Síndrome de Li-Fraumeni / Li Fraumeni síndrome

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Neumatosis gástrica: cuándo no operar / Gastric neumatosis: When not to operate

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Resultados de satisfacción y calidad de vida percibida en pacientes intervenidos de hernia primaria de pared abdominal / Satisfaction and perceived quality of life results in patients operated on for primary hernia of the abdominal wall

INTRODUCCIÓN: La cirugía ambulatoria es el procedimiento estándar en el 60-70% de los procesos quirúrgicos más prevalentes. La cirugía poco invasiva ha mejorado aspectos fundamentales tales como el dolor postoperatorio y la estancia hospitalaria, pero hay pocas publicaciones relacionadas con aspectos de calidad y satisfacción de resultados percibidos por los pacientes, como la necesidad de cuidados informales a domicilio o la demora preoperatoria. El objetivo del estudio fue conocer la satisfacción global percibida por los pacientes intervenidos de hernia de pared abdominal. MÉTODOS: Una muestra de 203 pacientes intervenidos de hernia en un año ha cumplimentado un cuestionario de satisfacción, una semana o un mes después de la intervención. Las variables incluyeron dolor postoperatorio, necesidad de cuidados informales, demora quirúrgica, adecuación de información recibida, trato dispensado y satisfacción global. RESULTADOS: El 48,28% de los pacientes precisaron cuidados informales a domicilio, que fueron atendidos mayoritariamente por familiares durante pocos días. En un 45,81% se dio el alta el mismo día, y en el otro 53,2% antes de 72 h. La satisfacción global en el programa de cirugía de día y corta estancia fue del 94,6%. CONCLUSIONES: La satisfacción global no estuvo relacionada con la edad, el sexo ni el nivel de estudios de los pacientes, pero existió una relación inversa entre el grado de satisfacción y los días de ingreso hospitalario y días de dolor que precisaron analgesia domiciliaria. INTRODUCTION: Outpatient surgery is currently the standard procedure in 60-70% of the most prevalent surgical procedures. Minimally invasive models in health care have improved basic aspects such as postoperative pain and hospital stay, but there are few publications related to perceived quality shown by patients, such as the need for informal care at home or delay before surgery. The aim of the study was to determine the global satisfaction perceived by patients undergoing abdominal wall hernia repair. METHODS: An ad hoc split questionnaire has been completed on satisfaction after a week and postoperative quality a month after intervention by 203 patients operated on for abdominal hernia in a year. Variables included postoperative pain, need for informal care, surgical delay, information supplied, professional management and overall satisfaction. RESULTS: A total of 48.28% of patients needed informal care at home. They were largely attended by women, wives or daughters, for a few days. In 45.81% they were discharged on the same day, and 53.2% in less than 72 h. Overall satisfaction in the program of day surgery and short hospital stay was 94.6%. CONCLUSIONS: The overall process of satisfaction was not related to age, sex or educational level of patients, while there was an inverse relationship between satisfaction and days of hospitalization and days of pain that required analgesia at home

INTRODUCTION: Outpatient surgery is currently the standard procedure in 60-70% of the most prevalent surgical procedures. Minimally invasive models in health care have improved basic aspects such as postoperative pain and hospital stay, but there are few publications related to perceived quality shown by patients, such as the need for informal care at home or delay before surgery. The aim of the study was to determine the global satisfaction perceived by patients undergoing abdominal wall hernia repair. METHODS: An ad hoc split questionnaire has been completed on satisfaction after a week and postoperative quality a month after intervention by 203 patients operated on for abdominal hernia in a year. Variables included postoperative pain, need for informal care, surgical delay, information supplied, professional management and overall satisfaction. RESULTS: A total of 48.28% of patients needed informal care at home. They were largely attended by women, wives or daughters, for a few days. In 45.81% they were discharged on the same day, and 53.2% in less than 72h. Overall satisfaction in the program of day surgery and short hospital stay was 94.6%. CONCLUSIONS: The overall process of satisfaction was not related to age, sex or educational level of patients, while there was an inverse relationship between satisfaction and days of hospitalization and days of pain that required analgesia at home

Estudio del coste de la accesibilidad y de la satisfacción comparando una unidad de CMA integrada en un hospital frente a un modelo teórico en un centro periférico / Study of accessibility costs and satisfaction comparing a MAS unit incorporated in a Hospital versus a theoretical model in a peripheral centre

Introducción La existencia de barreras geográficas condiciona la accesibilidad a la asistencia hospitalaria. La Atención Sanitaria debe introducir modificaciones estructurales que mejoren la accesibilidad geográfica. El objetivo del trabajo es comparar los costes de accesibilidad y el nivel de satisfacción obtenidos en un Centro de Especialidades adaptado con una unidad de CMA periférica frente a la ya existente integrada en el Hospital Virgen de la Luz para lograr una atención de calidad en la subpoblación más cercana al centro periférico. Material y métodos Se realiza un estudio de comparación de costes atribuibles a la accesibilidad con un grupo de 133 pacientes operados por patología herniaria abdominal en el año 2008 en el Hospital de Cuenca (SESCAM), pertenecientes a su área de salud, comparándolo mediante un estudio de simulación por un Centro Quirúrgico Ambulatorio más cercano a la población atendida, funcionalmente operativo pero sin actividad quirúrgica de Cirugía Mayor Ambulatoria (CMA), estudiando las opiniones de los pacientes y el coste efectividad incremental para cada alternativa propuesta. Resultados El coste de accesibilidad, considerando la utilización teórica del Centro Ambulatorio sería de 208.028,09 € y la real del hospital fue de 209.088,94 €, con una mínima diferencia entre ambas de 1.060,85 €, asumiendo resultados clínicos equiparables. Conclusiones Aunque no hay diferencias importantes de costes de accesibilidad en la utilización de un Centro Quirúrgico Ambulatorio frente al hospital, sí es importante la valoración preferente sobre la utilización del primero de ellos expresadas en la encuesta de satisfacción de los pacientes (AU)

Introduction Geographical barriers are a determining factor in the accessibility of Hospital health care, and structural changes to improve geographic accessibility must be introduced. The purpose of this study is to compare accessibility costs and the level of satisfaction obtained in an adapted Specialist Centre with a peripheral MAS (Major Ambulatory Surgery) Unit, with an already existing one incorporated into the Virgen de la Luz Hospital (Cuenca, Spain) to obtain quality health care in the sub-population nearest the peripheral Centre. Material and methods A study was made on a comparison of the costs attributable to accessibility of 133 patients operated on due to hernia disorders in 2008 in the Cuenca Hospital of Castille-La Mancha Health Service (SESCAM), and who lived in its health area. These were compared using a simulation study for an ambulatory surgical Centre, functionally operational, but with no Major Ambulatory Surgery activity nearest to this patient population. The opinions of the patients and the increased cost-effectiveness for each alternative proposal were studied. Results The accessibility cost, taking into account the theoretical use of the Ambulatory Centre would be 208,028.09 € and the real costs of the Hospital were 209,088.94 €, with a minimum difference between the two of 1,060.85 €, assuming similar clinical results. Conclusions Although there are no significant differences in accessibility costs by using an ambulatory surgery Centre compared to the Hospital, a special assessment of the use of the former is important, expressed in the satisfaction of the patients (AU)