Quality of health care perceived by users in Catalan prisons.

OBJECTIVES: To describe inmates' perceptions of healthcare quality in Catalonian prisons. MATERIAL AND METHOD: Transversal study of 6,856 inmates in Catalan prisons in September 2017. Randomized simple screening was used to randomly distribute 1,048 polls in which different aspects of perceived quality of healthcare were evaluated. The results were also categorized according to age, sex, time spent in prison, background and academic levels. We also analysed the differences between results in healthcare quality according to socio-demographic variables. RESULTS: 84.87% of patients show satisfaction with the quality of healthcare received. Women are more satisfied with consultations than men (OR: 2.04; p = 0.009). Patients with a higher educational level are less satisfied than those with a lower educational level, with significant differences in 11 of the 14 items. Those over 65 years of age were more satisfied than the rest in 11 of the 14 items evaluated. Foreign patients were more satisfied than Spanish inmates in time flexibility (OR: 0.69; p = 0.018) and in waiting times for visits (OR: 0,63; p = 0.006), whereas they are less satisfied with the healthcare professionals' image (OR: 1.97; p = 0.03). DISCUSSION: Noteble features of our study include the fact that although global satisfaction is high, some dimensions, like reliability, could improve. The results were submitted to the General Directorate to enable more in-depth study of the variables where there is less satisfaction and to design further improvements.

Diagnosed diabetes and optimal disease control of prisoners in Catalonia.

OBJECTIVES: To determine the prevalence of diagnosed diabetes (DD) and its control amongst prisoners in Catalonia. MATERIALS AND METHODS: Transversal study carried out in four Catalan prisons between April and May 2016. The prevalence of DD in inmates was calculated by intentional sampling and collecting the following variables about: a) type of diabetes, value of glycosylated hemoglobin (HbA1c) and treatment; b) comorbidities; c) epidemiological and prison variables; knowledge of hyperglycaemia/hypoglycaemia, and e) participation in educational activities. Optimal control was considered to exist if Hb1A<7.5% and high risk if Hb1Ac >9%. Test x2 was used in order to study the association among qualitative variables. Multivariate analysis was carried out using logistic regression to determine variables associated with disease control. RESULTS: The study group considered 4,307 male patients, 50.2 years of average age. Ninety-three cases of DD were detected (prevalence 2.16%). 22.6% were treated with insulin, 51.6% with oral antidiabetics (OAD) and 25.8% with both. Type 1 users were younger, thinner, diagnosed at a younger age, heavy drug users and acknowledged to know how to act in the event of hyperglycaemia/hypoglycaemia. Optimal control was more common in type 2 diabetics, but multivariate analysis only associated it with OAD treatment. DISCUSSION: The prevalence observed in DD is much lower than that of the population outside prison and may be underestimated. Optimal control is low, and risk is very high, the results may be biased by the type of population, frequently drug-dependent and with few healthy habits. It is recommended to implement diabetes programmes or improve existing ones in order to increase the diagnosis and management of the disease.

Diabetes diagnosticada y control óptimo de la enfermedad en presos de Cataluña / Diagnosed diabetes and optimal disease control of prisoners in Catalonia

OBJETIVOS: Determinar la prevalencia de diabetes diagnosticada (DD) y su control en presos de Cataluña. MATERIAL Y MÉTODOS: Estudio transversal realizado en cuatro prisiones catalanas de hombres, entre abril y mayo de 2016. Se calculó la prevalencia de DD mediante un muestreo intencional, recogiéndose: a) datos de diabetes: tipo, valor de hemoglobina glucosilada (HbA1c) y tratamiento; b) comorbilidades; c) variables epidemiológicas y penitenciarias; d) conocimiento sobre hiperglucemia/hipoglucemia; y e) participación en actividades educativas. Se consideró un control óptimo si la HbA1c era menor del 7,5%; y de alto riesgo si la HbA1c era mayor del 9%. Para estudiar la asociación entre variables cualitativas, se utilizó la prueba de chi cuadrado o Χ2. Para determinar las variables asociadas al control óptimo, se realizó un análisis multivariante mediante una regresión logística. RESULTADOS: Se estudiaron 4.307 pacientes, con una edad media de 50,2 años. Se detectaron 93 DD (2,16%), 23,7% diabetes tipo 1 (DT1) y 76,3% tipo 2 (DT2). El 22,6% mantenía tratamiento con insulina, el 51,6% con antidiabéticos orales (ADO) y el 25,8% con ambos. Los pacientes con DT1 eran más jóvenes, delgados, diagnosticados más jóvenes, más consumidores de drogas y decían saber actuar ante hiperglucemias/hipoglucemias. El control óptimo era más frecuente en la DT2, pero solo se asoció al tratamiento con ADO. DISCUSIÓN: La prevalencia de DD es muy inferior a la extrapenitenciaria y posiblemente está subestimada. El control óptimo es bajo, y el de riesgo, muy alto, probablemente por el tipo de población, frecuentemente drogodependiente y con pocos hábitos saludables. Se recomienda aplicar programas de diabetes o mejorar los actuales con objeto de incrementar el diagnóstico y optimizar el control de la enfermedad

OBJECTIVES: To determine the prevalence of diagnosed diabetes (DD) and its control amongst prisoners in Catalonia. MATERIALS AND METHODS: Transversal study carried out in four Catalan prisons between April and May 2016. The prevalence of DD in inmates was calculated by intentional sampling and collecting the following variables about: a) type of diabetes, value of glycosylated hemoglobin (HbA1c) and treatment; b) comorbidities; c) epidemiological and prison variables; knowledge of hyperglycaemia/hypoglycaemia, and e) participation in educational activities. Optimal control was considered to exist if Hb1A <7.5% and high risk if Hb1Ac >9%. Test χ² was used in order to study the association among qualitative variables. Multivariate analysis was carried out using logistic regression to determine variables associated with disease control. RESULTS: The study group considered 4,307 male patients, 50.2 years of average age. Ninety three cases of DD were detected (prevalence 2.16%).22.6% were treated with insulin, 51.6% with oral antidiabetics (OAD) and 25.8% with both. Type 1 users were younger, thinner, diagnosed at a younger age, heavy drug users and acknowledged to know how to act in the event of hyperglycaemia/hypoglycaemia. Optimal control was more common in type 2 diabetics, but multivariate analysis only associated it with OAD treatment. DISCUSSION: The prevalence observed in DD is much lower than that of the population outside prison and may be underestimated. Optimal control is low and risk is very high, the results may be biased by the type of population, frequently drug- dependent and with few healthy habits. It is recommended to implement diabetes programmes or improve existing ones in order to increase the diagnosis and management of the disease