Universal healthcare coverage for first episode of schizophrenia-spectrum disorders in Chile: analysis of the administrative database.

Aim of the study was to analyse the Ministry of Health's (MINSAL) administrative database of the Universal Health Coverage (UHC) program for First Episode of Schizophrenia Spectrum Disorders (FEP-SSD). The database included every case registered in the program between 2004 and 2017. According to the timeframes established for permanence in the program, cases were defined as Suspected, FEP in diagnostic observation and FEP-SSD. Only first registers were analysed. We compared gender, age at entry, level of care and region where the case was registered. Denominator data for estimation of incidence rates were obtained from the last census. We adjusted incidence rate ratios by age, gender, and region. During the studied period, 33.207 suspected cases were registered. 27.006 (81%) were confirmed as FEP and after 6-month follow-up, 22.701 (68%) were confirmed as FEP-SSD. The median age at entry was 24 years, males entering at younger age. Male proportion was higher than female in all groups. 46.9% of all cases were detected in primary care. FEP-SSD cases were six years younger and had a higher proportion of males than discarded cases (62.6 vs 53.2%). During 169.4 million person-years at risk, crude incidence for suspected cases was 19.58 per 100.000 person-years; for FEP, 15.92 per 100.000 person-years and for FEP-SSD, 13.38 per 100.000 person-years. Chile has lower incidence of FEP-SSD compared to current world estimations but gender proportions are comparable. This UHC program has allowed early access through the integration of mental health to the health network at all levels of care.

Validación de la Encuesta de Percepción de Enfermedad Revisada (Illness Perception Questionnaire) entre pacientes con patologías crónicas médicas y psiquiátricas / Validation of Illness Perception Survey Revised (Illness Perception Questionnaire) among patients with medical and psychiatric chronic diseases

MARCO TEÓRICO: La Percepción de Enfermedad es una variable importante en la evolución de los pacientes. Existen métodos de evaluación cualitativa de éste parámetro, sin embargo, no son aplicables a la población chilena por no estar adaptados al lenguaje local y cotidiano. OBJETIVO: Realizar una traducción del Illness Perception Questionnaire Revised, conservando la validez y fiabilidad original. MATERIALES Y MÉTODOS: Traducción y retraducción de la escala por experto. Piloteo de evaluación a 33 pacientes con enfermedades crónicas. Encuesta a 112 pacientes (49 diabéticos, 37 hipertensos y 33 esquizofrénicos) todos pertenecientes al CRS Hospital El Pino. CONCLUSIONES: En base al porcentaje de concordancia obtenido (95%) entre la versión original y la traducida a la lengua española y al reporte de los entrevistadores con respecto a la comprensibilidad manifestada por los pacientes, podemos concluir que la traducción por nosotros aplicada cumple con los criterios de validez.

THEORETICAL FRAMEWORK: The perception of disease is an important variable in the patient evolution. There are methods of qualitative evaluation of this parameter, however, are not applicable to the Chilean people for not being adapted to the local and everyday language. OBJECTIVE: A translation of the Revised Illness Perception Questionnaire, preserving the original set reliability and validity. MATERIALS AND METHODS: Translation and back translation of the scale by an expert. Piloting assessment to 33 patients with chronic diseases. Survey of 112 patients (49 diabetic and 33 hypertensive schizophrenics 37) all belonging to the CRS Hospital Pino. CONCLUSIONS: Based on the percentage of concordance obtained (95%) between the original version and the translated version in the Spanish language and the interviewers' report regarding the comprehensibility expressed by the patients, we can conclude that the translation applied by us meets the criteria of validity