[Operational planning of health services: How do we make it possible?] / Planificación operativa en servicios sanitarios: ¿cómo lo hacemos posible?

INTRODUCTION AND OBJECTIVE: The Catalan Health Service carries out the operational planning of service delivery and organization. The goal is to describe the methodology and procedure followed to perform these functions. METHODS: The process of operational planning in healthcare services (OPHS) is continuous, dynamic, participatory, objective, and adaptable. OPHS can be divided into three stages prior to implementation and evaluation: Service delivery planning, Organization of healthcare resources, and Procurement planning. RESULTS: Three examples of projects are presented following the POSS framework. It is essential to adapt the process to the characteristics of each project. CONCLUSIONS: The proposed framework is useful to achieve high quality and equity in access to services.

Análisis de la demanda en los servicios de urgencias de Barcelona / Analysis of demand in the emergency services of Barcelona

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Utilización innecesaria de la radiografía de tórax prequirúrgica en una red de hospitales públicos

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Estudio y análisis de las urgencias atendidas en el primer trimestre de 1999 en la Fundación Hospital Alcorcón / Study and analysis of the emergency visits attended to in the first trimesster of 1999 in the Alcorcon Hospital Foundation

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Anti-anisakis antibodies in the clinical course of Crohn's disease.

BACKGROUND: Human anisakidosis is a parasitic disease whose intestinal form shares several characterictics with Crohn's disease (CD), like the ileocolonic location predominantly and the presence of granuloma. METHODS: 73 CD patients diagnosed according to Lennard-Jones' criteria were studied. The disease activity was measured by means of Harvey-Bradshaw Index. Different clinical variables were analyzed. Antigenic extract of Anisakis simplex larvae extracted from blue whiting was prepared. Determination of IgG, IgM, IgA and total specific immunoglobulin against A. simplex were carried out in sera by enzyme-linked immunosorbent assay. Immunorecognition patterns of these sera were realized by immunoblotting analysis. Results were compared with prevalence of antibodies anti-Anisakis in 251 healthy controls. RESULTS: 29% of CD patients showed detectable specific total Ig (G+M+A) against A. simplex (95% CI, 19-41). For IgG, IgM and IgA the percentages were 44, 18 and 53% (95% CI, 32-56, 10-26, and 41-65) respectively. In positive specific total Ig cases CD was localized mainly in ileum. In IgG-, IgM- and IgA-positive cases the location was predominantly ileocolonic. CD activity index was higher for groups with positive IgA (2.86 vs. 5.55; p < 0.05). CONCLUSION: Patients with CD have high prevalence of specific immunoglobulin against A. simplex. Specific IgA are associated to higher activity index of CD.