[Analysis criteria's influence on incidence and factors associated tuberculin conversion in health care workers]. / Influencia del criterio de análisis sobre la incidencia y los factores de riesgo de conversión tuberculínica en personal sanitario.

BACKGROUND: To know from two different criteria, CDC's and Spanish national consensus (NC), the tuberculin conversion rate and the factors associated to this phenomenon. PATIENTS AND METHODS: A retrospective cohort study was designed over 475 health care workers. Risk factors were identified by using a Cox's proportional hazards model for each criteria. RESULTS: Not being vaccinated with BCG appears to be a risk factor in NC model 5.37 (CI 95%: 2.21-13.00) and does not in CDC. There was a difference of 45% between both incidence density rates. CONCLUSIONS: We did not find a total concordance between the results from the two models.

Underreporting of percutaneous exposure accidents in a teaching hospital in Spain.

The study's objectives were to determine the frequency of biological-risk accidents involving percutaneous exposure and to identify factors associated with underreporting. Two hundred fifty healthcare professionals from inpatient services at high risk for exposure at the Puerta del Mar University Hospital of Cádiz, Spain, participated in the study. A questionnaire was used to measure personal and work variables, the number of accidents suffered and reported in the last year, and the circumstances motivating the reporting or nonreporting. Two hundred thirty-two persons (92.8%) completed the questionnaire. The accident rate was 12 per 100,000 hours worked. Physicians were the most frequent accident victims (rate 22/100,000 hours). The general surgery and emergency services had higher rates than other services (rates 19.82 and 14.17, respectively). Sixty-six percent of the accidents were not reported to the register. The main predictors of the underreporting were length of professional service greater than 19 years, working in the surgery service, and the perception that the accidents did not involve health risk. The true accident rate was higher than that reflected in the Accident Register. Underreporting was high. The main variables associated with underreporting were length of professional service, work area or department, and perception of risk from the accident.

[Data envelopment analysis: its use to assess efficiency of hospital preventive medicine services of Andalusia]. / Análisis envolvente de datos: aplicación en la medida de la eficiencia en los servicios de Medicina Preventiva hospitalarios de Andalucía.

BACKGROUND: The evaluation of hospital units efficiency is a major matter of health services management. Among the techniques to measure efficiency. The Data Envelopment Analysis (DEA) can be used in multiple resources units (inputs) obtaining multiple products (outputs). The objective of this study is the evaluation of Hospital Preventive Medicine Services in Andalucia, using the technique DEA. METHODS: The Preventive Medicine Services from seven hospitals of Andalucia were selected. DEA is technique, based on a linear programming, which finds the weights, which make a Service efficient in relation with the rest. The relative efficiency of seven units was calculated. The unit with the best practice was found by means of cross efficiency matrixes. With regard to the inefficient services, their necessity of increasing activities to achieve efficiency was identified. RESULTS: Two efficiency assumptions were elaborated. In the first one, 4 services were efficient (Efficiency = 1) in relation with the rest. In the second one, the Service S.1 was inefficient. Among the efficient units, S.2 shown the highest average efficiency in both assumptions and appeared as the reference unit for all the inefficient ones. CONCLUSIONS: In the evaluation of Preventive Medicine Services efficiency, at least, three of them shown some kind of inefficiency. The Service S.2 was the point of reference for inputs and outputs selected.