External urology consultation quality at a third-level public hospital in Mexico.

INTRODUCTION: Patient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems. OBJECTIVE: To identify the quality of care in the Urology outpatient department of a third-level hospital. MATERIALS AND METHODS: The NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25min was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico. RESULTS: According to responses, 92% (n=230) knew the reason for the consultation. 64.8% (n=162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2h in 29.6% (n=74). As for consultation time, 212 patients responded and the duration was 11-20min in 52.8% (n=112). Finally, 33.2% (n=83) considered the quality of service to be good. CONCLUSIONS: The use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.

[Immediate-acting oral morphine sulfate in patients with cancer pain]. / Sulfato de morfina oral de liberación inmediata en pacientes con dolor por cáncer.

In this article, we describe our experience with oral morphine for the treatment of patients with cancer pain who were referred to a Palliative Care Unit. Morphine was used in 3,399 days treatment with an average of 65 days per patient. In 50 patients (96%), there was a decreased intensity of pain from severe (Visual Analogue Scale average (VAS) 8.7) to mild (VAS average 1.9). Daily average dose was 95.6 mg. Only 26 patients (50%) required an increase in dosage. The side effects were minimal and controllable. Even though most authors recommend morphine q4h, in our population q6h was enough to achieve pain control in 83% of patients. It should be known by the medical population that morphine is essential therapy for pain in cancer patients. This study confirms that morphine is an excellent drug for the control of pain in cancer patients, with minimal dosages and controllable side effects.