ABSTRACT
Objetivo: Estimar el coste hospitalario de una muestra de casos atendidos en siete hospitales del Sistema Nacional de Salud de diferentes ciudades españolas. Método: Estudio basado en 78 casos de enfermedad profesional reconocida por la Seguridad Social, atendidos en centros hospitalarios de Badalona, Barcelona, Ferrol, Gijón, Girona, Madrid y Vigo entre 2017 y 2019. Resultados: La actividad asistencial generada en estos hospitales para atender estos procesos supuso un coste total para el Sistema Nacional de Salud de 282.927 . Conclusiones: Urge mejorar la coordinación entre los dos sistemas públicos de salud: la asistencia sanitaria de la Seguridad Social y el Sistema Nacional de Salud. (AU)
Objective: To estimate the hospital cost of a sample of cases treated in seven hospitals of the National Health System in several Spanish cities. Method: Study based on 78 cases of occupational disease recognized by the social security, and previously treated in hospitals in Badalona, Barcelona, Ferrol, Gijón, Girona, Madrid and Vigo between 2017 and 2019. Results: The healthcare activity generated by these hospitals to attend these processes involved a total cost of 282,927. Conclusions: It is urgent to improve the coordination between the two public health systems, the social security health care system and the National Health System. (AU)
Subject(s)
Humans , History, 21st Century , Health Care Costs , Occupational Diseases , Health Systems , Social Security , Public Health , Hospitals , SpainABSTRACT
OBJECTIVE: To estimate the hospital cost of a sample of cases treated in seven hospitals of the National Health System in several Spanish cities. METHOD: Study based on 78 cases of occupational disease recognized by the social security, and previously treated in hospitals in Badalona, Barcelona, Ferrol, Gijón, Girona, Madrid and Vigo between 2017 and 2019. RESULTS: The healthcare activity generated by these hospitals to attend these processes involved a total cost of 282,927. CONCLUSIONS: It is urgent to improve the coordination between the two public health systems, the social security health care system and the National Health System.
Subject(s)
Occupational Diseases , Delivery of Health Care , Hospital Costs , Hospitals , Humans , Occupational Diseases/epidemiology , Occupational Diseases/therapy , SpainABSTRACT
Antecedentes: La infra-notificación y reconocimiento de enfermedad profesional (EP) es un problema secular en España y demás países europeos. El proyecto de Carga de la Enfermedad Profesional en España (CEPS) pretende contribuir a resolver este problema. Objetivo: Describir el proceso de identificación y reconocimiento de EP en siete hospitales españoles entre 2017 y 2019. Material y Métodos: En los siete hospitales que participan en el estudio se creó una unidad de patología laboral (UPL) la cual estimulaba en los servicios asistenciales la identificación de posibles EP atendidas en el hospital. Los pacientes confirmados por la UPL fueron acompañados en el proceso de reconocimiento. Resultados: En este periodo fueron derivados 308 casos, y en 154 (62%) se confirmó la sospecha EP. De éstos, 78 (65%) han sido reconocidos. La tasa de confirmación (casos confirmados/ derivados) varió según hospitales (de un 25% en el Badalona Serveis Assistencials a un 100% en el Hospital Universitario Fundación Jiménez Díaz) y grupos de diagnósticos (de un 13% para trastornos musculoesqueléticos a un 100% para patologías varias). La tasa de reconocimiento (casos confirmados/casos reconocidos) varió según centro, diagnóstico, sexo y edad, siendo más alta en mujeres, con ≥ 55 años y diagnosticados con patologías varias (oculares, infecciosas, mentales, entre otras). Conclusión: Las UPL contribuyen significativamente en el proceso de identificación y reconocimiento de EP, lo que los pacientes posiblemente no hubieran obtenido de otra forma (AU)
Background: Under-reporting and recognition of occupational disease (OD) is a secular problem in Spain and other European countries. The burden of occupational disease in Spain project (CEPS) aims to contribute. Objective: To describe the process of identification and recognition of OD in seven Spanish between 2017 and 2020. Material and Methods: In the seven hospitals that participate in the study an occupational pathology unit (OPU) was created. The OPU encouraged the healthcare services to identify possible OD treated in the hospital. The patients confirmed by the OPU were accompanied in the recognition process. Results: 308 cases were referred in this period and 154 OD was confirmed (62%). Of these, 78 have been recognized (65%). The confirmation rate (confirmed/ referred cases) varied according to hospitals (from 25% at the Badalona Serveis Assistencials to 100% at the Hospital Universitario Fundación Jiménez Díaz) and diagnosis groups (from 13% for musculoskeletal disorders to 100% for various pathologies). The recognition rate (confirmed/ recognized cases) varied according to hospitals, diagnosis, sex and age, being higher in women, aged ≥ 55 years and diagnosed with various pathologies (ocular, infectious, mental, among others). Conclusion: OPU contribute significantly in the process of identification and recognition of OD, which the patients might not have obtained otherwise (AU)
Subject(s)
Humans , Hospitals, Public , Occupational Diseases/diagnosis , Social Security , Occupational Medicine , SpainSubject(s)
Humans , Male , Female , Adult , Psychology, Industrial/methods , Psychology, Industrial/trends , Occupational Health Services/methods , Psychology, Industrial/organization & administration , Psychology, Industrial/standards , Occupational Health/legislation & jurisprudence , Occupational Health/standardsABSTRACT
OBJECTIVE: To determine the incidence of adult-onset asthma, along with lung function and immunologic characteristics, causes, and clinical course of the disease. PATIENTS AND METHODS: After identifying incident cases of asthma among adult residents of the district of North Barcelona, Spain, we proceeded to characterize the disease using a questionnaire, lung function tests, and skin allergy tests. Patients with an occupation associated with asthma, wheezing at work, and/or sensitization to workplace allergens were considered as having occupational asthma. The risk factors for developing chronic asthma were determined by multivariate analysis. RESULTS: In the 2-year study period, 218 incident cases of adult-onset asthma were identified (in a population of 68 067 adults, corresponding to an annual incidence of 160 per 100 000 per year). In total, 152 patients agreed to participate in the study (response rate, 70%); 140 reported wheezing and/or asthma in the last year (92%). The skin tests showed atopy in 57 cases (41%). Occupational asthma was diagnosed in 19 cases (14%). Domestic mammals were identified as causal agents in 8 patients (6%), drugs in 7 (5%), and environmental allergens in 44 (31%). Household cleaning was the occupation most frequently associated with the disease (26%). Of the 102 patients examined again after 2 years, 70 had chronic asthma (69%). Atopy (odds ratio [OR], 3.39; 95% confidence interval [CI], 1.15-9.99) and risk occupation when the disease was diagnosed (OR, 5.54; 95% CI, 1.05-29.11) were the factors associated with development of chronic disease. CONCLUSIONS: Occupation was related to adult-onset asthma in a little over 10% of the cases and was the main determinant of the development of chronic symptoms.
Subject(s)
Asthma/diagnosis , Asthma/epidemiology , Adult , Age of Onset , Female , Humans , Incidence , Male , Spain/epidemiology , Urban PopulationABSTRACT
OBJETIVO: Determinar la incidencia del asma del adulto, junto con las características funcionales e inmunológicas de la enfermedad, sus causas y su evolución. PACIENTES Y MÉTODOS: Tras la identificación de los habitantes de Barcelona Norte con un primer diagnóstico de asma del adulto, se procedió a la caracterización de la enfermedad por cuestionario, función respiratoria y pruebas cutáneas de alergia. Los pacientes con una ocupación causante de asma, sibilancias durante el trabajo y/o sensibilización a un alérgeno laboral se consideraron afectados de asma relacionada con la ocupación. Los factores de riesgo de cronificación del asma se determinaron por medio de análisis multivariante. RESULTADOS: En 2 años se identificaron 218 primeros diagnósticos de asma del adulto (población: 68.067 adultos; incidencia anual: 160/100.000). Aceptaron participar en el estudio 152 pacientes (índice de respuesta: 70%), de los que se caracterizó a 140 que referían sibilancias y/o asma bronquial en el último año (92%). Las pruebas cutáneas mostraron atopia en 57 casos (41%). Se diagnosticó asma relacionada con la ocupación en 19 casos (14%), por mamíferos domésticos en 8 (6%), por fármacos en 7 (5%) y por alérgenos ambientales en 44 (31%), siendo la limpieza doméstica la ocupación más frecuentemente asociada a la enfermedad (26%). De los 102 pacientes examinados de nuevo a los 2 años, 70 presentaban asma crónica (69%); la atopia (odds ratio [OR] = 3,39; intervalo de confianza [IC] del 95%, 1,15-9,99) y una ocupación de riesgo cuando se diagnosticó la enfermedad (OR = 5,54; IC del 95%, 1,05-29,11) fueron los factores de cronificación del asma. CONCLUSIONES: La ocupación del paciente está relacionada con el asma del adulto en algo más de una décima parte de los casos y es un determinante principal de la cronicidad de sus síntomas
OBJECTIVE: To determine the incidence of adult-onset asthma, along with lung function and immunologic characteristics, causes, and clinical course of the disease. PATIENTS AND METHODS: After identifying incident cases of asthma among adult residents of the district of North Barcelona, Spain, we proceeded to characterize the disease using a questionnaire, lung function tests, and skin allergy tests. Patients with an occupation associated with asthma, wheezing at work, and/or sensitization to workplace allergens were considered as having occupational asthma. The risk factors for developing chronic asthma were determined by multivariate analysis. RESULTS: In the 2-year study period, 218 incident cases of adult-onset asthma were identified (in a population of 68 067 adults, corresponding to an annual incidence of 160 per 100 000 per year). In total, 152 patients agreed to participate in the study (response rate, 70%); 140 reported wheezing and/or asthma in the last year (92%). The skin tests showed atopy in 57 cases (41%). Occupational asthma was diagnosed in 19 cases (14%). Domestic mammals were identified as causal agents in 8 patients (6%), drugs in 7 (5%), and environmental allergens in 44 (31%). Household cleaning was the occupation most frequently associated with the disease (26%). Of the 102 patients examined again after 2 years, 70 had chronic asthma (69%). Atopy (odds ratio [OR], 3.39; 95% confidence interval [CI], 1.15-9.99) and risk occupation when the disease was diagnosed (OR, 5.54; 95% CI, 1.05-29.11) were the factors associated with development of chronic disease. CONCLUSIONS: Occupation was related to adult-onset asthma in a little over 10% of the cases and was the main determinant of the development of chronic symptoms
