ABSTRACT
Conocer la satisfacción de los médicos con el proyecto especialista consultor en el Área 7, y su opinión respecto a éste. Explorar la opinión de estos médicos sobre los problemas y soluciones en la relación entre atención primaria (AP) y atención especializada (AE). Material y métodos: Estudio descriptivo transversal mediante cuestionario autoadministrado. Población de estudio: Médicos de AP del Área 7 de Madrid (n=304). Variables Demográficas y profesionales, relacionadas con la satisfacción con el desarrollo del proyecto, relacionadas con la percepción general del proyecto, el beneficio potencial para los pacientes y con la opinión acerca de las dificultades en la relación AP-AE y las posibles soluciones. Resultados: La tasa de respuesta fue del 56% (contestaron el cuestionario 170 médicos). Respecto a la satisfacción con el proyecto, la puntuación global fue de 8,9 sobre 10. Al 83% de los médicos de AP les resultó fácil el contacto con el especialista de referencia, y el 90% refirió que las cuestiones planteadas se habían resuelto de forma satisfactoria. La herramienta peor valorada para establecer comunicación fue el teléfono. El 27% de los médicos de AP refirió registrar las actividades del proyecto siempre y el 39%, casi siempre. Resultados: En cuanto a la opinión sobre el proyecto, los encuestados reconocieron el mayor beneficio potencial para el proceso diagnóstico y valoraron la necesidad del proyecto en el área con un 9, su utilidad con 9,1 y la prioridad con un 8,7. El 74% de los médicos opinó que sería de interés incorporar un consultor de otra especialidad. Resultados: Los problemas de coordinación AP-AE priorizados fueron la falta de comunicación y diálogo y la masificación de la asistencia. La solución más valorada fue la historia única informatizada (AU)
Objective: To find out the level of satisfaction and opinions of doctors on the specialist consultant project (SCP) in Area 7. To report on these opinions on the difficulties and possible solutions in inter-relationships between of primary health care and specialised care. Material and Methods: Transversal descriptive study using a self-administered questionnaire. Study population: Doctors working in a primary health care district of Madrid (Area 7). Variables: Demographic and professional variables, including their satisfaction after the implementation of the SCP, their general opinion of SCP, potential benefits and their opinions on the difficulties and possible solutions in interrelationships between primary health care and specialised care. Results: A total of 170 (56%) doctors working in primary health care responded. As regards satisfaction with the SCP, the overall score in the evaluation was 8.9, (0 to 10). The majority of primary health care doctors (83%) found it easy to contact the specialist and 90% said that problems were solved satisfactorily. The telephone was the worst communication tool. Only 27% of primary health care doctors said they always register SCP activities, and 39% register them almost always. Results: They thought that the most useful part of this project was the potential benefit on diagnosis. The SCP need score was 9, SCP usefulness 9.1 and priority 8.7. A large majority (74%) of primary health care doctors thought it would be of great interest to incorporate consultants from other specialisations. Results: The main coordination problems found where the lack of communication, and overcrowding. The most valued solution to these problems is the computerised clinical history (AU)
Subject(s)
Humans , Male , Female , Primary Health Care/methods , Data Analysis/methods , Data Analysis/policies , Health Programs and Plans/trends , Project Formulation , Surveys and Questionnaires , Primary Health Care/trends , Primary Health Care/organization & administration , Cross-Sectional Studies , Data Analysis/statistics & numerical dataABSTRACT
OBJECTIVE: To find out the level of satisfaction and opinions of doctors on the specialist consultant project (SCP) in Area 7. To report on these opinions on the difficulties and possible solutions in inter-relationships between of primary health care and specialised care. MATERIAL AND METHODS: Transversal descriptive study using a self-administered questionnaire. STUDY POPULATION: Doctors working in a primary health care district of Madrid (Area 7). VARIABLES: Demographic and professional variables, including their satisfaction after the implementation of the SCP, their general opinion of SCP, potential benefits and their opinions on the difficulties and possible solutions in interrelationships between primary health care and specialised care. RESULTS: A total of 170 (56%) doctors working in primary health care responded. As regards satisfaction with the SCP, the overall score in the evaluation was 8.9, (0 to 10). The majority of primary health care doctors (83%) found it easy to contact the specialist and 90% said that problems were solved satisfactorily. The telephone was the worst communication tool. Only 27% of primary health care doctors said they always register SCP activities, and 39% register them almost always. They thought that the most useful part of this project was the potential benefit on diagnosis. The SCP need score was 9, SCP usefulness 9.1 and priority 8.7. A large majority (74%) of primary health care doctors thought it would be of great interest to incorporate consultants from other specialisations. The main coordination problems found where the lack of communication, and overcrowding. The most valued solution to these problems is the computerised clinical history. CONCLUSIONS: Doctors are very satisfied with this project. They considered the project to be very useful, necessary and a priority, with high potential benefit in several areas of patient care. As quality improvement areas we stress the importance of continuing to promote SCP, of adequate telephone communications and to assess a new easy to fill-in register system.
Subject(s)
Job Satisfaction , Medicine/organization & administration , Physicians , Primary Health Care/organization & administration , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Surveys and QuestionnairesABSTRACT
Spinal epidural abscess is an infectious disorder with high morbidity and mortality rates, which is often associated with delayed diagnosis. We report a case of a 73-year-old man with cervical pyogenic spondylodiscitis complicated with epidural abscess following a prostatic biopsy. Clinical presentation included fever, malaise, neck rigidity in all axes, minor paresis of the right arm, and gait ataxia. A cervical vertebral magnetic resonance imaging (MRI) scan showed pyogenic spondylodiscitis with an epidural abscess. Blood, urine, and cerebrospinal fluid cultures were sterile. The patient was treated with intravenous vancomycin, metronidazole, and ceftazidime for 4 weeks, and was discharged from the hospital and treated with oral cloxacillin, metronidazole, and cefixime for another 2 weeks. His neurological symptoms disappeared completely, and he walked normally, without support. It is important for clinicians to be alert to symptoms accompanying back pain following a prostatic biopsy and to consider the possibility of a diagnosis of spinal abscess.
