ABSTRACT
We define in this paper different modalities of endoscopic treatment as well as the criteria for this procedure. Endoscopic drainage were done through cystoenterostomy and nasocystic drainage and enterocystic prosthesis plus sphincterostomy of the principal pancreatic and biliary duct, in all patients, but only in eleven of them we implanted the prosthesis in both ducts. The complication was bleeding, in two patients (16.7%) and they were treated with endoscopic inyectotherapy.
Subject(s)
Endoscopy , Pancreatic Pseudocyst/surgery , Acute Disease , Chronic Disease , Drainage/instrumentation , Drainage/methods , Endoscopes , Endoscopy/methods , Follow-Up Studies , Hemorrhage/epidemiology , Humans , Pancreatic Pseudocyst/etiology , Pancreatitis/complications , Postoperative Complications/epidemiologyABSTRACT
Evaluators of family planning programs have begun to use simulated client ratings to assess the quality of services. However, little is known about the reliability of such ratings when they are used to assess individual provider performance. This study examined the reliability of quality-of-care ratings in a Peruvian community-based distribution program by using pairs of concealed observers--a simulated client and a companion. Average interrater agreement, measured by intraclass correlation, was .50, indicating that ratings are not reliable enough for the evaluation of a single provider by a single rater. The study results suggest that checklist-item scores referring to specific provider behaviors will be more reliable and useful than ratings.
Subject(s)
Family Planning Services , Health Knowledge, Attitudes, Practice , Patient Satisfaction , Program Evaluation/methods , Quality of Health Care , Adolescent , Adult , Decision Trees , Female , Humans , Middle Aged , Observer Variation , Reproducibility of ResultsABSTRACT
Family planning program managers may be easily misled by conclusions about the effects of price increases on the demand for services when the findings are based on pre-experiments such as the single-group pretest-posttest study, generally believed to be practical. This report presents financial and service data from clinics of the Asociación Pro-Bienestar de la Familia Ecuatoriana (APROFE) in Ecuador, which, analyzed according to the single-group pretest-posttest design, would suggest that the demand for intrauterine device services is inelastic. However, considerable demand elasticity is detected when data are analyzed according to more rigorous quasi-experimental designs. Using the single-group pretest-posttest design for pricing studies is too flawed to be considered practical. Wherever possible, strong designs should be used in operations research, especially in pricing studies.
