[Cost-benefit analysis of a population-based cervical cancer screening program designed for Cantabria]. / Análisis coste-beneficio de un programa poblacional de diagnóstico precoz de cáncer de cuello uterino diseñado para Cantabria.

INTRODUCTION: Cervical cancer is the second most common cancer worldwide in women, with an annual mortality of 3.6 per 100.000 women in Spain. An opportunistic screening protocol is currently being developed in Cantabria. The objective of the study is to propose a population-based screening program in Cantabria and assess its cost-benefits. PATIENTS AND METHODS: The population-based program design has been carried out according to the description of the natural course of cervical cancer and its incidence and mortality in Cantabria during 2000-2009. There have been some proposals to increase participation in the program and to evaluate its quality. Costs and benefits (direct and indirect) have been analyzed in several scenarios by modifying the frequency of tests (3-5 years), the age at which the program can be accessed (21, 25 or 30 years), the coverage of the program (60-80%), and discount rates (0-3-6%). RESULTS: A program carried out with coverage of 80% and tests performed every 3 years generates annual costs of €893.000 (discount rate of 3%) compared to the current opportunistic protocol. Scenarios with tests performed every 5 years generate an annual benefit higher than €618.000, depending on the age of accessing the program. CONCLUSIONS: Scenarios with coverage lower than 60% or with women over 30 years old having access to the program are not of interest because of the lower health benefits. However, performing tests every 5 years is more economically advantageous than every 3 years, with similar health benefits.

Compartiendo experiencias: rotatorio en atención primaria de salud en Posadas, Argentina / Sharing experiences: rotation in primary care in Posadas, Argentina

La atención primaria debe ser el eje fundamental de cualquier sistema de salud. Es el primer contacto de la comunidad con el sistema de salud de cualquier país. La Declaración de Alma-Ata, de 1978, busca dar la base para la construcción de un nuevo sistema de salud que permita el ejercicio pleno del derecho a la salud. La realización de un rotatorio externo en atención primaria en Posadas, provincia de Misiones, en Argentina, durante el período de formación M I R, permite conocer el funcionamiento en otros sistemas sanitarios, prestar atención a la comunidad en un centro de atención primaria de un país con sus semejanzas y diferencias al nuestro, seguir la implantación de programas y trabajar con residentes de medicina de familia en otro país, así como vivir una experiencia personal y profesional enriquecedora (AU)

Primary care should be the cornerstone of any health system. It is the first contact with the community health system of any country. The Declaration of Alma-Ata, 1978, seeks to provide the basis for the construction of a new health system that will allow the full exercise of the right to health. Carrying out an external rotation in Primary Care in Posadas, Misiones Province, Argentina, during medical training, in family medicine, offers an insight into how other health systems work, provide health care to the community in a Primary Care Center in a country with its similarities and differences like ours, follow the implementation of programs, working with family medicine residents in another country, and living a rewarding personal and professional experience (AU)

[Sharing experiences: rotation in primary care in Posadas, Argentina]. / Compartiendo experiencias: rotatorio en atención primaria de salud en Posadas, Argentina.

Primary care should be the cornerstone of any health system. It is the first contact with the community health system of any country. The Declaration of Alma-Ata, 1978, seeks to provide the basis for the construction of a new health system that will allow the full exercise of the right to health. Carrying out an external rotation in Primary Care in Posadas, Misiones Province, Argentina, during medical training, in family medicine, offers an insight into how other health systems work, provide health care to the community in a Primary Care Center in a country with its similarities and differences like ours, follow the implementation of programs, working with family medicine residents in another country, and living a rewarding personal and professional experience.