Indicadores de calidad en gastroscopia. Procedimiento de la gastroscopia / Quality indicators in gastroscopy. Gastroscopy procedure

Enmarcado dentro del proyecto "Indicadores de calidad en endoscopia digestiva", liderado por la Sociedad Española de Patología Digestiva (SEPD), el objetivo de esta investigación es proponer los procedimientos e indicadores de estructura, proceso y resultado necesarios para aplicar y evaluar la calidad en la gastroscopia. Primero, se ha diseñado un diagrama con los pasos a seguir durante el procedimiento de gastroscopia. En segundo lugar, un grupo de expertos en calidad asistencial y/o endoscopia han realizado una revisión cualitativa de la literatura haciendo referencia a la búsqueda de indicadores de calidad en los procedimientos endoscópicos, incluidas las gastroscopias. Posteriormente, por un procedimiento de análisis por pares se ha hecho la selección y el análisis de la literatura seleccionada. Se ha identificado para gastroscopias un total de nueve indicadores de procesos (uno de preprocedimiento y ocho de procedimiento). La calidad de la evidencia se ha analizado aplicando la escala de clasificación utilizada en GRADE (Grading of Recommendations Assessment, Development and Evaluation)

Within the project "Quality indicators in digestive endoscopy", pioneered by the Spanish Society for Digestive Diseases (SEPD), the objective of this research is to suggest the structure, process, and results procedures and indicators necessary to implement and assess quality in the gastroscopy setting. First, a chart was designed with the steps to be followed during a gastroscopy procedure. Secondly, a team of experts in care quality and/or endoscopy performed a qualitative review of the literature searching for quality indicators for endoscopic procedures, including gastroscopies. Finally, using a paired analysis approach, a selection of the literature obtained was undertaken. For gastroscopy, a total of nine process indicators were identified (one preprocedure, eight intraprocedure). Evidence quality was assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification scale

Quality indicators in gastroscopy. Gastroscopy procedure.

Within the project "Quality indicators in digestive endoscopy", pioneered by the Spanish Society for Digestive Diseases (SEPD), the objective of this research is to suggest the structure, process, and results procedures and indicators necessary to implement and assess quality in the gastroscopy setting. First, a chart was designed with the steps to be followed during a gastroscopy procedure. Secondly, a team of experts in care quality and/or endoscopy performed a qualitative review of the literature searching for quality indicators for endoscopic procedures, including gastroscopies. Finally, using a paired analysis approach, a selection of the literature obtained was undertaken. For gastroscopy, a total of nine process indicators were identified (one preprocedure, eight intraprocedure). Evidence quality was assessed with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification scale.

Indicadores de calidad en colangiopancreatografía retrógrada endoscópica. Procedimiento de la colangiopancreatografía retrógrada endoscópica / Quality indicators for endoscopic retrograde cholangiopancreatography. The procedure of endoscopic retrograde cholangiopancreatography

El objetivo del proyecto en el que se inscribe este trabajo es proponer procedimientos e indicadores de calidad y seguridad útiles para facilitar la mejora de la calidad en unidades de endoscopia digestiva. En este tercer resultado se proponen procedimientos e indicadores de la colangiopancreatografía retrógrada endoscópica (CPRE). Primero, se ha diseñado un diagrama de los pasos previos y consecutivos a la realización de la CPRE. Un grupo de expertos en calidad asistencial y/o endoscopia, bajo el amparo de la Sociedad Española de Patología Digestiva (SEPD), ha realizado una revisión cualitativa de la literatura haciendo referencia a la búsqueda de indicadores de calidad en la CPRE. Posteriormente, por un procedimiento de análisis por pares se ha hecho la selección y análisis de la literatura seleccionada. Se han identificado un total de seis indicadores específicos, independientemente de los ya descritos comunes, todos de proceso (dos de preprocedimiento y cuatro de procedimiento). Se ha analizado la calidad de la evidencia de cada uno de ellos aplicando la clasificación utilizada en Grading of Recommendations Assessment, Development and Evaluation) GRADE

The goal of the project encompassing the present paper is to propose useful quality procedures and indicators in order to improve quality in digestive endoscopy units. In this third part outcome procedures and indicators are suggested for endoscopic retrograde cholangiopancreatography (ERCP). First, a diagram of pre- and post-ERCP steps was developed. A group of experts in healthcare quality and/or endoscopy, under the shelter of the Spanish Society of Digestive Diseases (Sociedad Española de Patología Digestiva - SEPD), carried out a qualitative review of the literature regarding quality indicators for ERCP. Then, a paired analysis was used for the selection of identified references. A total of six specific indicators, apart from the common indicators already described, were identified, all of them process indicators (two pre-procedure and four post-procedure). Evidence quality was analyzed for each indicator using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) classification

Quality indicators for endoscopic retrograde cholangiopancreatography. The procedure of endoscopic retrograde cholangiopancreatography.

The goal of the project encompassing the present paper is to propose useful quality procedures and indicators in order to improve quality in digestive endoscopy units. In this third part outcome procedures and indicators are suggested for endoscopic retrograde cholangiopancreatography (ERCP). First, a diagram of pre- and post-ERCP steps was developed. A group of experts in healthcare quality and/or endoscopy, under the shelter of the Spanish Society of Digestive Diseases (Sociedad Española de Patología Digestiva - SEPD), carried out a qualitative review of the literature regarding quality indicators for ERCP. Then, a paired analysis was used for the selection of identified references. A total of six specific indicators, apart from the common indicators already described, were identified, all of them process indicators (two pre-procedure and four post-procedure). Evidence quality was analyzed for each indicator using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) classification.

Calidad y seguridad, imperativos éticos en sanidad / Quality and safety, ethical imperatives in health

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Indicadores de calidad en colonoscopia. Procedimiento de la colonoscopia / Quality indicators in colonoscopy. The colonoscopy procedure

El objetivo del proyecto en el que se inscribe este trabajo es proponer procedimientos e indicadores de calidad y seguridad útiles para facilitar la mejora de la calidad en unidades de Endoscopia Digestiva. En este segundo resultado se proponen procedimientos e indicadores de la colonoscopia. Primero, se ha diseñado un diagrama de los pasos previos y consecutivos a la realización de la colonoscopia. Un grupo de expertos en calidad asistencial y/o endoscopia, bajo el amparo de la Sociedad Española de Patología Digestiva (SEPD), han realizado una revisión cualitativa de la literatura haciendo referencia a la búsqueda de indicadores de calidad en la colonoscopia. Posteriormente, por un procedimiento de análisis por pares se ha hecho la selección y análisis de la literatura seleccionada. Se han identificado un total de 13 indicadores específicos, independientemente de los ya descritos comunes, de los cuales diez son de proceso (uno de preprocedimiento, siete de procedimiento y dos de posprocedimiento) y tres, de resultado. Se ha analizado la calidad de la evidencia de cada uno de ellos aplicando la clasificación utilizada en GRADE (Grading of Recommendations Assessment, Development and Evaluation)

The aim of the project this paper is part of was to propose quality and safety procedures and indicators to facilitate quality improvement in digestive endoscopy units. In this second issue, procedures and indicators are suggested regarding colonoscopy. First, a diagram charting the previous and subsequent steps of colonoscopy was designed. A group of experts in health care quality and/or endoscopy, under the auspices of the Sociedad Española de Patología Digestiva (SEPD), performed a qualitative review of the literature regarding colonoscopy-related quality indicators. Subsequently, using a paired-analysis method, the aforementioned literature was selected and analyzed. A total of 13 specific indicators were found aside of the common markers elsewhere described, ten of which are process-related (one pre-procedure, seven procedure, and two post-procedure markers) while the remaining three are outcome-related. Quality of evidence was assessed for each one of them using the GRADE (Grading of Recommendations Assessment, Development and Evaluation) classification

Relevancia del contexto socioeconómico y sanitario en la satisfacción del paciente / Relevance of the socioeconomic and health context in patient satisfaction

Objetivo: Determinar qué factores de los contextos socioeconómico y sanitario influyen sobre la percepción de la satisfacción de la población con los servicios de salud. Método: Los datos provienen de la Encuesta Europea de Salud de 2009. En los 22.188 sujetos encuestados se estudió la relación entre percepción de la satisfacción con los servicios sanitarios recibidos y las variables tanto individuales como contextuales, aplicando un análisis multinivel. Resultados: Los factores de los contextos socioeconómico y sanitario que influyen sobre la satisfacción son las mayores tasas de población sin estudios, en la cual la percepción de excelencia es menos probable (odds ratio [OR]: 0,48-0,82) y la insatisfacción es más prevalente (OR: 1,46-1,63). Asimismo, la proporción de personas insatisfechas es menor cuando el gasto per cápita en servicios sanitarios es muy elevado (>1400 Euros) (OR: 0,49-0,87) y la ratio entre médicos de atención primaria de salud y habitantes es alta (>60) (OR: 0,50-0,85). Además, la prevalencia de insatisfacción describe una tendencia lineal positiva con la tasa de paro (OR: 1,12; p=0,0001) y la magnitud relativa del sector servicios (OR:1,03; p=0,001). Por el contrario, esta tendencia lineal es negativa conforme aumenta el índice de cobertura de la prestación sanitaria (OR: 0,88; p=0,04). Conclusiones: Los factores individuales que determinan la satisfacción del paciente son el sexo, la edad, la salud mental y el país de nacimiento. Además, hay diferencias en la satisfacción del paciente entre las comunidades autónomas de acuerdo con determinantes socioeconómicos, como el producto interior bruto per cápita, las tasas de población sin estudios, las tasas de paro o la ratio número de habitantes/consultorios. Los estudios de satisfacción del usuario, además de ajustarse por variables individuales como el sexo, la edad o el nivel de salud, también deberían tomar en consideración características del entorno socioeconómico del área geográfica de residencia (AU)

Objective: To determine which factors of the socioeconomic and health contexts influence the perception of the satisfaction of the population with the health services. Methods: The data come from the European Health Survey of 2009. In the 22,188 subjects surveyed, the relationship between the perception of satisfaction with the health services received and the individual and contextual variables was studied, applying a multilevel analysis. Results: The factors of the socioeconomic and health contexts that influence satisfaction are: higher rates of low level of studies where the perception of excellence is less likely (odds ratio [OR]: 0.48-0.82) and dissatisfaction is more prevalent (OR: 1.46-1.63). Likewise, the proportion of unsatisfied citizens is lower when per capita expenditure on health services is very high (>1400 Euros) (OR: 0.49-0.87) and the ratio "primary health care physicians/inhabitants" is high (>60) (OR: 0.500.85). In addition, the prevalence of dissatisfaction describes a positive linear trend with the unemployment rate (OR: 1.12; p=0.0001) and the relative magnitude of the services sector (OR: 1.03; p=0.001). By contrast, this linear trend is negative as the Health Care Coverage Ratio increases (OR: 0.88; p=0.04). Conclusions: The individual factors that determine patient satisfaction are: sex, age, mental health and country of birth. In addition, there are differences in patient satisfaction among the autonomous communities according to socio-economic determinants such as GDP per capita, low-level study rates, unemployment rates or number of inhabitants/doctor's ratio. User satisfaction studies as well as being adjusted for individual variables such as sex, age or health level should also take into account characteristics of the socioeconomic environment of the geographic area where they reside (AU)

[Relevance of the socioeconomic and health context in patient satisfaction]. / Relevancia del contexto socioeconómico y sanitario en la satisfacción del paciente.

OBJECTIVE: To determine which factors of the socioeconomic and health contexts influence the perception of the satisfaction of the population with the health services. METHODS: The data come from the European Health Survey of 2009. In the 22,188 subjects surveyed, the relationship between the perception of satisfaction with the health services received and the individual and contextual variables was studied, applying a multilevel analysis. RESULTS: The factors of the socioeconomic and health contexts that influence satisfaction are: higher rates of low level of studies where the perception of excellence is less likely (odds ratio [OR]: 0.48-0.82) and dissatisfaction is more prevalent (OR: 1.46-1.63). Likewise, the proportion of unsatisfied citizens is lower when per capita expenditure on health services is very high (>1400 €) (OR: 0.49-0.87) and the ratio "primary health care physicians/inhabitants" is high (>60) (OR: 0.500.85). In addition, the prevalence of dissatisfaction describes a positive linear trend with the unemployment rate (OR: 1.12; p=0.0001) and the relative magnitude of the services sector (OR: 1.03; p=0.001). By contrast, this linear trend is negative as the Health Care Coverage Ratio increases (OR: 0.88; p=0.04). CONCLUSIONS: The individual factors that determine patient satisfaction are: sex, age, mental health and country of birth. In addition, there are differences in patient satisfaction among the autonomous communities according to socio-economic determinants such as GDP per capita, low-level study rates, unemployment rates or number of inhabitants/doctor's ratio. User satisfaction studies as well as being adjusted for individual variables such as sex, age or health level should also take into account characteristics of the socioeconomic environment of the geographic area where they reside.

Indicadores de calidad en endoscopia digestiva: introducción a los indicadores comunes de estructura, proceso y resultado / Quality indicators in digestive endoscopy: introduction to structure, process, and outcome common indicators

El objetivo general del proyecto en el que se inscribe este trabajo es proponer procedimientos e indicadores de calidad y seguridad útiles para facilitar la mejora de la calidad en unidades de Endoscopia Digestiva. En este primer resultado se proponen procedimientos e indicadores comunes a las pruebas de endoscopia digestiva. Primero, se ha diseñado un diagrama de los pasos previos y consecutivos a la realización de la endoscopia digestiva. Un grupo de expertos en calidad asistencial y/o endoscopia, bajo el amparo de la Sociedad Española de Patología Digestiva, han realizado una revisión cualitativa de la literatura haciendo referencia a la búsqueda de indicadores de calidad en los procedimientos endoscópicos. Posteriormente, por un procedimiento de análisis por pares se ha hecho la selección y análisis de la literatura seleccionada. Se ha identificado un total de 20 indicadores, de los cuales siete son de estructura; once, de proceso (cinco de preprocedimiento, tres de procedimiento y tres de posprocedimiento); y dos, de resultado. Se ha analizado la calidad de la evidencia de cada uno de ellos aplicando la clasificación utilizada en GRADE (Grading of Recommendations Assessment, Development and Evaluation) (AU)

The general goal of the project wherein this paper is framed is the proposal of useful quality and safety procedures and indicators to facilitate quality improvement in digestive endoscopy units. This initial offspring sets forth procedures and indicators common to all digestive endoscopy procedures. First, a diagram of pre- and post-digestive endoscopy steps was developed. A group of health care quality and/or endoscopy experts under the auspices of the Sociedad Española de Patología Digestiva (Spanish Society of Digestive Diseases) carried out a qualitative review of the literature regarding the search for quality indicators in endoscopic procedures. Then, a paired analysis was used for the selection of literature references and their subsequent review. Twenty indicators were identified, including seven for structure, eleven for process (five pre-procedure, three intra-procedure, three post-procedure), and two for outcome. Quality of evidence was analyzed for each indicator using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification (AU)

Quality indicators in digestive endoscopy: introduction to structure, process, and outcome common indicators.

The general goal of the project wherein this paper is framed is the proposal of useful quality and safety procedures and indicators to facilitate quality improvement in digestive endoscopy units. This initial offspring sets forth procedures and indicators common to all digestive endoscopy procedures. First, a diagram of pre- and post-digestive endoscopy steps was developed. A group of health care quality and/or endoscopy experts under the auspices of the Sociedad Española de Patología Digestiva (Spanish Society of Digestive Diseases) carried out a qualitative review of the literature regarding the search for quality indicators in endoscopic procedures. Then, a paired analysis was used for the selection of literature references and their subsequent review. Twenty indicators were identified, including seven for structure, eleven for process (five pre-procedure, three intra-procedure, three post-procedure), and two for outcome. Quality of evidence was analyzed for each indicator using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) classification.

[Economic recession (2006-2012) and changes in the health status of the Spanish population]. / Recesión económica (2006-2012) y cambios en el estado de salud de la población española.

OBJECTIVE: To analyze the relationship of mental health problems in Spanish population with the economic recession (2006-2012), and find out how it affects the self-perception of health status. MATERIALS AND METHODS: Cross-sectional study using the National Health Survey of Spain, 2006/2007 and 2011/2012. Using logistic regression models, three indicators linked to mental health and perceived health were analyzed. RESULTS: In 2011/2012 the consumption of anti-anxiety medications and sleeping pills increased in men and women. Mental dysfunction increased during the economic crisis in the male population. The perception of optimal health did not suffer significantly in either men or women. CONCLUSIONS: The economic recession showed a changing relation to the mental and general health of the population, coinciding with an increase in mental health disorders, such as anxiety.

Recesión económica (2006-2012) y cambios en el estado de salud de la población española / Economic recession (2006-2012) and changes in the health status of the Spanish population

Objetivo. Analizar la relación de los problemas de salud mental en población española con la recesión económica (2006-2012) y establecer en qué sentido afecta a la autopercepción del estado de salud. Material y métodos. Estudio transversal comparativo utilizando la Encuesta Nacional de Salud de España, 2006/2007 y 2011/2012. Mediante modelos de regresión logística, se analizaron tres indicadores relacionados con la salud mental y la salud percibida. Resultados. En 2011/2012 aumentó el consumo de medicamentos ansiolíticos y somníferos en hombres y mujeres. La disfunción mental aumentó durante el periodo de crisis económica en la población de varones. La percepción de una salud óptima no sufrió cambios significativos en hombres ni en mujeres. Conclusiones. La recesión económica mostró una relación variable con la salud mental y general de la población, y coincidió con un aumento de los trastornos de salud mental, como la ansiedad.

Objective. To analyze the relationship of mental health problems in Spanish population with the economic recession (2006-2012), and find out how it affects the self-perception of health status. Materials and methods. Cross-sectional study using the National Health Survey of Spain, 2006/2007 and 2011/2012. Using logistic regression models, three indicators linked to mental health and perceived health were analyzed. Results. In 2011/2012 the consumption of anti-anxiety medications and sleeping pills increased in men and women. Mental dysfunction increased during the economic crisis in the male population. The perception of optimal health did not suffer significantly in either men or women. Conclusions. The economic recession showed a changing relation to the mental and general health of the population, coinciding with an increase in mental health disorders, such as anxiety.