Prevención secundaria post infarto agudo de miocardio en hospitales públicos: implementación y resultados de las garantías GES / Universal health coverage and accomplishment of secondary prevention goals among patients with acute myocardial infarction
Rev. méd. Chile
;
141(8): 977-986, ago. 2013. ilus, graf, tab
Article
in Spanish
| LILACS
| ID: lil-698695
ABSTRACT
Background:
In 2005, acute myocardial infarction (AMI) was included in a universal health plan (GES) to reduce inequity in care and optimize its diagnosis and treatment.Aim:
To evaluate the effect of GES in risk factor control and therapeutic management among patients with AMI. Material andMethods:
A survey was conducted in 2008-2009 in six public hospitals. Patients were identified from a hospital based registry of AMI and evaluated one year later with laboratory tests and an interview.Results:
The registry enrolled 534 patients with ST and non ST segment elevation myocardial infarction. Of these, 416 patients aged 63 ± 12 years (25% women) were evaluated one year later. Eighty three percent were evaluated by a cardiologist and 37% by a general practitioner. Twenty two percent were evaluated by a nurse and 22% by a nutritionist. At the moment of the interview, 9% smoked, 78% were overweight or obese, 24% performed moderate or vigorous physical activity ≥ 150 min/week, 60% had systolic pressure > 130 mmHg and 63% a diastolic pressure > 80 mmHg. In 30%, LDL cholesterol was > 100 mg/dl and in 43%, triglycerides were > 150 mm/dl. Twenty two percent were diabetic and among them, 52% had a glycosilated hemoglobin > 7%. Forty five percent of non-diabetic patients had a fasting glucose > 100 mg/dl. Ninety three percent were in treatment with aspirin, 86% with statins, 66% with b-blockers, and 73% with angiotensin converting enzyme inhibitors or angiotensin receptor blockers and 20% with clopidogrel.Conclusions:
Despite the high proportion of patients in treatment with evidence-based therapy, many do not achieve the targets for risk factor control with the new health care model.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Program Evaluation
/
Universal Health Insurance
/
Secondary Prevention
/
Myocardial Infarction
Type of study:
Etiology study
/
Evaluation studies
/
Observational study
/
Prognostic study
Limits:
Aged
/
Female
/
Humans
/
Male
Country/Region as subject:
South America
/
Chile
Language:
Spanish
Journal:
Rev. méd. Chile
Journal subject:
Medicine
Year:
2013
Type:
Article
Affiliation country:
Chile
Institution/Affiliation country:
Universidad de Chile/CL
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