La Salud Pública en el Ecuador de la Revolución Ciudadana / Public Health in Ecuador of the Citizen Revolution

En estos últimos años de gobierno la salud ha sido un importante pendón de la gestión del gobierno de la Revolución Ciudadana. Se destaca el enorme crecimiento de la red de atención en salud, con el incremento de hospitales y centros de salud, muchos de estos equipados con importante tecnología, la inclusión en la atención médica a importantes sectores sociales, el crecimiento significativo del personal de salud y la adopción del Modelo Atención Integral de Salud Familia y Comunitario (MAISFC). A pesar de ello, los indicadores de salud NO mejoraron, y los principales problemas de morbi-mortalidad NO fueron solucionados. Se observó un deterioro de las condiciones laborales de los trabajadores de salud, y un rompimiento de las relaciones entre los actores públicos y privados de la salud pública. (AU)

Abstract:in these last years of government, healthcare has been an important symbol of the management of the government of the Revolución Ciudadana. The enormous growth of the health care network stands out, with the increase of hospitals and health centers, many of them equipped with important technology, the inclusion in medical attention to other important social sectors, the significant growth of health personnel and the adoption of the Integral Family and Community Health Care Model (MAISFC). Despite this, the health indicators did NOT improve, and the main morbidity and mortality problems were NOT solved. There was a deterioration in the working conditions of health workers, and a breakdown in relations between public and private public health actors. (AU)

[Clinical competence measurement in Mexican resident physicians for diagnosis and treatment of Chagas disease]. / Evaluación de la competencia clínica en médicos residentes mexicanos para el diagnóstico y tratamiento de la enfermedad de Chagas.

OBJECTIVE: Evaluate clinical competence of a mexican resident physicians sample for diagnosis and treatment of Chagas disease. MATERIAL AND METHODS: Cross-sectional and analytic study in 122 resident physicians of epidemiology, family medicine and internal medicine specialty, assigned to a third level medical unit from Guadalajara, Jalisco, Mexico, taking a sample for convenience. An instrument was designed and validated for to evaluate clinical competence in five dimensions: risk factors identification, clinical data identification, diagnostic test interpretation, diagnostic integration and therapeutic resources utilization; that classified competence level in four strata: random defined, low, medium and high, with 89% of reliability accord to Kunder-Richardson test. Descriptive and no parametric inferential statistics were obtained. RESULTS: A total of 122 physicians, 55.7% males (n = 68) and 44.3% females (n = 54). Random defined clinical competence 4.9% (n = 6), low 49.2% (n = 60), medium 44.3% (n = 54) and high 1.6% (n = 2). Median significantly higher in epidemiologists (p = 0.03). CONCLUSIONS: Improve clinical competence level of resident physicians for diagnosis and treatment of Chagas disease is necessary. Intervention studies are required.