The RAPid COmmunity COGnitive screening Programme (RAPCOG): Developing the Portuguese version of the Quick Mild Cognitive Impairment (Qmci-P) screen as part of the EIP on AHA Twinning Scheme.

As populations age and the prevalence of cognitive impairment increases, healthcare professionals and researchers require short, validated cognitive screening instruments (CSIs). As part the EIP-on-AHA Twinning Support Scheme (2016), four reference sites developed the RAPid COmmunity COGnitive screening Programme (RAPCOG) twinning project to validate translated versions of the Quick Mild Cognitive Impairment (Qmci) screen that could be adapted quickly for use with future eHealth screening and assessment programmes. Here we present the cultural adaption and translation of the Qmci-Portuguese (Qmci-P) screen as part of RAPCOG and explore its subsequent validation against two commonly-used CSIs (MMSE-P and MoCA-P) with 93 participants aged ≥65, attending ten day care centres or resident in two long-term care institutions; median age 74 (+/-15), 66% female. The Qmci-P's internal consistency was high (Cronbach's Alpha 0.82), compared with the MoCA (0.79) and SMMSE (0.54). Qmci-P screen scores moderately correlated with the SMMSE (r=0.61, 95% CI:0.45-0.72, p<0.001) and MoCA (r=0.63, 95% CI:0.36-0.80, p<0.001). The Qmci-P screen demonstrates high internal consistency and concurrent validity against more established CSIs and given its brevity (3-5mins), may be preferable for use in community settings. This project shows the potential of the EIP-on-AHA Twinning initiative to promote the scaling-up of innovative good practices.

[Analysis of the claims in a specialist primary care center]. / Análisis de las reclamaciones en un centro de atención primaria de salud de especialidades.

OBJECTIVE: To analyze the written claims attended at a specialists unit of a Primary Health Care Center in Nou Barris, Barcelona. DESIGN: Evaluative observational study. SETTING: Health Care District of Nou Barris, with a population of 170,849. Period of study covers claims attended between 1-6-1996 to 31-12-1998. PARTICIPANTS: 220 claims registered at a specialist unit of a primary health care center. MEASUREMENTS: Claimer's age and gender, heath care net of origin, claim's motive, claimed person or service and health care activity. Statistical analyses performed included descriptive techniques and Khi-square (chi 2) tests (alpha = 0.05). RESULTS: Cumulative incidence of claims was 4.03 per 10,000 person-year in 1996, 4.70 in 1997 and 5.88 in 1998 (p = 0.0128). 220 claims were analyzed, 53.1% of them came from women. Mean age was 51.12 +/- 15.8 years. 60% of claims came from people using the traditional health care net, and 40% from reformed health care net. Mean time of response was 12.3 +/- 12.7 days. Ophthalmology was the most claimed service (18.64%), followed by "the system" (13.64%), and "the center" (13.64%). 64% of claims pointed to specialists, and don't adjusted with their health care activity (p = 0.0001). Relative risk of being claimed at the specialists unit was 2.91, compared to the rest of the primary health care centers of Nou Barris in 1998. CONCLUSIONS: Health care user's claims become useful to detect some difficult aspects. However, improvements in the methodology of their evaluation are needed.

Análisis de las reclamaciones en un centro de atención primaria de salud de especialidades / Analysis of claims to specialists in a primary health care center

Objetivo. Analizar las reclamaciones presentadas en la Unidad de Atención al Usuario del Centro de Atención Especializada de la Dirección de Atención Primaria (DAP) Nou Barris de Barcelona ciudad. Diseño. Investigación evaluativa observacional. Emplazamiento. DAP de Nou Barris que atiende una población de 170.849 personas, según datos censales de 1996. El período de estudio comprende las reclamaciones presentadas entre el 1 de junio de 1996 y el 31 de diciembre de 1998. Participantes. Cada una de las 220 reclamaciones registradas en el centro de atención especializada. Mediciones. Edad y género del demandante, modelo asistencial de procedencia, motivo de la reclamación, persona o servicio reclamado y actividad de la consulta. Se ha utilizado la descripción estadística y las pruebas de ji-cuadrado (*2) pertinentes. El riesgo * ha sido del 5 por ciento. Resultados. La incidencia acumulada del número de reclamaciones ha sido de 4,03 por 10.000 personas-año en 1996, de 4,70 en 1997 y de 5,88 en 1998 (p = 0,0128). De las 220 reclamaciones registradas, un 53,1 por ciento corresponde a mujeres. La edad media es de 51,12 ñ 15,80 años. El 60 por ciento de las reclamaciones proviene de la asistencia no reformada y el 40 por ciento de la reformada. El tiempo medio de demora en la respuesta es de 12,3 ñ 12,7 días. Las reclamaciones más frecuentes van dirigidas a oftalmología (18,64 por ciento), al sistema (13,64 por ciento) y al centro (13,64 por ciento). El 64 por ciento de las reclamaciones van dirigidas a médicos especialistas y no se ajustan a la actividad asistencial desarrollada (p = 0,0001). El riesgo relativo de presentar reclamaciones en el centro de atención especializada fue de 2,91 respecto del resto de centros de la DAP Nou Barris en 1998. Conclusiones. Las reclamaciones de los usuarios de la atención primaria de salud son un instrumento útil para detectar algunos aspectos conflictivos. Sin embargo, hay que mejorar la metodología de evaluación de las mismas (AU)