ayudar a conocer la magnitud y las características de la violencia de odio y su repercusión en la salud. Esta información permitiría elaborar estrategias de prevención e intervención dirigidas, especialmente, a los sectores de población más expuestos a este tipo de violencia


OBJECTIVE: In the context of the SIVIVO project, the development of a tool to facilitate the detection, recording and description of cases of hate violence and its consequences on health was proposed. METHOD: A two-round Delphi method was used with experts from clinical-care, public health, epidemiological, academic, administration and non-governmental organizations to assess the relevance of different items using a Likert scale, presenting the results with medians and coefficients of variation. RESULTS: The best evaluated questions, with scores equal to or greater than 4, and which make up the final version of the questionnaire are the relative socio-demographic characteristics of the victim, the injuries, description of the incident, the motivations perceived by the aggrieved person, possible evidence of hatred, the intention to denounce and the perception of the health personnel of the motive for the aggression. The piloting showed the adequacy of the questions that were finally selected. CONCLUSIONS: The systematic incorporation of this tool can help us to learn the magnitude and characteristics of hate violence and its impact on health. This information would allow the elaboration of prevention and intervention strategies aimed, specifically, at the sectors of the population most exposed to this type of violence


Subject(s)
Humans , Psychometrics/instrumentation , Violence/psychology , Hate , Exposure to Violence/psychology , Surveys and Questionnaires , Violence/classification , Emergency Medical Services/statistics & numerical data , Delphi Technique
3.
Gac Sanit ; 34(6): 561-566, 2020.
Article in Spanish | MEDLINE | ID: mdl-31561917

ABSTRACT

OBJECTIVE: To describe the cases of hate violence attended in emergency services. METHOD: A cross-sectional study of a series of cases of aggression treated in the emergency rooms of two hospitals in Madrid, between April 2015 and March 2018. The cases of hate violence are described in terms of their sociodemographic, clinical-epidemiological and incident data and compared with other types of violence within the study. RESULTS: A total of 147 patients were included and 49% reported having been victims of hate violence. Among the victims, 61% were men, the average age was 36 years and 48% had a medium-high level of education. The most frequent motivations were physical appearance, nationality and ethnic origin. The place of aggression was the street in 50%, and in 61% of the cases it was perpetrated by more than one person (83% by men). The most common injury was contusion (71%) and the most frequent location the head and neck (71%). Only 8% required admission. CONCLUSIONS: The surveillance of hate violence would foster more accurate knowledge of the real magnitude and characteristics of this health problem and improve the quality of care for victims.


Subject(s)
Hate , Violence , Adult , Cross-Sectional Studies , Emergency Service, Hospital , Hospitals , Humans , Male , Spain/epidemiology
4.
Gac Sanit ; 34(2): 166-170, 2020.
Article in Spanish | MEDLINE | ID: mdl-31101332

ABSTRACT

OBJECTIVE: In the context of the SIVIVO project, the development of a tool to facilitate the detection, recording and description of cases of hate violence and its consequences on health was proposed. METHOD: A two-round Delphi method was used with experts from clinical-care, public health, epidemiological, academic, administration and non-governmental organizations to assess the relevance of different items using a Likert scale, presenting the results with medians and coefficients of variation. RESULTS: The best evaluated questions, with scores equal to or greater than 4, and which make up the final version of the questionnaire are the relative socio-demographic characteristics of the victim, the injuries, description of the incident, the motivations perceived by the aggrieved person, possible evidence of hatred, the intention to denounce and the perception of the health personnel of the motive for the aggression. The piloting showed the adequacy of the questions that were finally selected. CONCLUSIONS: The systematic incorporation of this tool can help us to learn the magnitude and characteristics of hate violence and its impact on health. This information would allow the elaboration of prevention and intervention strategies aimed, specifically, at the sectors of the population most exposed to this type of violence.


Subject(s)
Emergency Service, Hospital , Hate , Surveys and Questionnaires , Violence , Adult , Delphi Technique , Ethnicity , Exposure to Violence , Female , Gender Identity , Humans , Male , Motivation , Pilot Projects , Prejudice , Sex , Socioeconomic Factors , Violence/prevention & control , Violence/psychology , Violence/statistics & numerical data
6.
Gac. sanit. (Barc., Ed. impr.) ; 33(4): 317-324, jul.-ago. 2019. tab, graf
Article in Spanish | IBECS | ID: ibc-187987

ABSTRACT

Objetivo: Describir la epidemiología de la violencia interpersonal en España. Método: Estudio descriptivo de los casos de pacientes con diagnóstico secundario de agresión registrados en el Conjunto Mínimo Básico de Datos de altas hospitalarias, entre 1999 y 2011, utilizando los códigos E960 a E969 de la Clasificación Internacional de Enfermedades (CIE-9). Se describe la distribución por sexo, edad y tipo de alta y de atención requerida, morbilidad asociada, mortalidad y comunidad autónoma. Se estudia la calidad del registro en función de su variación temporal. Resultados: El perfil de agresión en hombres (85%) es el de un paciente de entre 15 y 44 años, que en un 93,7% de los casos precisa atención urgente y cuya gravedad es moderada (95% alta a domicilio). El 2,5% de los pacientes reingresa, y se produce la muerte en el 1,1% de las ocasiones. El perfil en las mujeres (15%) difiere ligeramente: edad comprendida entre 31 y 52 años, el 94% requiere atención urgente (si bien el 96% tiene una gravedad moderada), el 3% reingresa y en el 1,7% de las ocasiones la paciente muere. Conclusiones: Aunque necesitan ser mejorados para evitar ciertas limitaciones, los sistemas de información sanitaria constituyen una riquísima fuente de datos que pueden ser utilizados para la investigación en salud y, a través de sus resultados, para el desarrollo de planes de prevención e intervención sociosanitaria en temas de violencia


Objective: To describe the epidemiology of interpersonal violence in Spain. Method: Descriptive study of the cases of patients with secondary diagnosis of aggression registered on a national hospital discharge database, between 1999 and 2011, using the codes from E960 to E969 of the ICD-9. The distribution by sex, age and type of discharge, associated morbidity, mortality and by autonomous community is described. The quality of the record is studied according to its temporal variation. Results: The case profile of aggression in men (85%) is of a patient between 15 and 44 years old, who in 93.7% of cases requires urgent care and whose severity is moderate (95% discharge home). Two point five percent of patients are readmitted and death occurs in1.1%. The profile in women (15%) differs slightly, with an age between 31 and 52 years, 94% require urgent attention, although 96% have moderate severity; 3% are readmitted and 1.7% die. Conclusions: Although they need to be improved to avoid certain limitations, health information systems are a rich source of data that can be used for research in health and, through their results, for the development of prevention plans and intervention in matters of violence


Subject(s)
Humans , Violence/statistics & numerical data , Exposure to Violence/statistics & numerical data , Indicators of Morbidity and Mortality , Spain/epidemiology , Interpersonal Relations , Epidemiology, Descriptive , Patient Discharge Summaries/statistics & numerical data , Hospital Statistics
8.
Rev Esp Salud Publica ; 932019 05 29.
Article in Spanish | MEDLINE | ID: mdl-31155609

ABSTRACT

OBJECTIVE: The health of transgender people is a little studied topic and hospital records can be an opportunity to make an approach. The aim of this study was to describe the cause for admission and the associated comorbidities of transgender people in Spain between 2001 and 2013. METHODS: Retrospective observational study with population-based administrative records (Minimum Basic Data Set). The discharges generated by the transgender in Spanish public and private hospitals were selected using one of the following ICD-9-CM codes in any diagnostic field: Trans-sexualism (302.5), Disorders of psychosexual identity (302.6) and Gender identity disorder in adolescents or adults (302.85). The causes of admission and comorbidity according were described. The qualitative variables were described in their frequency distribution according to their number(n) and proportion(%) and the quantitative variables according to their mean and standard deviation (SD) or median (MD) and interquartile range (RIQ) according to their distribution. RESULTS: A total of 2,010 highs were recorded corresponding to 1,878 patients. The mean age was 33 years (SD = 10). 51% were male, 46% female and 3% undetermined or unspecified. The discharges were motivated in 59% by the process of body modification, followed by HIV (4%) and personality disorders (3%). The most common comorbidities were those associated with body modification (49%), mental health problems (40%) and infectious diseases (15%). CONCLUSIONS: It is necessary to address the health of transgender people in a comprehensive way that takes into account their specific health needs, including bodily modification, mental health, HIV and other infections, through strategies that include improve research, tailor health information systems and develop guidelines and training of healthcare providers in this transgender health.


OBJETIVO: La salud de las personas transexuales es un tema poco estudiado y los registros hospitalarios pueden suponer una oportunidad para hacer una aproximación. El objetivo de este trabajo fue describir el motivo de ingreso hospitalario y las comorbilidades asociadas de las personas transexuales en España entre los años 2001 y 2013. METODOS: Estudio observacional con registros administrativos de base poblacional (Conjunto Mínimo Básico de Datos). Se seleccionaron las altas generadas de los hospitales españoles con alguno de los siguientes códigos CIE-9-MC en cualquier campo diagnóstico: Transexualismo (302.5), Trastorno de identidad sexual en niños (302.6) y Trastornos de identidad sexual en adolescentes o adultos (302.85). Se describieron las causas de ingreso y las comorbilidadades. Las variables cualitativas se describieron en su distribución de frecuencias según su número (n) y proporción (%) y las variables cuantitativas según su media y desviación estándar (DE) o mediana (MD) y rango intercuartíl (RIC) según su distribución. RESULTADOS: Se registraron 2.010 altas correspondientes a 1.878 pacientes. La edad media fue de 33 años (DE = 10). El 51% eran varones, el 46% mujeres y el 3% indeterminado. Los motivos de ingreso más frecuentes fueron los relacionados con proceso de transición (59%), seguido de VIH (4%) y trastornos de la personalidad (3%). Las comorbilidades más frecuentes estuvieron relacionadas con el proceso de transición (49%), los problemas de salud mental (40%) y las enfermedades infecciosas (15%). CONCLUSIONES: Es necesario abordar la salud de las personas trans teniendo en cuenta sus necesidades específicas de salud, entre las que se encuentran la modificación corporal, la salud mental, el VIH y otras infecciones mediante estrategias que incluyan la investigación, la adecuación de los sistemas de información sanitaria, la elaboración de guías de atención y la formación de personal de salud.


Subject(s)
Comorbidity , Patient Discharge , Transgender Persons/psychology , Transgender Persons/statistics & numerical data , Adolescent , Adult , Aged , Child , Female , Gender Dysphoria/diagnosis , Health Care Surveys , Hospitalization/statistics & numerical data , Humans , International Classification of Diseases , Male , Middle Aged , Retrospective Studies , Spain , Transsexualism/diagnosis , Young Adult
9.
Gac Sanit ; 33(4): 317-324, 2019.
Article in Spanish | MEDLINE | ID: mdl-29866371

ABSTRACT

OBJECTIVE: To describe the epidemiology of interpersonal violence in Spain. METHOD: Descriptive study of the cases of patients with secondary diagnosis of aggression registered on a national hospital discharge database, between 1999 and 2011, using the codes from E960 to E969 of the ICD-9. The distribution by sex, age and type of discharge, associated morbidity, mortality and by autonomous community is described. The quality of the record is studied according to its temporal variation. RESULTS: The case profile of aggression in men (85%) is of a patient between 15 and 44 years old, who in 93.7% of cases requires urgent care and whose severity is moderate (95% discharge home). Two point five percent of patients are readmitted and death occurs in1.1%. The profile in women (15%) differs slightly, with an age between 31 and 52 years, 94% require urgent attention, although 96% have moderate severity; 3% are readmitted and 1.7% die. CONCLUSIONS: Although they need to be improved to avoid certain limitations, health information systems are a rich source of data that can be used for research in health and, through their results, for the development of prevention plans and intervention in matters of violence.


Subject(s)
Interpersonal Relations , Violence/statistics & numerical data , Adolescent , Adult , Cause of Death , Clinical Coding , Female , Health Care Surveys , Hospitalization/statistics & numerical data , Humans , Male , Middle Aged , Patient Discharge/statistics & numerical data , Sex Factors , Spain/epidemiology , Trauma Severity Indices , Violence/classification , Young Adult
10.
Rev. esp. salud pública ; 93: 0-0, 2019. tab, graf
Article in Spanish | IBECS | ID: ibc-189513

ABSTRACT

OBJETIVO: La salud de las personas transexuales es un tema poco estudiado y los registros hospitalarios pueden suponer una oportunidad para hacer una aproximación. El objetivo de este trabajo fue describir el motivo de ingreso hospitalario y las comorbilidades asociadas de las personas transexuales en España entre los años 2001 y 2013. MÉTODOS: Estudio observacional con registros administrativos de base poblacional (Conjunto Mínimo Básico de Datos). Se seleccionaron las altas generadas de los hospitales españoles con alguno de los siguientes códigos CIE-9-MC en cualquier campo diagnóstico: Transexualismo (302.5), Trastorno de identidad sexual en niños (302.6) y Trastornos de identidad sexual en adolescentes o adultos (302.85). Se describieron las causas de ingreso y las comorbilidadades. Las variables cualitativas se describieron en su distribución de frecuencias según su número (n) y proporción (%) y las variables cuantitativas según su media y desviación estándar (DE) o mediana (MD) y rango intercuartíl (RIC) según su distribución. RESULTADOS: Se registraron 2.010 altas correspondientes a 1.878 pacientes. La edad media fue de 33 años (DE = 10). El 51% eran varones, el 46% mujeres y el 3% indeterminado. Los motivos de ingreso más frecuentes fueron los relacionados con proceso de transición (59%), seguido de VIH (4%) y trastornos de la personalidad (3%). Las comorbilidades más frecuentes estuvieron relacionadas con el proceso de transición (49%), los problemas de salud mental (40%) y las enfermedades infecciosas (15%). CONCLUSIONES: Es necesario abordar la salud de las personas trans teniendo en cuenta sus necesidades específicas de salud, entre las que se encuentran la modificación corporal, la salud mental, el VIH y otras infecciones mediante estrategias que incluyan la investigación, la adecuación de los sistemas de información sanitaria, la elaboración de guías de atención y la formación de personal de salud


OBJECTIVE: The health of transgender people is a little studied topic and hospital records can be an opportunity to make an approach. The aim of this study was to describe the cause for admission and the associated comorbidities of transgender people in Spain between 2001 and 2013. METHODS: Retrospective observational study with population-based administrative records (Minimum Basic Data Set). The discharges generated by the transgender in Spanish public and private hospitals were selected using one of the following ICD-9-CM codes in any diagnostic field: Trans-sexualism (302.5), Disorders of psychosexual identity (302.6) and Gender identity disorder in adolescents or adults (302.85). The causes of admission and comorbidity according were described. The qualitative variables were described in their frequency distribution according to their number(n) and proportion(%) and the quantitative variables according to their mean and standard deviation (SD) or median (MD) and interquartile range (RIQ) according to their distribution. RESULTS: A total of 2,010 highs were recorded corresponding to 1,878 patients. The mean age was 33 years (SD = 10). 51% were male, 46% female and 3% undetermined or unspecified. The discharges were motivated in 59% by the process of body modification, followed by HIV (4%) and personality disorders (3%). The most common comorbidities were those associated with body modification (49%), mental health problems (40%) and infectious diseases (15%). CONCLUSIONS: It is necessary to address the health of transgender people in a comprehensive way that takes into account their specific health needs, including bodily modification, mental health, HIV and other infections, through strategies that include improve research, tailor health information systems and develop guidelines and training of healthcare providers in this transgender health


Subject(s)
Humans , Male , Female , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Comorbidity , Patient Discharge , Transgender Persons/psychology , Transgender Persons/statistics & numerical data , Gender Dysphoria/diagnosis , Health Care Surveys , Hospitalization/statistics & numerical data , International Classification of Diseases , Retrospective Studies , Spain , Transsexualism/diagnosis
11.
Educ. med. (Ed. impr.) ; 19(5): 283-287, sept.-oct. 2018. tab
Article in Spanish | IBECS | ID: ibc-193396

ABSTRACT

INTRODUCCIÓN: La elección de especialidad y unidad docente (UD) es un momento importante en la trayectoria profesional médica. La Asociación de Residentes de Medicina Preventiva y Salud Pública detectó necesidades de información de los aspirantes no cubiertas por las UD. Por este motivo se evaluó la accesibilidad y la calidad de las páginas web de las UD. MÉTODOS: La accesibilidad se consideró como el orden de aparición de la página de cada UD entre los resultados de las búsquedas realizadas en Google. La calidad se midió mediante un cuestionario ad hoc realizado a partir del análisis de las consultas a la Asociación de Residentes de Medicina Preventiva y Salud Pública de los aspirantes, cuya puntuación varía de 0, mínima calidad, a 100, máxima calidad. RESULTADOS: De las 24 UD 13 presentan página web accesible. La mediana de calidad es 30,5 puntos y solamente una UD tiene una puntuación superior a 50 puntos. CONCLUSIONES: Las necesidades de los opositores están parcialmente cubiertas. Es necesario aumentar la accesibilidad y mejorar la calidad de la información de las webs de las UD


INTRODUCTION: Choosing a specialty and a teaching unit (TU) is an important time in a medical career. The Association of Preventive Medicine and Public Health Residents has detected the information needs of candidates that are not met by TUs. The aim of this article is to evaluate the accessibility and quality of TU websites. METHODS: Accessibility was measured by the order of appearance of the TU website in the results of a Google search. Quality was measured by an ad hoc questionnaire based on the analysis of queries made by candidates to Association of Preventive Medicine and Public Health Residents. The scores in this questionnaire ranged from 0, minimum quality, to 100, maximum quality. RESULTS: Of the 24 TUs evaluated, only 13 had websites. The median of the quality questionnaire was 30.5 points, and only one TU had a score higher than 50 points. CONCLUSION: The needs of candidates are partly met, but it is necessary to improve the accessibility and the quality of the information in TU websites


Subject(s)
Humans , Access to Information , Internship and Residency , Preventive Medicine/education , Public Health/education , Preventive Medicine/statistics & numerical data , Public Health/statistics & numerical data , Specialization/trends , Surveys and Questionnaires
16.
Cir. Esp. (Ed. impr.) ; 94(5): 280-286, mayo 2016. tab
Article in Spanish | IBECS | ID: ibc-151411

ABSTRACT

INTRODUCCIÓN: Con el propósito de disminuir la variabilidad en la petición de pruebas preoperatorias y facilitar la toma de decisiones, nuestro centro ha establecido un protocolo de pruebas preoperatorias para pacientes ASA I y ASA II tratados mediante cirugía mayor ambulatoria (CMA). El objetivo del estudio fue calcular el impacto económico relacionado con la falta de adherencia de los profesionales al protocolo establecido. MÉTODOS: Estudio de costes retrospectivo con un muestreo aleatorizado simple de 353 pacientes atendidos en la consulta de anestesia durante un año. Se analizaron aspectos relacionados con los costes, así como el perfil de pacientes y especialidades según el grado de cumplimiento del protocolo establecido. RESULTADOS: La falta de adherencia al protocolo fue del 70%. Se realizaron 138 radiografías de tórax y 218 electrocardiogramas no indicados, lo que supuso un exceso de coste medio de 34 € por paciente. Teniendo en cuenta el coste de ambas pruebas y la población atendida en CMA durante el año evaluado, la falta de adherencia al protocolo supuso un exceso de coste anual para el centro entre 69.337 € y 84.727 €. CONCLUSIONES: Es preciso reducir la variabilidad clínica y favorecer la creación de sinergias entre los diferentes servicios para adecuar la petición de pruebas complementarias, disminuir los costos de la atención y mejorar la calidad asistencial


BACKGROUND: With the purpose of decreasing the existing variability in the criteria of preoperative evaluation and facilitating the clinical decision-making process, our hospital has a protocol of preoperative tests to use with ASA I and ASA II patients. The aim of the study was to calculate the economic impact caused by clinicians' non-adherence to the protocol for the anaesthesiological evaluation of ASA 1 and ASA II patients. METHODS: A retrospective study of costs with a random sample of 353 patients that were seen in the consultation for Anesthesiology over a period of one year. Aspects related to the costs, patient's profiles and specialties were analysed, according to the degree of fulfillment of the protocol. RESULTS: The lack of adherence to the the protocol was 70%. 130 chest X-rays and 218 ECG were performed without indication. This generated an excess costs of 34 € per patient. Taking into account the expenses of both tests and the attended population undergoing ambulatory surgery during the one-year period, an excess spending for the hospital of between 69.164 € and 83.312 € was estimated. CONCLUSIONS: Clinical variability should be reduced and the creation of synergies between the different departments should be enhanced in order to adjust the request for unnecessary complementary tests to decrease health care and to improve the quality of patient care


Subject(s)
Humans , Male , Female , Preoperative Care/economics , Preoperative Care/instrumentation , Preoperative Care , Surgical Clearance/economics , Surgical Clearance/instrumentation , Surgical Clearance/methods , Ambulatory Surgical Procedures/economics , Ambulatory Surgical Procedures/rehabilitation , Surgical Procedures, Operative/economics , Surgical Procedures, Operative/methods , Health Care Costs , Radiography/instrumentation , Radiography/methods , Radiography , Electrocardiography/instrumentation , Electrocardiography/methods , Electrocardiography , Health Expenditures , Retrospective Studies , Non-Randomized Controlled Trials as Topic , Spain
17.
Cir Esp ; 94(5): 280-6, 2016 May.
Article in English, Spanish | MEDLINE | ID: mdl-26895923

ABSTRACT

BACKGROUND: With the purpose of decreasing the existing variability in the criteria of preoperative evaluation and facilitating the clinical decision-making process, our hospital has a protocol of preoperative tests to use with ASA I and ASA II patients. The aim of the study was to calculate the economic impact caused by clinicians' non-adherence to the protocol for the anaesthesiological evaluation of ASA 1 and ASA II patients. METHODS: A retrospective study of costs with a random sample of 353 patients that were seen in the consultation for Anesthesiology over a period of one year. Aspects related to the costs, patient's profiles and specialties were analysed, according to the degree of fulfillment of the protocol. RESULTS: The lack of adherence to the the protocol was 70%. 130 chest X-rays and 218 ECG were performed without indication. This generated an excess costs of 34 € per patient. Taking into account the expenses of both tests and the attended population undergoing ambulatory surgery during the one-year period, an excess spending for the hospital of between 69.164 € and 83.312 € was estimated. CONCLUSIONS: Clinical variability should be reduced and the creation of synergies between the different departments should be enhanced in order to adjust the request for unnecessary complementary tests to decrease health care and to improve the quality of patient care.


Subject(s)
Ambulatory Surgical Procedures/economics , Diagnostic Tests, Routine , Guideline Adherence/statistics & numerical data , Preoperative Care , Adult , Female , Humans , Male , Middle Aged , Retrospective Studies
18.
Gac. sanit. (Barc., Ed. impr.) ; 29(5): 387-389, sept.-oct. 2015. tab
Article in Spanish | IBECS | ID: ibc-144008

ABSTRACT

En este trabajo se describe el proceso de creación de una herramienta para evaluar la satisfacción con la calidad de la docencia recibida en las rotaciones de la especialidad de Medicina Preventiva y Salud Pública. Para ello se adaptó la Encuesta de Satisfacción de la Formación Especializada por parte de un panel de expertos formado por 23 residentes de nueve comunidades autónomas, que valoraron y adaptaron la encuesta a las rotaciones de la especialidad mediante una escala de Likert de 5 puntos y la inclusión de nuevas dimensiones e ítems. Las dimensiones mejor valoradas fueron la planificación y la consecución de objetivos específicos, la supervisión, la delegación de responsabilidades, los recursos y el ambiente laboral del dispositivo, la valoración personal, el estímulo, el apoyo recibido y la productividad de la rotación. El desarrollo y la utilización de esta herramienta permitirán la elección informada del itinerario formativo de los residentes de Medicina Preventiva y Salud Pública (AU)


This study describes the process of developing an instrument intended for use in assessing satisfaction with the quality of training in preventive medicine and public health for resident physicians. To develop this instrument, the National Survey of Satisfaction with Medical Residency was adapted by an expert panel consisting of 23 resident physicians in preventive medicine and public health belonging to 9 autonomous communities in Spain. The adaptation of the survey to the specialty rotations included new dimensions and items and was evaluated with a 5-point Likert scale. The most important dimensions were planning and the achievement of specific objectives, supervision, delegation of responsibilities, resources and work environment, personal assessment, encouragement, support, and whether the rotation resulted in a publication or research project, etc. The development and utilization of this tool will enable future trainees in preventive medicine and public health to make an informed choice about their training itineraries (AU)


Subject(s)
Humans , Preventive Medicine/education , Education, Medical/organization & administration , Specialization/trends , Public Health/education , Educational Measurement , Quality Improvement/trends , Internship and Residency/statistics & numerical data , Community Participation
19.
Gac Sanit ; 29(5): 387-9, 2015.
Article in Spanish | MEDLINE | ID: mdl-26112655

ABSTRACT

This study describes the process of developing an instrument intended for use in assessing satisfaction with the quality of training in preventive medicine and public health for resident physicians. To develop this instrument, the National Survey of Satisfaction with Medical Residency was adapted by an expert panel consisting of 23 resident physicians in preventive medicine and public health belonging to 9 autonomous communities in Spain. The adaptation of the survey to the specialty rotations included new dimensions and items and was evaluated with a 5-point Likert scale. The most important dimensions were planning and the achievement of specific objectives, supervision, delegation of responsibilities, resources and work environment, personal assessment, encouragement, support, and whether the rotation resulted in a publication or research project, etc. The development and utilization of this tool will enable future trainees in preventive medicine and public health to make an informed choice about their training itineraries.


Subject(s)
Curriculum/standards , Internship and Residency , Physicians/psychology , Preventive Medicine/education , Public Health/education , Surveys and Questionnaires , Career Choice , Community Participation , Humans , Internship and Residency/standards , Job Satisfaction , Research Personnel/psychology , Spain
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