Quality of health care perceived by users in Catalan prisons.

OBJECTIVES: To describe inmates' perceptions of healthcare quality in Catalonian prisons. MATERIAL AND METHOD: Transversal study of 6,856 inmates in Catalan prisons in September 2017. Randomized simple screening was used to randomly distribute 1,048 polls in which different aspects of perceived quality of healthcare were evaluated. The results were also categorized according to age, sex, time spent in prison, background and academic levels. We also analysed the differences between results in healthcare quality according to socio-demographic variables. RESULTS: 84.87% of patients show satisfaction with the quality of healthcare received. Women are more satisfied with consultations than men (OR: 2.04; p = 0.009). Patients with a higher educational level are less satisfied than those with a lower educational level, with significant differences in 11 of the 14 items. Those over 65 years of age were more satisfied than the rest in 11 of the 14 items evaluated. Foreign patients were more satisfied than Spanish inmates in time flexibility (OR: 0.69; p = 0.018) and in waiting times for visits (OR: 0,63; p = 0.006), whereas they are less satisfied with the healthcare professionals' image (OR: 1.97; p = 0.03). DISCUSSION: Noteble features of our study include the fact that although global satisfaction is high, some dimensions, like reliability, could improve. The results were submitted to the General Directorate to enable more in-depth study of the variables where there is less satisfaction and to design further improvements.

[Concordance of tuberculin tests and Interferon gamma release assays in the prison population]. / Concordancia de las pruebas de tuberculina e Interferón gamma en población reclusa.

OBJECTIVE: To study the agreement of Tuberculin Skin Tests (TST) and Interferon Gamma Release Assays (IGRA) when screening tuberculosis infection amongst inmates recently admitted to prison. MATERIALS AND METHODS: Prospective study conducted in a prison during the months of May and June 2009. Inmates without a TB history, with previous TST negatives or without prior TSTs were included. Participants signed an informed consent form and the study was approved by an independent Ethical Committee. TST (positive 10 > or = mm) and IGRA (Quantiferon TB-Gold) were performed and standardized data collection was carried out. The agreement between both tests was analysed using the Kappa index. RESULTS: A total of 181 people were included. 62% were foreign-born, 17% had previous BCG vaccination, 8.4% were IDUs and 4% HIV-infected. Foreign born subjects were more frequently vaccinated and presented less drug use and HIV infection than people born in Spain. (p=0.02, p=0.02 and p=0.01 respectively). TST results were positive in 24% and IGRA in 26%. Both tests were performed in 149 people (82%). Discordant results were observed in 15.8%. Agreement of the Kappa coefficient was 0.6 (CI 0.4-0.7). Agreement was better in the native population (K=0.8) and worse in BCG vaccinated (K=0.4) and foreign-born subjects (K=0.8). CONCLUSION: Overall agreement was moderate and was less amongst vaccinated subjects and those born abroad. Extension of the study could be useful to evaluate which test better predicts the risk of progression to active TB and the cost-benefit of both tests among the prison population.

Concordancia de las pruebas de tuberculina e Interferón gamma en población reclusa / Concordance of tuberculin test and Interferon gamma release assays in the prison population

Objetivo: Estudiar en población penitenciaria la concordancia de la prueba de la tuberculina (PT) y las pruebas de interferón gamma (IFG). Material y Métodos: Estudio prospectivo realizado en una prisión en mayo-junio de 2009. Se estudian los ingresos sin antecedente de tuberculosis (TB) o con PT previa negativa o no realizada. Se realizó IDR de Mantoux (positivo ³ 10 mm) y extracción sanguínea para prueba de IFG (QuantiFERON®-TB Gold). En los infectados, se realizó despistaje de TB. Se pasó un cuestionario y se solicitó consentimiento informado. El estudio fue aprobado por un Comité Ético ajeno a instituciones penitenciarias. La concordancia entre PT e IFG se basó en el índice Kappa. Resultados: Se incluyeron 181 casos. El 62% eran extranjeros, el 17% vacunados por BCG, el 8,4% UDI y el 4% VIH+. En los extranjeros había más vacunados, menos UDI y menos infectados por VIH que en autóctonos (p=0,02, p=0,02, y p=0,01, respectivamente). La PT fue positiva en el 24% y la IFG en el 26%. Hubo información de ambas en 149 (82%) casos. El 15,8% fueron discordantes. El índice Kappa fue de 0,6 (0,4-0,7). La concordancia varió según subgrupos, siendo mayor en autóctonos (kappa= 0,8) y menor en vacunados (kappa=0,4) e inmigrantes (kappa=0,5). Conclusión: La concordancia global fue moderada-buena, pero en vacunados e inmigrantes fue menor. El nivel de discordancia aconseja ampliar el estudio, así como evaluar que prueba predice mejor el riesgo de progresión a TB y el coste-beneficio de ambas en la población reclusa de nuestro país(AU)

Objective: To study the agreement of Tuberculin Skin Tests (TST) and Interferon Gamma Release Assays (IGRA) when screening tuberculosis infection amongst inmates recently admitted to prison. Materials and Methods: Prospective study conducted in a prison during the months of May and June 2009. Inmates without a TB history, with previous TST negatives or without prior TSTs were included. Participants signed an informed consent form and the study was approved by an independent Ethical Committee. TST (positive 10 >= mm) and IGRA (Quantiferon TB-Gold) were performed and standardized data collection was carried out. The agreement between both tests was analysed using the Kappa index. Results: A total of 181 people were included. 62% were foreign-born, 17% had previous BCG vaccination, 8.4% were IDUs and 4% HIV-infected. Foreign born subjects were more frequently vaccinated and presented less drug use and HIV infection than people born in Spain. (p=0.02, p=0.02 and p=0.01 respectively). TST results were positive in 24% and IGRA in 26%. Both tests were performed in 149 people (82%). Discordant results were observed in 15.8%. Agreement of the Kappa coefficient was 0.6 (CI 0.4-0.7). Agreement was better in the native population (K=0.8) and worse in BCG vaccinated (K=0.4) and foreign-born subjects (K=0.8) Conclusion: Overall agreement was moderate and was less amongst vaccinated subjects and those born abroad. Extension of the study could be useful to evaluate which test better predicts the risk of progression to active TB and the cost-benefit of both tests among the prison population(AU)