Subject(s)
Humans , Private Health Care Coverage , Health Expenditures , Supplemental Health/statistics & numerical data , Insurance, Health , Consumer Advocacy , United States , Income/statistics & numerical data , Prepaid Health Plans/legislation & jurisprudence , Insurance Carriers/statistics & numerical data , Private SectorSubject(s)
Humans , Health Expenditures , Insurance, Health , Private Health Care Coverage , Supplemental Health/statistics & numerical data , Consumer Advocacy , Income/statistics & numerical data , Private Sector , Prepaid Health Plans/legislation & jurisprudence , Insurance Carriers/statistics & numerical data , United StatesABSTRACT
OBJECTIVES: Limited data exists about Inflammatory Bowel Disease (IBD) in Hispanic populations. The aims of the present study were to estimate overall and specific prevalence of IBD (Crohn's disease and ulcerative colitis) and to describe the characteristics of a group of patients from the University of Puerto Rico's IBD Registry. METHODS: To estimate the prevalence of IBD, computerized records of all physician billing and hospital discharges from a major health insurer in Puerto Rico and classified with ICD-9-CM codes 555.0-555.9 (Crohn's disease) and 556.0-556.9 (ulcerative colitis) during 1996 were searched. Prevalence was estimated by age group, sex, and type of insurance. To describe demographic and selected clinical information from patients with IBD, data gathered in the University of Puerto Rico's IBD Registry from 1995 through 2000 was analyzed. RESULTS: Out of 802,726 insured individuals, 332 had a diagnosis of Crohn's disease, 499 of ulcerative colitis and 21 had both diagnoses. The estimated prevalence per 100,000 was 41.4 for Crohn's disease, 62.2 for ulcerative colitis, and 106.1 cases per 100,000 for IBD. Peak prevalence of Crohn's disease occurred among the age groups 50-59 years and > or = 60 years, and the overall female:male prevalence ratio of Crohn's disease was 1.13 (95 per cent CI: 0.91-1.42). Ulcerative colitis was most prevalent among insured individuals aged 50-59 years and 40-49 years. The prevalence of ulcerative colitis was significantly higher among females than among males, with an overall prevalence ratio of 1.42 (95 per cent CI: 1.18-1.71). Of 342 patients participating in the IBD Registry, 155 (45.3 per cent) had Crohn's disease and 187 (54.7 per cent) had ulcerative colitis. Among patients diagnosed with Crohn's disease, 51.6 per cent were females, the mean age was 35.2 +/- 18.3 years, and 18.1 per cent had a family history of IBD. More than half (57.8 per cent) of patients with ulcerative colitis were females, the mean age was 42.6 +/- 17 years, and 17.1 per cent had a family history of IBD. CONCLUSIONS: The estimated prevalence of IBD in this insured population in Puerto Rico places it among the middle-range of that reported for other countries. Additional studies must be conducted in Puerto Rico in order to confirm the observed findings. Population-based epidemiologic studies aimed at estimating the burden of IBD in Hispanic populations in the United States and Latin America are essential for health care planning.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Colitis, Ulcerative/epidemiology , Crohn Disease/epidemiology , Insurance Coverage , Medical Records Systems, Computerized , Prevalence , Puerto Rico/epidemiology , Retrospective Studies , Insurance Carriers/statistics & numerical data , Registries/statistics & numerical dataABSTRACT
Entre las distintas formas en que pueden clasificarse las empresas está el criterio de dividirlas en grandes, pequeñas y medianas. En las empresas la salud ocupacional puede ser atendida por una estructura interna o por un servicio externo. Al respecto la actual legislación ha fijado reglas que limitan la eficiencia del médico laboral dado la cantidad de personas que debe atender y la difusa lista de ocupaciones que se le asignan. Las consecuencias de esta legislación recaen en particular sobre las PyMES. Este artículo, luego de precisar el actual cuadro de situación, se ocupa de desarrollar propuestas para que los médicos laborales tengan posibilidades de revalorar su función, y sobre todo, puedan contribuir a prevenir riesgos y enfermedades en el medio laboral. Para ello se subraya la importancia de la capacitación profesional contínua
Subject(s)
Work Hours , Occupational Health , Insurance Carriers/statistics & numerical data , Occupational Medicine/standards , Occupational Medicine , Medical Examination/standards , Legislation, LaborABSTRACT
Estudio epidemiológico sobre los accidentes laborales de una compañía aseguradora de riesgos de trabajo( (ART) que al 31 de diciembre de 1997 registró 514-519 trabajadores (13,3 por ciento del total de trabajadores asegurados por todas las ART del país). Material y Métodos: Con los datos de empresas contratantes, cantidad de trabajadores asegurados, cantidad y características de los accidentes se calcularon tasas por cada mil asegurados para el total y para distintos tipos de actividades. Resultados: En el período se registraron 63.564 accidentes. La tasa mensual promedio de accidentes fue del 7,4 por ciento. Pisadas, choques y golpes más las caídas de personas y objetos constituyen el 45,5 por ciento de todas las formas de accidente. Las contusiones y heridas cortantes el 44,3 por ciento de la naturaleza de la lesión. Ambos miembros superiores e inferiores reúnen 54,5 por ciento de la parte del cuerpo afectada. Según el agente material, el piso y las herramientas provocan el 32,9 por ciento. Las tasas de accidentes según tipos de actividades mostraron un máximo de 14,6 por ciento en la construcción, seguido por 12,6 por ciento en minas y canteras, y 11,8 por ciento en industrias manufactureras. Se hizo también la comparación de los datos de este estudio con los del total de ART de Argentina y de otros países de América y Europa.