Analisis del proceso de Evaluación de Tecnologías Sanitarias del Sistema de Protección Financiera Para Diagnósticos y Tratamientos de Alto Costo en Chile (Ley Ricarte Soto).

OBJECTIVES: In Chile, Ricarte Soto Law defines a financial protection system for high-cost health technologies through a process of prioritization and evaluation of health technologies (ETESA). This study aims to evaluate the ETESA process in terms of its technical content and its coherence with the Chilean regulatory framework. METHODS: This is a documentary review of 34 reports prepared by the Ministry of Health. A data extraction matrix was applied to evaluate the elements in content and process. The analysis evaluated technical errors, process inconsistencies, and disagreements in interpreting results. RESULTS: From 98 technologies, 59 were considered favorable, and 25 received coverage. A total of 20 inconsistencies were identified in the evaluation process, and 39 disagreements were documented on interpreting the results and technical errors. In the prioritization stage, we identified controversies in 44 technologies. CONCLUSION: The ETESA process of the Ricarte Soto Law is generally consistent with the regulations. Nevertheless, weaknesses persist in both technical and procedural terms. It is expected that the regulatory entity can use these results to implement the necessary improvements.

[Cavum carcinoma. A review of retrospective study about 18 patients in 12 year period]. / Carcinomas de cavum. Estudio descriptivo y retrospectivo de 18 pacientes en un período de 12 años.

The cavum or rhinopharynx carcinomas are rare tumors who are divided basically in two histologic types: epidermoid carcinoma and indiferenciated carcinoma. We present a personal revision of 18 patients (15 males and 3 females) diagnosed of cavum carcinoma, the majority (72.2% of indiferenciated type. We have done a descriptive-retrospective study of 12 years (1990-2001) with the following parameters: clinic presentation, associated symptoms, TNM stage, anatomopathology, treatment and clinic evolution. The 38.9% of the patients (7) are actually in complete remission after at last 2 years treatment completion. 3 patients have died and another 2 have not followed the periodic controls in our hospital. The others present a residual tumor in rhinopharynx or in ganglionar level. In one case there are distant metastasis (liver and lungs).