ABSTRACT
OBJECTIVE: Assess compliance with the IDF recommendations for patients with Diabetes Type2 (DM2), and its variability, by groups of doctors and nurses who provide primary care services in Navarre (Spain). MATERIALS AND METHODOLOGIES: A cross-sectional study of a population of 462,568 inhabitants, aged ≥18 years in 2013, attended by 381 units of doctor/nurse (quota). Clinical data were collected retrospectively through electronic records. Using cluster analysis, we identified two groups of units according to the score for each indicator. We calculated the Odds Ratio, adjusted for age sex, BMI, socioeconomic status and smoking, for complying with each recommendation whether a patient was treated by one of the quota from the highest score to the lowest. 30,312 patients with DM2 were identified: prevalence: 6.39%; coefficient of variation between UDN: 22.8%; biggest cluster 7.7% and smallest 5.3%; OR=1.54 (1.50-1.58). The HbA1c control at ≤8% was 82.8% (82.2-83.3) and >9% was 7.6% (7.3-8.0), with OR 1.79 (1.69-1.89) and 2.62 (2.36-2.91) respectively. Control of BP and LDL-C show significant differences between the clusters. CONCLUSIONS: An important variability was identified according to the doctor treating patients. The average HbA1c control is acceptable being limited in BP and LDL-C.
Subject(s)
Blood Glucose/drug effects , Diabetes Mellitus, Type 2/drug therapy , Guideline Adherence/standards , Hypoglycemic Agents/therapeutic use , Practice Guidelines as Topic/standards , Practice Patterns, Physicians'/standards , Primary Health Care/standards , Adolescent , Adult , Anticholesteremic Agents/therapeutic use , Antihypertensive Agents/therapeutic use , Biomarkers/blood , Blood Glucose/metabolism , Blood Pressure/drug effects , Cholesterol, LDL/blood , Cluster Analysis , Cross-Sectional Studies , Diabetes Mellitus, Type 2/blood , Diabetes Mellitus, Type 2/diagnosis , Diabetes Mellitus, Type 2/epidemiology , Electronic Health Records , Female , Glycated Hemoglobin/metabolism , Guideline Adherence/trends , Humans , Logistic Models , Male , Middle Aged , Odds Ratio , Practice Patterns, Physicians'/trends , Prevalence , Primary Health Care/trends , Retrospective Studies , Risk Reduction Behavior , Spain/epidemiology , Time Factors , Young AdultABSTRACT
BACKGROUND: The demand placed on both hospital as well as extrahospital emergency care units currently continues to increase at a growing rate. This study has a twofold objective: the quantification and study of the personal characteristics of the users who are demanding emergency care and assessing whether televised soccer games have any bearing on the utilization of emergency care services. METHODS: A longitudinal descriptive study (9,723 users demanding care) and study of cases and controls (1,284 users demanding care) according to whether or not a soccer game was being televised by means of a logistic regression model. The associations were quantified by means of the odds ratio (OR). Those dealt with by telephone or in infirmaries were not included in the study. RESULTS: A total 10.6% of the demand involved home visits, 4.8% of this total having been sent to hospital. A total 13.3% of the demand corresponds to individuals visiting from other healthcare districts, a total of 65 being overusers of emergency care (8 or more visits). The month of August (32.3%). Sundays (44.56%) and the 12:00 p.m.-2:00 p.m. timeframe (8.38%) are the times when the greatest demand for care occurs, the differences being statistically significant. Televised soccer games were associated to a 19.8% (p < 0.001) rise in demand as compared to the control period. CONCLUSIONS: A high degree of use of the extrahospital emergency care units has been found to exist, a major part of the demand being concentrated at highly specific points in time. A major degree of care is provided to those visiting from outside their own healthcare districts. Television soccer game broadcasts is associated with the greater utilization of the emergency care services.
Subject(s)
Ambulatory Care Facilities/statistics & numerical data , Emergencies , Health Services Needs and Demand/statistics & numerical data , Soccer , Television , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , SpainABSTRACT
BACKGROUND: The enteritis due to Salmonella is still an important cause of infectious gastroenteritis, that is responsible of 85% of the foodborne outbreaks in Spain. It represents without any doubt a public health problem that involves several health care services and preventive services. SUBJECTS AND METHOD: Using two sources of information: the National Diseases Surveillance System and the Microbiology Laboratories of the Hospitals (MLH) we estimated the incidence of Salmonella infection by the capture-recapture method. Besides, a descriptive study of the disease is done and the more frequent serogroups in the province of Huesca during the period 1996-1999. RESULTS: The total number of cases was 959, which means a media annual rate of 116.6 3 105. The estimated number of cases was 1,145 (media annual rate 5 139.5 3 105). The completeness is higher for the MLH (68%, CI 95%: 66-71). The group D is the more frequent (53.4%) and of this, specially the Salmonella enteritidis. 31% of the cases are under 5 years, and 38.2% are admitted to the hospital. The cases appear seasonally from May to September, with an important peak during the month of August. CONCLUSIONS: The improve in the notification and identification of cases by the reporting sources and by the Laboratory Services allowed us to better know the disease. Our results and the proportion of groups-serotypes are similar to the results of other studies.
Subject(s)
Gastroenteritis/epidemiology , Salmonella Infections/epidemiology , Salmonella enteritidis/isolation & purification , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Gastroenteritis/microbiology , Humans , Incidence , Infant, Newborn , Male , Middle Aged , Registries , Retrospective Studies , Salmonella Infections/microbiology , Seasons , Spain/epidemiologyABSTRACT
FUNDAMENTO. La enteritis por Salmonella continúa siendo una importante causa de gastroenteritis infecciosa, y se estima que es responsable del 85 por ciento de los brotes de origen alimentario en España. Constituye, sin duda, un problema de salud pública en el que se encuentran implicados diversos servicios asistenciales y preventivos. PACIENTES Y MÉTODO. Utilizando dos fuentes de información, el sistema de Enfermedades de Declaración Obligatoria (EDO) y los Laboratorios Microbiológicos Hospitalarios (LMH), se obtiene una estimación de la incidencia de salmonelosis mediante la aplicación del método de captura-recaptura. Así mismo, se realiza un estudio descriptivo de la misma y se identifican los serogrupos más frecuentes de Salmonella en la provincia de Huesca en el período 1996-1999. RESULTADOS. Se obtiene un total de 959 casos, lo que representa una tasa media anual de 116,6 por 105 habitantes. El número de casos estimados es de 1.145 (tasa media anual de 139,5 10-5). La tasa de exhaustividad es mayor para LMH (68 por ciento; IC del 95 por ciento, 66-71).El grupo D es el más frecuente (53,4 por ciento) y dentro de él, Salmonella enteritidis. En el 31 por ciento de los casos se presenta en menores de 5 años y en el 38,2 por ciento del total de casos hay un ingreso hospitalario. Los casos presentan una clara estacionalidad en los meses de mayo a septiembre, con un pico en el mes de agosto. CONCLUSIONES. La mejora de la notificación e identificación de casos a partir de las fuentes declarantes y de los servicios de laboratorio permite establecer un mejor conocimiento de la enfermedad. Las cifras obtenidas y su clasificación por grupo-serotipo son similares respecto a otros estudios (AU)
Subject(s)
Middle Aged , Child, Preschool , Child , Adolescent , Adult , Aged , Male , Infant, Newborn , Female , Humans , Seasons , Salmonella enteritidis , Spain , Salmonella Infections , Incidence , Retrospective Studies , Registries , GastroenteritisABSTRACT
Fundamentos: Los géneros Salmonella y Campylobacter son los principales agentes bacterianos causantes de enteritis en el hombre en los países desarrollados. El objetivo del presente trabajo es estudiar las características descriptivas de los casos de infección por Salmonella y por Campylobacter y describir su tendencia y variación estacional en la provincia de Huesca para el período 1996-1999 Método: Las fuentes de información han sido los Laboratorios Microbiológicos Hospitalarios (LMH) que realizan analíticas de coprocultivo tanto de enfermos ambulatorios como hospitalarios. Se toma el municipio como unidad de referencia para representar la distribución espacial. Para el estudio de la tendencia se utiliza un modelo determinista multiplicativo, agrupando los datos en períodos cuatrisemanales Resultados: Se han recogido un total de 781 casos de infección por Salmonella y 654 casos de infección por Campylobacter, con unas tasas medias anuales de 95 y 79,5 x 10 elevado a 5 habitantes respectivamente. La enteritis por Campylobacter se presenta mayoritariamente en menores de 5 años (73,4 por ciento), contra el 35,5 por ciento para la salmonelosis. La situación se invierte en el caso de porcentaje de ingreso hospitalario; así, el ingreso por salmonelosis es casi 5 veces superior. Ambos géneros presentan una clara estacionalidad, con un pico pronunciado en el mes de agosto. Conclusiones: Se observa una tendencia ascendente en el número de aislamientos positivos para ambos microorganismos y una clara estacionalidad en la época estival (AU)