ABSTRACT
A Residência Médica (RM) é considerada o padrão-ouro em termos da especialização médica no país. A bioética integra o rol de disciplinas obrigatórias para a formação em nível de RM, merecendo destaque pela (i) crescente complexidade do trabalho em saúde e (ii) incipiente abordagem dos problemas éticos na formação dos profissionais da saúde. Com base nestas considerações, foi desenhada a primeira "Oficina de Formação em Bioética e Atenção Primária à Saúde", para o Programa de Residência em Medicina de Família e Comunidade do Município do Rio de Janeiro (PRMFC-SMS-RJ), com o objetivo de fomentar o debate sobre os aspectos bioéticos da prática profissional na Atenção Primária à Saúde/Estratégia Saúde da Família (APS/ESF). O escopo do presente artigo é relatar a experiência e contribuir para as discussões sobre a necessária abordagem dos conflitos éticos para a excelência do cuidado em saúde na APS/ESF.
The Medical Residency (MR) is considered the golden standard in terms of medical specialization in the country. Bioethics incorporates the list of compulsory subjects for the RM level qualification, noteworthy for the (i) increasing complexity of the work in health care and (ii) its incipient approach to the ethical problems in the formation of health professionals. Based on these considerations, the first "Graduation in Bioethics and Primary Health Care Workshop" was designed for the Internship Program in Medicine of Family and Community in the county of Rio de Janeiro (FCHRP-MSH-RJ). The objective of this workshop was to foster the debate on the aspects of bioethics in the professional practice of Primary Health Care/Family Health Strategy (PHC/FHS). The scope of the present article attempts to present the experience and contribute to discussions about the necessary address of ethical conflicts for the excellence of health care in the PHC/FMS
La Residencia Médica (RM) es considerada el estándar de oro en términos de la especialización médica en Brasil. La bioética integra el rol de disciplinas obligatorias para la formación a nivel de RM, mereciendo destaque por la (i) creciente complejidad del trabajo en salud y (ii) el incipiente abordaje de los problemas éticos en la formación de los profesionales de la salud. Con base en estas consideraciones, fue diseñada la primera "Taller de Formación en Bioética y Atención Primaria a la Salud", para el Programa de Residencia en Medicina de Familia y Comunidad del Municipio de Río de Janeiro (PRMFC-SMS-RJ), con el objetivo de fomentar el debate sobre los aspectos bioéticos de la práctica profesional en la Atención Primaria a la Salud/Estrategia Salud de la Familia (APS/ESF). El alcance del presente artículo es relatar la experiencia y contribuir a las discusiones sobre el necesario enfoque de los conflictos éticos para la excelencia del cuidado en salud en la APS/ESF.
Subject(s)
Humans , Primary Health Care , Bioethics , Family Health , Education, Medical , Internship and ResidencyABSTRACT
ObjetivoAnalizar la frecuentación en consultas de atención primaria de los inmigrantes, respecto a los autóctonos. Analizar las diferencias existentes según la zona geográfica de procedencia.DiseñoEstudio descriptivo retrospectivo. Se analizaron todas las citaciones de medicina y pediatría, a partir de datos de la historia clínica electrónica.EmplazamientoCentro de salud urbano de Zaragoza.Participantestodos los pacientes citados en el centro de salud durante un periodo de un año.IntervencionesSe ajustó con la población de referencia de tarjeta sanitaria según sexo y edad. Se realizó estandarización directa para evitar las diferencias debidas a la distinta distribución poblacional.Medidas principalesNúmero de visitas/año al médico y pediatra en función de origen, sexo y edad.ResultadosSe analizaron 110.046 citas de adultos sobre una población de 20.675 personas (20% inmigrantes) y 17.647 citas pediátricas sobre 2.452 niños (29% inmigrantes).La frecuentación anual ajustada de españoles fue mayor que de la de inmigrantes (7,1 visitas vs 4,8 en niños, y 4,7 vs 2,8 en adultos) (p<0,001). Los pacientes de Europa del Este tuvieron la menor frecuentación (1,6). En atención continuada, la frecuentación pediátrica fue mayor en españoles, pero en adultos fue mayor en inmigrantes.ConclusionesLa población inmigrante tanto pediátrica como adulta tuvo una menor frecuentación que la autóctona en cualquier tramo etario. Hay importantes diferencias según orígenes geográficos. Esto puede deberse a una mejor salud, a un mejor uso del sistema sanitario o a otros factores como dificultad de accesibilidad que es preciso estudiar(AU)
ObjectivesTo study the frequency of attendance in primary care of immigrant population compared to autochthonous one. To analyse differences in health services use according to geographical origin.MethodsA retrospective descriptive study was carried out. All Family Medicine and Paediatrics consultations were analysed using the electronic medical record.DesignRetrospective descriptive study. We analysed all the medicine and paediatrics appointments data from the electronic medical record.LocationUrban Health Centre, Zaragoza.ParticipantsAll patients with an appointment at the Health Centre during a one year period.InterventionIs in line with the reference population with health cards by sex and age. Direct standardisation was performed to avoid differences due to different population distribution.Main measuresNumber of visits annually to the doctor, on the basis of national origin, sex and age.ResultsWe analysed 110,046 adult consultations (based on a population of 20,675 inhabitants, 20% of immigrants) and 17,647 paediatric consultations (based on 2,452 children, 29% of immigrants).Adjusted annual consultation ratio of Spanish patients was higher than that of the immigrant population (7.1 consultations vs 4.8 in children, and 4.7 vs 2.8 in adults) (P<.001). Adults from Eastern Europe showed the lowest number of consultations (1.6). In emergency consultations in Primary Care, Spanish children consulted more frequently than immigrants, but immigrant adults consulted more frequently than Spanish adults.ConclusionsImmigrant population consulted primary care services less often compared with the Spanish population. There are notable differences according to geographical origin. This can be explained by better health, better use of healthcare system, and other difficulties in accessibility to health systems(AU)
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Young Adult , Adult , Middle Aged , Aged , Aged, 80 and over , Emigration and Immigration/legislation & jurisprudence , Health Services, Indigenous/legislation & jurisprudence , Health Services, Indigenous/ethics , Health Services, Indigenous/standards , Epidemiological Monitoring , Emigration and Immigration/statistics & numerical data , Emigration and Immigration/trends , Health Services, Indigenous/classification , Health Services, Indigenous/statistics & numerical data , Health Services, Indigenous/trends , Spain/ethnology , Retrospective Studies , Spain/epidemiologyABSTRACT
OBJECTIVES: To study the frequency of attendance in primary care of immigrant population compared to autochthonous one. To analyse differences in health services use according to geographical origin. METHODS: A retrospective descriptive study was carried out. All Family Medicine and Paediatrics consultations were analysed using the electronic medical record. DESIGN: Retrospective descriptive study. We analysed all the medicine and paediatrics appointments data from the electronic medical record. LOCATION: Urban Health Centre, Zaragoza. PARTICIPANTS: All patients with an appointment at the Health Centre during a one year period. INTERVENTION: Is in line with the reference population with health cards by sex and age. Direct standardisation was performed to avoid differences due to different population distribution. MAIN MEASURES: Number of visits annually to the doctor, on the basis of national origin, sex and age. RESULTS: We analysed 110,046 adult consultations (based on a population of 20,675 inhabitants, 20% of immigrants) and 17,647 paediatric consultations (based on 2,452 children, 29% of immigrants). Adjusted annual consultation ratio of Spanish patients was higher than that of the immigrant population (7.1 consultations vs 4.8 in children, and 4.7 vs 2.8 in adults) (P<.001). Adults from Eastern Europe showed the lowest number of consultations (1.6). In emergency consultations in Primary Care, Spanish children consulted more frequently than immigrants, but immigrant adults consulted more frequently than Spanish adults. CONCLUSIONS: Immigrant population consulted primary care services less often compared with the Spanish population. There are notable differences according to geographical origin. This can be explained by better health, better use of healthcare system, and other difficulties in accessibility to health systems.
