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1.
Ig Sanita Pubbl ; 77(1): 414-425, 2021.
Artigo em Italiano | MEDLINE | ID: mdl-33883751

RESUMO

OBJECTIVES: To evaluate the effectiveness and the frequency of use of a pulsed xenon ultraviolet light-emitting no-touch portable device (PX-UV), applied after perform current cleaning, in reducing environmental bacterial burden and the presence of pathogens on surfaces in the operating rooms at the Policlinico University Hospital of Foggia. DESIGN: Prospective before-and-after study with a follow up duration of four months, from May to August 2019. SETTING AND PARTICIPANTS: Two operating rooms of an Orthopaedic and a Neurosurgical ward in a 780-bed university hospital in the District of Foggia, Italy (about 600,000 inhabitants). MAIN OUTCOME MEASURES: According to the hygienic standards proposed by the Italian Workers Compensation Authority (ISPESL), the total and the average bacterial load and the presence of six pathogens were evaluated between pre- and post- PX-UV use combined with routine manual cleaning. RESULTS: The PX-UV system was applied at five distinct time points: t1: start of the experiment, t2: after 28 days, t3: after 13 days, t4: after 7 days, and t5: after 8 days (t2-t5: 28 days in total). About 16-min of PX-UV cycle showed significant reduction in the level of environmental contamination by decreasing the mean colony count by 87.5%, compliant with the standard (5< X ≤15 CFU per plat). Staphylococcus aureus and Acinetobacter baumannii that had been isolated in some of the samplings before PX-UV were no longer detected after t1, t2 and t5 treatments. Before PX-UV, the mean colony count was similar between t1 and t2 (p>0.05); after t3 and t4 treatments, it was lower before t5 in both the Orthopaedic and Neurosurgical operating rooms (= -97% and -75%, respectively; p<0,01). CONCLUSIONS: Implication for practice: PX-UV could supplement the standard cleaning process in reducing the microbial burden in the operating rooms and potentially achieving lower healthcare-associated surgical site infections rates.


Assuntos
Infecção Hospitalar , Desinfecção , Humanos , Itália , Salas Cirúrgicas , Estudos Prospectivos , Xenônio
4.
PLoS One ; 16(4): e0249586, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33819294

RESUMO

Medical procedures that produce aerosolized particles are under great scrutiny due to the recent concerns surrounding the COVID-19 virus and increased risk for nosocomial infections. For example, thoracostomies, tracheotomies and intubations/extubations produce aerosols that can linger in the air. The lingering time is dependent on particle size where, e.g., 500 µm (0.5 mm) particles may quickly fall to the floor, while 1 µm particles may float for extended lengths of time. Here, a method is presented to characterize the size of <40 µm to >600 µm particles resulting from surgery in an operating room (OR). The particles are measured in-situ (next to a patient on an operating table) through a 75mm aperture in a ∼400 mm rectangular enclosure with minimal flow restriction. The particles and gasses exiting a patient are vented through an enclosed laser sheet while a camera captures images of the side-scattered light from the entrained particles. A similar optical configuration was described by Anfinrud et al.; however, we present here an extended method which provides a calibration method for determining particle size. The use of a laser sheet with side-scattered light provides a large FOV and bright image of the particles; however, the particle image dilation caused by scattering does not allow direct measurement of particle size. The calibration routine presented here is accomplished by measuring fixed particle distribution ranges with a calibrated shadow imaging system and mapping these measurements to the in-situ imaging system. The technique used for generating and measuring these particles is described. The result is a three-part process where 1) particles of varying sizes are produced and measured using a calibrated, high-resolution shadow imaging method, 2) the same particle generators are measured with the in-situ imaging system, and 3) a correlation mapping is made between the (dilated) laser image size and the measured particle size. Additionally, experimental and operational details of the imaging system are described such as requirements for the enclosure volume, light management, air filtration and control of various laser reflections. Details related to the OR environment and requirements for achieving close proximity to a patient are discussed as well.


Assuntos
Aerossóis/química , Salas Cirúrgicas/organização & administração , Tamanho da Partícula , /prevenção & controle , Humanos
5.
AANA J ; 89(2): 109-116, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33832570

RESUMO

Coronavirus disease 2019 (COVID-19) has resulted in severe health, economic, social, political, and cultural consequences while thrusting Certified Registered Nurse Anesthetists (CRNAs) at the forefront of battling an often invisible enemy. A mixed-methods study was conducted to assess the impact of the COVID-19 pandemic on CRNA practice. The purpose of the qualitative component of the study, a focused ethnography, was to use personal and group interviews to determine the shared experiences of CRNAs who worked during the COVID-19 pandemic. Six themes were identified: (1) CRNAs are part of the solution, (2) doing whatever it takes, (3) CRNAs are valued contributors, (4) removal of barriers promotes positive change, (5) trying times, and (6) expertise revealed. The quantitative component of the study will be discussed in a separate article.


Assuntos
/enfermagem , Enfermeiras Anestesistas/psicologia , Papel do Profissional de Enfermagem/psicologia , Salas Cirúrgicas/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Enfermeiras Anestesistas/estatística & dados numéricos , Pandemias
7.
JAMA Netw Open ; 4(4): e216857, 2021 04 01.
Artigo em Inglês | MEDLINE | ID: mdl-33871614

RESUMO

Importance: The COVID-19 pandemic has brought forth new challenges for health care workers, such as the daily use of personal protective equipment, including reusable facial respirators. Poor communication while wearing respirators may have fatal complications for patients, and no solution has been proposed to date. Objective: To examine whether use of an in-ear communication device is associated with improved communication while wearing different personal protective equipment (N95 mask, half-face elastomeric respirator, and powered air-purifying respirator [PAPR]) in the operating room. Design, Setting, and Participants: This quality improvement study was conducted in June 2020. Surgical residents from the Department of Otolaryngology-Head and Neck Surgery at McGill University in Montreal, Quebec, Canada, were recruited. All participants had normal hearing, were fluent in English, and had access to the operating rooms at the Royal Victoria Hospital. Exposures: All participants performed the speech intelligibility tasks with and without an in-ear communication device. Main Outcomes and Measures: Speech intelligibility was measured using a word recognition task (Modified Rhyme Test) and a sentence recognition task (AzBio Sentence Test). A percentage correct score (0% to 100%) was obtained for each speech intelligibility test. Listening effort was assessed using the NASA Task Load Index. An overall workload score, ranging from 0 points (low workload) to 100 points (high workload), was obtained. Results: A total of 12 participants were included (mean [SD] age, 31.2 [1.9] years; 8 women [66.7%]). AzBio Sentence Test results revealed that, while wearing the N95 mask, the mean (SD) speech intelligibility was 98.8% (1.8%) without the in-ear device vs 94.3% (7.4%) with the device. While wearing the half-face elastomeric respirator, the mean speech intelligibility was 58.5% (12.4%) without the in-ear device vs 90.8% (8.9%) with the device. While wearing the PAPR, the mean speech intelligibility was 84.6% (9.8%) without the in-ear device vs 94.5% (5.5%) with the device. Use of the in-ear device was associated with a significant improvement in speech intelligibility while wearing the half-face elastomeric respirator (32.3%; 95% CI, 23.8%-40.7%; P < .001) and the PAPR (9.9%; 95% CI, 1.4%-18.3%; P = .01). Furthermore, use of the device was associated with decreased listening effort. The NASA Task Load Index results reveal that, while wearing the N95 mask, the mean (SD) overall workload score was 12.6 (10.6) points without the in-ear device vs 17.6 (9.2) points with the device. While wearing the half-face elastomeric respirator, the mean overall workload score was 67.7 (21.6) points without the in-ear device vs 29.3 (14.4) points with the in-ear device. While wearing the PAPR, the mean overall workload score was 42.2 (18.2) points without the in-ear device vs 23.8 (12.8) points with the in-ear device. Use of the in-ear device was associated with a significant decrease in overall workload score while wearing the half-face elastomeric respirator (38.4; 95% CI, 23.5-53.3; P < .001) and the PAPR (18.4; 95% CI, 0.4-36.4; P = .04). Conclusions and Relevance: This study found that among participants using facial respirators that impaired communication, a novel in-ear device was associated with improved communication and decreased listening effort. Such a device may be a feasible solution for protecting health care workers in the operating room while allowing them to communicate safely, especially during the COVID-19 pandemic.


Assuntos
Comunicação , Auxiliares de Audição/normas , Audição , /normas , Salas Cirúrgicas , Dispositivos de Proteção Respiratória/efeitos adversos , Adulto , /prevenção & controle , Canadá , Feminino , Pessoal de Saúde , Humanos , Controle de Infecções/instrumentação , Masculino , Salas Cirúrgicas/organização & administração , Salas Cirúrgicas/normas , Melhoria de Qualidade , Treinamento por Simulação , Testes de Discriminação da Fala/métodos
8.
Soins ; 66(852): 38-40, 2021.
Artigo em Francês | MEDLINE | ID: mdl-33750557

RESUMO

Pivotal members of the operating theatre team, theatre nurses have seen their practice and training evolve to be able to offer a high quality and safe service when carrying out the new activities associated with the operating procedure. A 2015 decree recognised their new exclusive competencies in the area of theatre assistance. These activities are set to be applied to all operating rooms, thanks to initial and continuing training.


Assuntos
Competência Clínica , Enfermagem Perioperatória , Humanos , Salas Cirúrgicas
10.
Ann R Coll Surg Engl ; 103(3): 151-154, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33645287

RESUMO

INTRODUCTION: Owing to the COVID-19 pandemic, there has been significant disruption to all surgical specialties. In the UK, units have cancelled elective surgery and a decrease in aerosol generating procedures (AGPs) was favoured. Centres around the world advocate the use of negative pressure environments for AGPs in reducing the spread of infectious airborne particles. We present an overview of operating theatre ventilation systems and the respective evidence with relation to surgical site infection (SSI) and airborne pathogen transmission in light of COVID-19. METHODS: A literature search was conducted using the PubMed, Cochrane Library and MEDLINE databases. Search terms included "COVID-19", "theatre ventilation", "laminar", "turbulent" and "negative pressure". FINDINGS: Evidence for laminar flow ventilation in reducing the rate of SSI in orthopaedic surgery is widely documented. There is little evidence to support its use in general surgery. Following previous viral outbreaks, some centres have introduced negative pressure ventilation in an attempt to decrease exposure of airborne pathogens to staff and surrounding areas. This has again been suggested during the COVID-19 pandemic. A limited number of studies show some positive results for the use of negative pressure ventilation systems and reduction in spread of pathogens; however, cost, accessibility and duration of conversion remain an unexplored issue. Overall, there is insufficient evidence to advocate large scale conversion at this time. Nevertheless, it may be useful for each centre to have its own negative pressure room available for AGPs and high risk patients.


Assuntos
Filtros de Ar , Ambiente Controlado , Salas Cirúrgicas , Isoladores de Pacientes , Procedimentos Cirúrgicos Operatórios/métodos , Ventilação/métodos , /transmissão , Humanos , Procedimentos Ortopédicos , Infecção da Ferida Cirúrgica/prevenção & controle
11.
Pediatr Dent ; 43(1): 33-41, 2021 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-33662248

RESUMO

Purpose: U.S. pediatric dentists require access to hospital operating rooms (ORs) to deliver safe and effective dental care to some children but have reported denial of access to ORs for general anesthesia (GA), causing long waiting times, deferral of medically necessary dental care, and unmeasured pain and anxiety for patients. The purpose of this pilot study was to examine the extent and possible underlying causes of operating room access denial. Methods: Public policy advocates (PPAs) of the American Academy of Pediatric Dentistry completed a written or electronic questionnaire about state-specific OR denials during March 2020. Results: Responses from 50 states and the District of Columbia showed 34 PPAs (67 percent) acknowledging OR access problems, with 14 out of 34 (41 percent) reporting a moderate or major problem. Western district PPAs reported the fewest states affected (four out of 11; 36 percent). Hospitals and reimbursement emerged as frequent foci for denials in comment analysis. Conclusions: Operating room access denial is a problem for pediatric dentists in the majority of U.S. states and the District of Columbia; in those states reporting it as a problem, it was considered moderate or major in significance by almost half.


Assuntos
Salas Cirúrgicas , Odontopediatria , Criança , Odontólogos , Humanos , Projetos Piloto , Inquéritos e Questionários , Estados Unidos
12.
Artigo em Alemão | MEDLINE | ID: mdl-33725738

RESUMO

Patients who undergo high-risk surgical procedures represent a large proportion of admissions to intensive care units. Postoperative outcomes are a result of the complex interplay between the exact surgical procedure performed, the previous health of the patient, and specific intra- and postoperative events. Appropriate triage of patients to intensive care postoperatively may have a relevant impact on patient outcomes after high-risk surgery. It remains challenging to accurately identify patients who are at high risk of complications or death and target the patients who will benefit most from this highest level of postoperative care. "Failure to rescue" as an expression for the proportion of deaths in patients who developed a postoperative complication out of the total number of patients who developed a postoperative complication adds to the mortality of surgical patients. General wards may not properly recognize and manage postoperative complications when they occur which emphasises the necessity for adequate triage of intensive care capacity. When admission to the intensive care unit is granted patient transport from the operating room to the intensive care unit and patient handover to ICU-staff are further issues relevant to postoperative patient safety. Intrahospital transports are prone to adverse events and need careful preparation to be executed safely. In addition, exchange of clinical information during the transfer of responsibility between anesthesiologist and the intensive care physician has been recognized as a high-risk area for medical errors to occur. Structured handover protocols can reduce communication breakdowns during postoperative transfer of patients from the OR to the ICU.


Assuntos
Cuidados Críticos , Unidades de Terapia Intensiva , Hospitalização , Humanos , Salas Cirúrgicas , Cuidados Pós-Operatórios
13.
Artigo em Alemão | MEDLINE | ID: mdl-33725739

RESUMO

The early postoperative period is of increasing importance in modern operative medicine with a continuously increasing surgical spectrum and patients with increasingly complex comorbidities. Even with optimal preoperative evaluation and intraoperative care, postoperative complications are not uncommon. The fastest possible diagnosis, including possible differential diagnoses and any combined disorders, is essential in order to initiate the indicated therapeutic measures. The spatial correlate of the postoperative phase is the post-anaesthesia care unit (PACU). The qualification of the medical staff and spatial structure must meet the recommended minimum and must be in line with the existing operational structures. Good interdisciplinary and interprofessional communication reduces the loss of information and a good error reporting culture helps to reduce critical incidents.


Assuntos
Salas Cirúrgicas , Cuidados Pré-Operatórios , Hospitais , Humanos , Complicações Pós-Operatórias/prevenção & controle
14.
Ann R Coll Surg Engl ; 103(5): e144-e147, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33682425

RESUMO

The current global COVID-19 pandemic is caused by the novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Currently, acquired tracheoesophageal fistulas are mainly iatrogenic lesions produced by prolonged tracheal intubation. We present a case of tracheoesophageal fistula with severe tracheal stenosis following tracheal intubation in a patient with SARS-CoV-2 infection.


Assuntos
/terapia , Intubação Intratraqueal/efeitos adversos , Procedimentos Cirúrgicos Otorrinolaringológicos/métodos , Estenose Traqueal/cirurgia , Fístula Traqueoesofágica/cirurgia , Adulto , Anastomose Cirúrgica/métodos , Broncoscopia/métodos , Humanos , Masculino , Salas Cirúrgicas , Isoladores de Pacientes , Respiração Artificial , Tomografia Computadorizada por Raios X , Estenose Traqueal/etiologia , Fístula Traqueoesofágica/etiologia
15.
World Neurosurg ; 148: 251-255, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33770847

RESUMO

The COVID-19 pandemic has impacted neurosurgery in unforeseeable ways. Neurosurgical patient care, research, and education have undergone extraordinary modifications as medicine and mankind have adapted to overcome the challenges posed by this pandemic. Some changes will disappear as the situation slowly recovers to a prepandemic status quo. Others will remain: This pandemic has sparked some long-overdue systemic transformations across all levels of medicine, including in neurosurgery, that will be beneficial in the future. In this paper, we present some of the challenges faced across different levels of neurosurgical clinical care, research, and education, the changes that followed, and how some of these modifications have transformed into opportunities for improvement and growth in the future.


Assuntos
Pesquisa Biomédica/métodos , Assistência à Saúde/métodos , Neurocirurgia/métodos , Cuidados Críticos , Educação a Distância/métodos , Procedimentos Cirúrgicos Eletivos , Número de Leitos em Hospital , Humanos , Unidades de Terapia Intensiva , Neurocirurgia/educação , Procedimentos Neurocirúrgicos , Salas Cirúrgicas , Inovação Organizacional , Consulta Remota/métodos , Telemedicina/métodos
16.
World Neurosurg ; 148: 256-262, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33770848

RESUMO

Coronavirus disease 2019 (COVID-19) has disrupted lives and indelibly impacted the practice of medicine since emerging as a pandemic in March 2020. For neurosurgery departments throughout the United States, the pandemic has created unique challenges across subspecialties in devising methods of triage, workflow, and operating room safety. Located in New York City, at the early epicenter of the COVID-19 crisis, the Weill Cornell Medicine Department of Neurological Surgery was disrupted and challenged in many ways, requiring adaptations in clinical operations, workforce management, research, and education. Through our department's collective experience, we offer a glimpse at how our faculty and administrators overcame obstacles, and transformed in the process, at the height of the COVID-19 pandemic.


Assuntos
Assistência à Saúde , Educação a Distância , Neurocirurgia/organização & administração , Procedimentos Neurocirúrgicos , Centros Médicos Acadêmicos , Pesquisa Biomédica , Docentes de Medicina , Pessoal de Saúde , Departamentos Hospitalares , Humanos , Neurocirurgia/educação , Neurocirurgia/métodos , Cidade de Nova Iorque , Salas Cirúrgicas , Administração de Recursos Humanos , Triagem , Webcasts como Assunto , Fluxo de Trabalho
17.
Sensors (Basel) ; 21(4)2021 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-33668544

RESUMO

Surgeons' procedural skills and intraoperative decision making are key elements of clinical practice. However, the objective assessment of these skills remains a challenge to this day. Surgical workflow analysis (SWA) is emerging as a powerful tool to solve this issue in surgical educational environments in real time. Typically, SWA makes use of video signals to automatically identify the surgical phase. We hypothesize that the analysis of surgeons' speech using natural language processing (NLP) can provide deeper insight into the surgical decision-making processes. As a preliminary step, this study proposes to use audio signals registered in the educational operating room (OR) to classify the phases of a laparoscopic cholecystectomy (LC). To do this, we firstly created a database with the transcriptions of audio recorded in surgical educational environments and their corresponding phase. Secondly, we compared the performance of four feature extraction techniques and four machine learning models to find the most appropriate model for phase recognition. The best resulting model was a support vector machine (SVM) coupled to a hidden-Markov model (HMM), trained with features obtained with Word2Vec (82.95% average accuracy). The analysis of this model's confusion matrix shows that some phrases are misplaced due to the similarity in the words used. The study of the model's temporal component suggests that further attention should be paid to accurately detect surgeons' normal conversation. This study proves that speech-based classification of LC phases can be effectively achieved. This lays the foundation for the use of audio signals for SWA, to create a framework of LC to be used in surgical training, especially for the training and assessment of procedural and decision-making skills (e.g., to assess residents' procedural knowledge and their ability to react to adverse situations).


Assuntos
Colecistectomia Laparoscópica , Competência Clínica , Cirurgia Geral , Reconhecimento Automatizado de Padrão , Cirurgia Geral/normas , Humanos , Salas Cirúrgicas , Fala
18.
Artigo em Chinês | MEDLINE | ID: mdl-33781039

RESUMO

Objective: To investigate the status quo of operating room nurse career management in Shandong Province, and to analysis its influencing factors. Methods: In February 2019, 1418 operating room nurses in Shandong province were selected to investigate their general situation and current status of career management and analyze possible influencing factors by using the General Information Questionnaire, the Career Management Questionnaire for Nurses and the Career Planning Questionnaire for Nurses. Results: The total score of organizational career management scale was (48.24±11.12) points, with the score of dimension from high to low as valueing training (12.64±2.54) points, justice in promotion (12.11±3.04) points, providing career information (12.10±3.21) points, promotion in career self-development (11.39±3.46) points. The total score of organizational career planning scale was (43.33±9.00) points. Multiple liner regression analysis showed that career planning (ß=0.742, P<0.001) , hospital grade (ß=-0.068, P<0.001) and age (ß=-0.065, P<0.001) were influencing factors of operating room nurse career management which could explained 57.1% of the variation (F=630.596, P<0.001) . Conclusion: Career management of operating room nurse is at a medium level, the scores of different dimensions are not balanced.Career planning score, hospital level, age and other factors affect the career management score of operating room nurses.


Assuntos
Hospitais , Salas Cirúrgicas , Estudos Transversais , Humanos , Inquéritos e Questionários
19.
Ann R Coll Surg Engl ; 103(3): 145-150, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33645280

RESUMO

INTRODUCTION: The relation between type of ventilation used in the operating theatre and surgical site infection has drawn considerable attention. It has been reported that there is a possible relationship between the type of ventilation used in the operation theatre and surgical site infection. This meta-analysis was performed to evaluate this relationship. METHODS: Through a systematic literature search up to May 2020, 14 studies describing 590,121 operations, 328,183 were performed under laminar airflow ventilation and 2,611,938 were performed under conventional ventilation. Studies were identified that reported relationships between type of ventilation with its different categories and surgical site infection (10 studies were related to surgical site infection in total hip replacement, 7 in total knee arthroplasties and 3 in different abdominal and open vascular surgery). Odds ratios with 95% confidence intervals were calculated comparing surgical site infection prevalence and type of theatre ventilation using the dichotomous method with a random or fixed-effect model. FINDINGS: No significant difference was found between surgery performed under laminar airflow ventilation and conventional ventilation in total hip replacement (OR 1.23; 95% CI 0.97-1.56, p = 0.09), total knee arthroplasties (OR 1.14; 95% CI 0.62-2.09, p = 0.67) or different abdominal and open vascular surgery (OR 0.75; 95% CI 0.43-1.33, p = 0.33). The impact of the type of theatre ventilation may have no influence on surgical site infection as a tool for decreasing its occurrence. CONCLUSIONS: Based on this meta-analysis, operating under laminar airflow or conventional ventilation may have no independent relationship with the risk of surgical site infection. This relationship forces us not to recommend the use of laminar airflow ventilation since it has a much higher cost compared with conventional ventilation.


Assuntos
Salas Cirúrgicas , Procedimentos Cirúrgicos Operatórios , Infecção da Ferida Cirúrgica/epidemiologia , Ventilação/estatística & dados numéricos , Artroplastia de Quadril , Artroplastia do Joelho , Ambiente Controlado , Humanos , Procedimentos Cirúrgicos Vasculares , Ventilação/métodos
20.
Rev Esp Salud Publica ; 952021 Mar 03.
Artigo em Espanhol | MEDLINE | ID: mdl-33654051

RESUMO

OBJECTIVE: In Spain, the number of persons that are in a surgery waiting list as well as the available surgery resources, differ across autonomous communities. The pandemic generated by COVID-19 has increased these waiting lists. In this study two objectives were pursued: on the one hand, to determine which are the resources that are determining the number of persons that are in a surgery waiting list per 1,000 inhabitants; on the other hand, to estimate the impact that the current pandemic has on the latter. METHODS: To estimate which are the resources that are having a greater impact on the waiting lists and to forecast the effect that the COVID-19 has on them, we use dynamic panel data models. The data on the surgery resources and on the waiting lists by autonomous communities is obtained from the Surveys on Health, Hospital Statistics and reports on waiting lists of the Ministry of Health, Consumption and Social Well Being and the Counsels. The sample period is 2012-2017 (last published year for surgery resources). In addition, a literature review is conducted and it shows the important and complexity of waiting list like a gestion tool of health system (Science, SciELO and Dialnet web data bases). RESULTS: COVID-19 will increase the waiting lists by approximately 7.6% to 19.14%, depending on the autonomous community. Not all the available surgery resources have the same relevance nor an equal effect on the reduction of the waiting lists. The most significant resources are the beds and operating rooms per 1,000 inhabitants. The hospital expenditure is not so relevant. CONCLUSIONS: The panel data models estimate the relation between the surgery resources and the waiting list. The latter is deemed complex and different across autonomous communities. In addition, these models allow to predict the expected increase in the waiting lists and are, thus, a useful instrument for their management.


Assuntos
/epidemiologia , Cirurgia Geral/estatística & dados numéricos , Listas de Espera , Coleta de Dados , Número de Leitos em Hospital , Humanos , Internet , Salas Cirúrgicas , Espanha
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