Barreras y facilitadores para la búsqueda de ayuda profesional en salud mental, desde la perspectiva de adolescentes con depresión / Barriers and facilitators to mental health help-seeking, from the perspective of adolescents with depression

La prevalencia de depresión en adolescentes es aproximadamente 7% en Chile. Sólo entre 18% y 34% de jóvenes con depresión accede a ayuda profesional. Objetivo: El objetivo de esta investigación fue analizar barreras y facilitadores para la búsqueda de ayuda profesional en salud mental, desde la perspectiva de adolescentes entre 15 y 17 años con depresión en Santiago de Chile. Método: Se llevó a cabo un estudio cualitativo exploratorio y descriptivo desde el enfoque fenomenológico. Se realizaron diez entrevistas semi estructuradas a adolescentes, que fueron analizadas con teoría fundamentada. Resultados: Las principales barreras fueron estigma, minimización de síntomas y preocupación por confidencialidad. Los principales facilitadores fueron contar con red de apoyo, reconocimiento de síntomas e intervenciones escolares que favorecen la detección de síntomas. Conclusiones: Se debe trabajar de manera conjunta con adolescentes, sus familias, pares y sistema escolar brindando información sobre la depresión y su tratamiento.

The prevalence of depression in adolescents is approximately 7% in Chile. Only between 18% and 34% of young people with depression access professional help. Objective: The aim of this research was to analyze the barriers and facilitators for seeking professional help in mental health, from the perspective of adolescents between 15 and 17 years of age with depression in Santiago, Chile. Methodology: An exploratory and descriptive qualitative study was carried out from the phenomenological approach. Ten semi-structured interviews were conducted with adolescents and analyzed with grounded theory. Results: The main barriers were stigma, minimization of symptoms, and concerns about confidentiality. The main facilitators were having a support network, symptom recognition, and school interventions that favor symptom detection. Conclusions: Joint work should be done with adolescents, their families, peers, and school system providing information about depression and its treatment.

Evaluation of the quality of life in children and adolescents with type 1 diabetes in two health institutions, Bogotá, D. C., Colombia / Evaluación de la calidad de vida en niños y adolescentes con diabetes de tipo 1 en dos instituciones de salud, Bogotá, D. C., Colombia

Introduction: Diabetes mellitus is one of the most prevalent chronic diseases in the pediatric and juvenile population that affects the quality of life of patients. Objective: To evaluate the quality of life of a pediatric population under 18 years of age diagnosed with type 1 diabetes from two pediatric institutions in the city of Bogotá. Material and methods: We collected of sociodemographic data and clinical variables and application of the PedsQL 4.0™ questionnaire, and the diabetes module 3.2 version validated in Spanish. The sociodemographic data, the clinical variables and the PedsQL™ were processed in the statistical software Stata 17™. Results: In the global score of the PedsQL™ 3.2, diabetes version, men presented better quality of life compared to women. The correlation between the hemoglobin A1c (HbA1c) values and the PedsQL scale in the global score was evaluated. Patients with HbA1c values below 9% presented a better health-related quality of life, while in the group with HbA1c greater than 9% a perception of low quality of life was observed (p=0.025). Regarding the type of therapy and the relationship with the domains of the PedsQL 3.2, diabetes version, patients who used insulin pumps had better scores in the domains barriers, adherence, concern, communication and in the global score compared to patients who used multiple daily injections of insulin as treatment (p=0.0363). Conclusions: In our patients, a better metabolic control (measured by the HbA1c value) and the use of an insulin pump contribute to a better perception of quality of life.

Introducción. La diabetes mellitus es una de las enfermedades crónicas con mayor prevalencia en la población pediátrica y juvenil, con efectos en la calidad de vida de los pacientes. Objetivo. Evaluar la calidad de vida de una población pediátrica menor de 18 años con diagnóstico de diabetes de tipo 1, de dos instituciones pediátricas de la ciudad de Bogotá. Materiales y métodos. Se recolectaron los datos sociodemográficos, y se emplearon la versión validada en español del cuestionario PedsQL 4.0™ y el módulo 3.2 sobre diabetes. Los datos se procesaron en el software estadístico STATA 17™. Resultados. Con el puntaje global del módulo 3.2 sobre diabetes, de la versión validada del PedsQL™, se evaluó la correlación entre los valores de la hemoglobina A1c (HbA1c) y los del cuestionario. Los pacientes con valores por debajo del 9 % de HbA1c presentaron una mejor calidad de vida relacionada con la salud, mientras que, en el grupo con HbA1c mayor de 9 %, se observó una baja percepción de calidad de vida (p=0,025). En cuanto el tipo de terapia y la relación con los dominios del PedsQL™ 3.2, versión diabetes, los pacientes que utilizaban la bomba de insulina o microinfusor presentaban mejor puntaje en los dominios barreras, cumplimiento, preocupación y comunicación, y en el puntaje global, respecto a quienes usaban múltiples inyecciones de insulina como tratamiento (p=0,0363). Conclusiones. En nuestros pacientes, un mejor control metabólico (medido por el valor de HbA1c) y el uso de microinfusora contribuyen a una percepción de mejor calidad de vida.

Propiedades psicométricas del cuestionario de actitudes hacia la práctica de actividad físico-deportiva orientada a la salud en adolescentes peruanos / Propriedades psicométricas do Questionário de Atitudes em relação à Prática da Actividade Físico-Sportiva Orientada para a Saúde em adolescentes peruanos / Psychometric properties of the Questionnaire of Attitudes towards the Practice of Health-Oriented Physical-Sports Activity in Peruvian adolescents

Las actitudes predicen el compromiso hacia la práctica de actividad físico-deportiva. Cuanto más se conozcan, mejor será la predicción de los posibles hábitos que las personas adoptarán. Por tanto, es necesario contar con un instrumento que evidencie validez y fiabilidad, especialmente para adolescentes, ya que la adolescencia constituye una etapa fundamental en la adopción de estilos de vida saludables. El objetivo de esteestudio fue analizar las propiedades psicométricas del Cuestionario de Actitudes hacia la Práctica de Actividad Físico-Deportiva Orientada a la Salud (CAAFS) en adolescentes peruanos. Se trata de un estudio descriptivo transversal en el que participaron 1314 adolescentes de edades entre 13 y 19 años (15.59±1.05 años), conformados por 716 hombres y 598 mujeres provenientes de Lima y Callao, Perú. Mediante el software R versión 4.1.0., se efectuó la validez de constructo (Análisis Factorial Exploratorio [AFE] y el Análisis Factorial Confirmatorio [AFC]) y el cálculo de fiabilidad. Los resultados del AFE arrojaron un modelo con tres factores del CAAFS, que explica el 35 % de la varianza total. El AFC reportó un buen ajuste del modelo de tres factores del CAAFSde 19 ítems (Chi-cuadrado sobre los grados de libertad = 2.38; error de aproximacióncuadrático medio = .046; residuo cuadrático medio estandarizado = .060; índice de ajuste comparativo = .940; índice de Tuker-Lewis = .931). El coeficiente de fiabilidad Omega reportó un valor de .77. Finalmente se demostró que el CAAFS de 19 ítems evidencia validez y fiabilidad; por lo tanto, el cuestionario puede ser aplicado en adolescentes del contexto peruano. (AU)

Attitudes predict commitment to the practice of physical-sporting activity. The more they are known, the better the prediction of the possible habits that people will adopt. Therefore, it is necessary to havean instrument that shows validity and reliability, especially for adolescents, since adolescence is a fundamental stage in the adoption of healthy lifestyles. The aim of this study was to analyze the psychometric properties of the Questionnaire of Attitudes towards the Practice of Health-Oriented Physical-Sports Activity (CAAFS) in Peruvian adolescents. This was a descriptive cross-sectional study in which 1314 adolescents aged 13 to 19 years (15.59±1.05 years), made up of 716 males and 598 females from Lima and Callao, Peru, participated. Using R software version 4.1.0, construct validity (Exploratory Factor Analysis [EFA] and Confirmatory Factor Analysis [CFA]) and reliability calculation were performed. The results of the EFA yielded a three-factor modelof the CAAFS, which explains 35% of the total variance. The AFC reported a good fit of the 19-item CAAFS three-factor model (Chi-square over degrees of freedom = 2.38; root mean square error of approximation = .046; standardized root mean square residual = .060; comparative fit index = .940; Tuker-Lewis index = .931). The Omega reliability coefficient reported a value of .77. Finally, it was demonstrated that the 19-item CAAFS shows validity and reliability; therefore, the questionnaire can be applied to adolescents in the Peruvian context. (AU)

As atitudes prevêem o compromisso com a actividade física e o desporto. Quanto mais forem conhecidos, melhor será a previsão dos possíveis hábitos que as pessoas irão adoptar. Por conseguinte, é necessário ter um instrumento que demonstre validade e fiabilidade, especialmente para os adolescentes, uma vez que a adolescência é uma fase chave na adopção de estilos de vida saudáveis. O objectivo deste estudo era analisar as propriedades psicométricas do Questionário de Atitudes para a Prática da Actividade Físico-Sportiva Orientada para a Saúde (CAAFS) em adolescentes peruanos. Este foi um estudo transversal descritivo envolvendo 1314 adolescentes com idades compreendidas entre 13-19 anos (15,59±1,05 anos), compreendendo 716 homens e 598 mulheres de Lima e Callao, Peru. Utilizando o software R versão 4.1.0, foram efectuados cálculos de validade de construção (Análise Exploratória de Factores [EFA] e Análise Confirmativa de Factores [CFA]) e de fiabilidade. Os resultados da AAE produziram um modelo de três factores do CAAFS, o que explica 35% da variação total. O CFA relatou um bom ajuste do modelo de três factores CAAFS de 19 itens (Qui-quadrado sobre graus de liberdade = 2,38; erro quadrático médio de aproximação = 0,046; raiz média quadrada residual padronizada = 0,060; índice de ajuste comparativo = 0,940; índice Tuker-Lewis = 0,931). O coeficiente de fiabilidade ómega comunicou um valor de 0,77. Finalmente, foi demonstrado que o CAAFS de 19 itens mostra validade e fiabilidade; por conseguinte, o questionário pode ser aplicado aos adolescentes no contexto peruano. (AU)

Evaluación de la calidad de vida en niños y adolescentes con diabetes de tipo 1 en dos instituciones de salud, Bogotá, D. C., Colombia / Evaluation of the quality of life in children and adolescents with type 1 diabetes in two health institutions, Bogotá, D. C., Colombia

Introducción. La diabetes mellitus es una de las enfermedades crónicas con mayor prevalencia en la población pediátrica y juvenil, con efectos en la calidad de vida de los pacientes. Objetivo. Evaluar la calidad de vida de una población pediátrica menor de 18 años con diagnóstico de diabetes de tipo 1, de dos instituciones pediátricas de la ciudad de Bogotá. Materiales y métodos. Se recolectaron los datos sociodemográficos, y se emplearon la versión validada en español del cuestionario PedsQL 4.0™ y el módulo 3.2 sobre diabetes. Los datos se procesaron en el software estadístico STATA 17™. Resultados. Con el puntaje global del módulo 3.2 sobre diabetes, de la versión validada del PedsQL™, se evaluó la correlación entre los valores de la hemoglobina A1c (HbA1c) y los del cuestionario. Los pacientes con valores por debajo del 9 % de HbA1c presentaron una mejor calidad de vida relacionada con la salud, mientras que, en el grupo con HbA1c mayor de 9 %, se observó una baja percepción de calidad de vida (p=0,025). En cuanto el tipo de terapia y la relación con los dominios del PedsQL™ 3.2, versión diabetes, los pacientes que utilizaban la bomba de insulina o microinfusor presentaban mejor puntaje en los dominios barreras, cumplimiento, preocupación y comunicación, y en el puntaje global, respecto a quienes usaban múltiples inyecciones de insulina como tratamiento (p=0,0363). Conclusiones. En nuestros pacientes, un mejor control metabólico (medido por el valor de HbA1c) y el uso de microinfusora contribuyen a una percepción de mejor calidad de vida.

Introduction: Diabetes mellitus is one of the most prevalent chronic diseases in the pediatric and juvenile population that affects the quality of life of patients. Objective: To evaluate the quality of life of a pediatric population under 18 years of age diagnosed with type 1 diabetes from two pediatric institutions in the city of Bogotá. Materials and methods: We collected of sociodemographic data and clinical variables and application of the PedsQL 4.0™ questionnaire, and the diabetes module 3.2 version validated in Spanish. The sociodemographic data, the clinical variables and the PedsQL™ were processed in the statistical software Stata 17™. Results: In the global score of the PedsQL™ 3.2, diabetes version, men presented better quality of life compared to women. The correlation between the hemoglobin A1c (HbA1c) values and the PedsQL scale in the global score was evaluated. Patients with HbA1c values below 9% presented a better health-related quality of life, while in the group with HbA1c greater than 9% a perception of low quality of life was observed (p=0.025). Regarding the type of therapy and the relationship with the domains of the PedsQL 3.2, diabetes version, patients who used insulin pumps had better scores in the domains barriers, adherence, concern, communication and in the global score compared to patients who used multiple daily injections of insulin as treatment (p=0.0363). Conclusions: In our patients, a better metabolic control (measured by the HbA1c value) and the use of an insulin pump contribute to a better perception of quality of life.

[Adolescents' and young people's experiences of health participation during the COVID-19 pandemic in ChileExperiências de participação de adolescentes e jovens na saúde em tempos de pandemia de COVID-19 no Chile]. / Experiencias de participación en salud de adolescentes y jóvenes en tiempos de la pandemia de COVID-19 en Chile.

Objective: Shed light on the experiences and determinants of young people's and adolescents' participation in formal participation mechanisms during the SARS-CoV-2 pandemic in Chile. Methods: Cross-sectional, descriptive study with a qualitative approach, within the constructivist research paradigm. Three focus groups were conducted with key informants: young people and adolescents who regularly participate in advisory councils of Chile's Ministry of Health (MINSAL). Content analysis was applied for theoretical and emerging categories in the study. The reports were transcribed and studied with data analysis and hermeneutics. This study was conducted during the COVID-19 pandemic, between the months of March and November 2021. Results: During the pandemic, adolescents' and young people's experiences of health participation were affected; however, formal participation mechanisms such as advisory councils allowed for continuity. In this context and based on their experiences, young people and adolescents highlighted some factors that facilitated or limited their participation at three levels: individual, relational, and structural. They highlighted virtual communication, use of social networks, and digital health as excellent tools for the participation of young people and adolescents during the pandemic in Chile. Conclusion: The pandemic affected the participation mechanisms used by young people and adolescents in Chile; however, among the experiences highlighted by young people, aspects that facilitated participation emerged, such as virtual communication, digital health, and other strategies. At the same time, some gaps in health participation widened during this global health crisis, such as access mainly in rural populations.

Objetivo: Divulgar as experiências e determinantes da participação dos jovens e adolescentes em mecanismos formais de participação durante a pandemia de SARS-CoV-2 no Chile. Métodos: Estudo transversal, descritivo, com abordagem qualitativa, ligado ao paradigma construtivista de pesquisa. Foram realizados 3 grupos focais com informantes-chave: jovens e adolescentes que participam regularmente dos conselhos consultivos do Ministério da Saúde do Chile. Foi aplicada a técnica de análise de conteúdo para as categorias teóricas e emergentes do estudo. Os relatos foram transcritos e estudados com técnicas de análise de dados e hermenêutica. Este estudo foi realizado durante a pandemia de COVID-19, entre os meses de março e novembro de 2021. Resultados: Durante a pandemia, as experiências de participação de adolescentes e jovens na saúde foram afetadas, porém os mecanismos formais de participação, como os conselhos consultivos, permitiram sua continuidade. Nesse contexto, os jovens e adolescentes, em suas experiências, destacaram alguns fatores que facilitaram ou limitaram a participação, conforme três níveis de gestão: individual, relacional e estrutural. A comunicação virtual, o uso das redes sociais e a saúde digital destacaram-se como excelentes ferramentas para a participação de jovens e adolescentes em tempos de pandemia no Chile. Conclusão: A pandemia afetou os mecanismos de participação de jovens e adolescentes no Chile. No entanto, dentro das experiências destacadas pelos jovens, surgiram aspectos como comunicação virtual, saúde digital e outras estratégias que facilitaram a participação. Por outro lado, nessa crise de saúde mundial, aumentaram algumas lacunas na participação em saúde, como o acesso, principalmente em populações rurais.

Experiencias de participación en salud de adolescentes y jóvenes en tiempos de la pandemia de COVID-19 en Chile

[RESUMEN]. Objetivo. Develar las experiencias y determinantes de la participación de adolescentes y jóvenes en meca- nismos formales de participación durante la pandemia por SARS-CoV-2 en Chile. Métodos. Estudio transversal, descriptivo de enfoque cualitativo, adscrito al paradigma constructivista de investigación. Se realizaron 3 grupos focales con informantes claves, adolescentes y jóvenes, quienes parti- cipan regularmente en consejos consultivos del Ministerio de Salud (MINSAL) en Chile. Se aplicó la técnica de análisis de contenido para categorías teóricas y emergentes del estudio. Los relatos fueron transcritos y estudiados con técnica de análisis de datos y hermenéutica. Este estudio fue realizado durante la pandemia de COVID-19, entre los meses de marzo y noviembre del 2021. Resultados. Durante la pandemia, las experiencias de participación en salud de adolescentes y jóvenes se vieron afectadas; no obstante, los mecanismos de participación formales, como los consejos consultivos, permitieron dar continuidad. En este contexto, adolescentes y jóvenes dentro de sus experiencias destacaron algunos factores que facilitaron o limitaron la participación, de acuerdo con tres niveles de gestión: individual, relacional y estructural, destacándo la comunicación virtual, el uso de redes sociales y la salud digital como excelentes herramientas para la participación de jóvenes y adolescentes en tiempos de pandemia en Chile. Conclusión. La pandemia ha afectado a los mecanismos de participación de adolescentes y jóvenes en Chile. No obstante, dentro de las experiencias destacadas por los jóvenes han surgido aspectos como la comunicación virtual, la salud digital y otras estrategias que han facilitado la participación. Por otro lado, en esta crisis sanitaria mundial se han acrecentado algunas brechas en la participación en salud, como el acceso principalmente en poblaciones rurales.

[ABSTRACT]. Objective. Shed light on the experiences and determinants of young people’s and adolescents’ participation in formal participation mechanisms during the SARS-CoV-2 pandemic in Chile. Methods. Cross-sectional, descriptive study with a qualitative approach, within the constructivist research paradigm. Three focus groups were conducted with key informants: young people and adolescents who regu- larly participate in advisory councils of Chile’s Ministry of Health (MINSAL). Content analysis was applied for theoretical and emerging categories in the study. The reports were transcribed and studied with data analysis and hermeneutics. This study was conducted during the COVID-19 pandemic, between the months of March and November 2021. Results. During the pandemic, adolescents’ and young people’s experiences of health participation were affected; however, formal participation mechanisms such as advisory councils allowed for continuity. In this context and based on their experiences, young people and adolescents highlighted some factors that facili- tated or limited their participation at three levels: individual, relational, and structural. They highlighted virtual communication, use of social networks, and digital health as excellent tools for the participation of young people and adolescents during the pandemic in Chile. Conclusion. The pandemic affected the participation mechanisms used by young people and adolescents in Chile; however, among the experiences highlighted by young people, aspects that facilitated participation emerged, such as virtual communication, digital health, and other strategies. At the same time, some gaps in health participation widened during this global health crisis, such as access mainly in rural populations.

[RESUMO]. Objetivo. Divulgar as experiências e determinantes da participação dos jovens e adolescentes em mecanis- mos formais de participação durante a pandemia de SARS-CoV-2 no Chile. Métodos. Estudo transversal, descritivo, com abordagem qualitativa, ligado ao paradigma construtivista de pesquisa. Foram realizados 3 grupos focais com informantes-chave: jovens e adolescentes que participam regularmente dos conselhos consultivos do Ministério da Saúde do Chile. Foi aplicada a técnica de análise de conteúdo para as categorias teóricas e emergentes do estudo. Os relatos foram transcritos e estudados com técnicas de análise de dados e hermenêutica. Este estudo foi realizado durante a pandemia de COVID-19, entre os meses de março e novembro de 2021. Resultados. Durante a pandemia, as experiências de participação de adolescentes e jovens na saúde foram afetadas, porém os mecanismos formais de participação, como os conselhos consultivos, permitiram sua continuidade. Nesse contexto, os jovens e adolescentes, em suas experiências, destacaram alguns fatores que facilitaram ou limitaram a participação, conforme três níveis de gestão: individual, relacional e estrutural. A comunicação virtual, o uso das redes sociais e a saúde digital destacaram-se como excelentes ferramentas para a participação de jovens e adolescentes em tempos de pandemia no Chile. Conclusão. A pandemia afetou os mecanismos de participação de jovens e adolescentes no Chile. No entanto, dentro das experiências destacadas pelos jovens, surgiram aspectos como comunicação virtual, saúde digital e outras estratégias que facilitaram a participação. Por outro lado, nessa crise de saúde mun- dial, aumentaram algumas lacunas na participação em saúde, como o acesso, principalmente em populações rurais.

Experiencias de participación en salud de adolescentes y jóvenes en tiempos de la pandemia de COVID-19 en Chile / Adolescents' and young people's experiences of health participation during the COVID-19 pandemic in Chile / Experiências de participação de adolescentes e jovens na saúde em tempos de pandemia de COVID-19 no Chile

RESUMEN Objetivo. Develar las experiencias y determinantes de la participación de adolescentes y jóvenes en mecanismos formales de participación durante la pandemia por SARS-CoV-2 en Chile. Métodos. Estudio transversal, descriptivo de enfoque cualitativo, adscrito al paradigma constructivista de investigación. Se realizaron 3 grupos focales con informantes claves, adolescentes y jóvenes, quienes participan regularmente en consejos consultivos del Ministerio de Salud (MINSAL) en Chile. Se aplicó la técnica de análisis de contenido para categorías teóricas y emergentes del estudio. Los relatos fueron transcritos y estudiados con técnica de análisis de datos y hermenéutica. Este estudio fue realizado durante la pandemia de COVID-19, entre los meses de marzo y noviembre del 2021. Resultados. Durante la pandemia, las experiencias de participación en salud de adolescentes y jóvenes se vieron afectadas; no obstante, los mecanismos de participación formales, como los consejos consultivos, permitieron dar continuidad. En este contexto, adolescentes y jóvenes dentro de sus experiencias destacaron algunos factores que facilitaron o limitaron la participación, de acuerdo con tres niveles de gestión: individual, relacional y estructural, destacándo la comunicación virtual, el uso de redes sociales y la salud digital como excelentes herramientas para la participación de jóvenes y adolescentes en tiempos de pandemia en Chile. Conclusión. La pandemia ha afectado a los mecanismos de participación de adolescentes y jóvenes en Chile. No obstante, dentro de las experiencias destacadas por los jóvenes han surgido aspectos como la comunicación virtual, la salud digital y otras estrategias que han facilitado la participación. Por otro lado, en esta crisis sanitaria mundial se han acrecentado algunas brechas en la participación en salud, como el acceso principalmente en poblaciones rurales.

ABSTRACT Objective. Shed light on the experiences and determinants of young people's and adolescents' participation in formal participation mechanisms during the SARS-CoV-2 pandemic in Chile. Methods. Cross-sectional, descriptive study with a qualitative approach, within the constructivist research paradigm. Three focus groups were conducted with key informants: young people and adolescents who regularly participate in advisory councils of Chile's Ministry of Health (MINSAL). Content analysis was applied for theoretical and emerging categories in the study. The reports were transcribed and studied with data analysis and hermeneutics. This study was conducted during the COVID-19 pandemic, between the months of March and November 2021. Results. During the pandemic, adolescents' and young people's experiences of health participation were affected; however, formal participation mechanisms such as advisory councils allowed for continuity. In this context and based on their experiences, young people and adolescents highlighted some factors that facilitated or limited their participation at three levels: individual, relational, and structural. They highlighted virtual communication, use of social networks, and digital health as excellent tools for the participation of young people and adolescents during the pandemic in Chile. Conclusion. The pandemic affected the participation mechanisms used by young people and adolescents in Chile; however, among the experiences highlighted by young people, aspects that facilitated participation emerged, such as virtual communication, digital health, and other strategies. At the same time, some gaps in health participation widened during this global health crisis, such as access mainly in rural populations.

RESUMO Objetivo. Divulgar as experiências e determinantes da participação dos jovens e adolescentes em mecanismos formais de participação durante a pandemia de SARS-CoV-2 no Chile. Métodos. Estudo transversal, descritivo, com abordagem qualitativa, ligado ao paradigma construtivista de pesquisa. Foram realizados 3 grupos focais com informantes-chave: jovens e adolescentes que participam regularmente dos conselhos consultivos do Ministério da Saúde do Chile. Foi aplicada a técnica de análise de conteúdo para as categorias teóricas e emergentes do estudo. Os relatos foram transcritos e estudados com técnicas de análise de dados e hermenêutica. Este estudo foi realizado durante a pandemia de COVID-19, entre os meses de março e novembro de 2021. Resultados. Durante a pandemia, as experiências de participação de adolescentes e jovens na saúde foram afetadas, porém os mecanismos formais de participação, como os conselhos consultivos, permitiram sua continuidade. Nesse contexto, os jovens e adolescentes, em suas experiências, destacaram alguns fatores que facilitaram ou limitaram a participação, conforme três níveis de gestão: individual, relacional e estrutural. A comunicação virtual, o uso das redes sociais e a saúde digital destacaram-se como excelentes ferramentas para a participação de jovens e adolescentes em tempos de pandemia no Chile. Conclusão. A pandemia afetou os mecanismos de participação de jovens e adolescentes no Chile. No entanto, dentro das experiências destacadas pelos jovens, surgiram aspectos como comunicação virtual, saúde digital e outras estratégias que facilitaram a participação. Por outro lado, nessa crise de saúde mundial, aumentaram algumas lacunas na participação em saúde, como o acesso, principalmente em populações rurais.

[Disparities in the use of mental health services of adolescents in Chile]. / Disparidades en el uso de servicios de salud mental de adolescentes en Chile.

OBJECTIVE: To examine disparities in the use of mental health services (MHS) in adolescents according to sociodemographic factors. SUBJECTS AND METHOD: 2,022 adolescents aged 13-19 years in Santiago, Chile, participated in the study. Between April and May 2008, they answered a self-report survey that assessed lifetime (history of treatment for depression) and current (psychological or pharmacological treatment) use of MHS, sociodemographic variables, and psychopathology as symptoms of depression, symptoms of generalized anxiety disorder, and risk of problematic substance use. Data were analyzed using logistic regression. RESULTS: 16.5% of participants reported lifetime use of MHS due to depression, 9.7% were on current psychological treatment, and 2.7% were on current pharmacological treatment. Among those meeting criteria for a mental health problem, only 14.9% to 18.9% were currently on treatment. Males, younger participants, and those who had immigrants' parents reported lower lifetime use of MHS due to depression. Those with parents with 9 to 12 years of education and who had immigrants' parents reported lower current MHS use. Youth not living with both parents reported higher lifetime and current MHS use. CONCLUSIONS: We observe a high treatment gap in those with mental health needs as well as differences in MHS use based on socio-demographic variables. These results may be useful for planning interventions that favor access to and use of MHS, especially in the most disadvantaged groups of adolescents.

[Public health measures during the COVID-19 pandemic in institutions for the protection of children and adolescents in two departments in ColombiaMedidas de saúde pública em instituições de proteção de crianças e adolescentes em dois departamentos da Colômbia durante a pandemia de COVID-19]. / Medidas de salud pública en instituciones de protección a la infancia y la adolescencia en dos departamentos de Colombia durante la pandemia de COVID-19.

Objective: Analyze facilitating processes, obstacles, and effects of the implementation of non-pharmacological public health measures for the prevention of COVID-19 in child and adolescent protection centers in two departments (Antioquia and La Guajira) in Colombia during the period 2020-2021. Methods: Mixed methods study with a convergent parallel design in 13 residential child/adolescent protection facilities in Colombia (11 in Antioquia and two in La Guajira). A questionnaire was given to 145 children and adolescents, and 23 interviews were held with persons responsible for the implementation of measures in the national family welfare system. Results: The implemented non-pharmacological public health measures did not differ by department; the most complex to implement were physical distancing and restriction of family visits. Conclusions: In centers for the protection of children and adolescents in Antioquia and La Guajira, non-pharmacological public health measures helped mitigate the spread of the virus in environments considered at-risk.

Objetivo: Analisar os processos que facilitam e dificultam a implementação de medidas não farmacológicas de saúde pública para a prevenção da COVID-19 em centros de proteção de crianças e adolescentes em dois departamentos (Antioquia e La Guajira) da Colômbia, e os efeitos de tal implementação, durante o período 2020-2021. Métodos: Estudo de métodos mistos com delineamento paralelo convergente em 13 internatos para a proteção de crianças e adolescentes na Colômbia (11 em Antioquia e 2 em La Guajira). Foi aplicado um questionário a 145 crianças e adolescentes, e foram realizadas 23 entrevistas com os responsáveis pela implementação das medidas do sistema nacional de bem-estar familiar. Resultados: As medidas não farmacológicas de saúde pública implementadas não diferiram por departamento. As mais complexas de serem aplicadas foram o distanciamento físico e a restrição de visitas familiares. Conclusões: Nos centros de proteção de crianças e adolescentes de Antioquia e La Guajira, medidas não farmacológicas de saúde pública contribuíram para mitigar a propagação do vírus em ambientes considerados de risco.

Medidas de salud pública en instituciones de protección a la infancia y la adolescencia en dos departamentos de Colombia durante la pandemia de COVID-19

[RESUMEN]. Objetivo. Analizar los procesos facilitadores y obstaculizadores y los efectos de la implementación de las medidas de salud pública no farmacológicas para la prevención de la COVID-19 en los centros de protección de la infancia y la adolescencia de dos departamentos (Antioquia y la Guajira) de Colombia durante el período 2020-2021. Métodos. Estudio de métodos mixtos con un diseño paralelo convergente en 13 internados de protección de la infancia y adolescencia de Colombia (11 en Antioquia y 2 en La Guajira). Se aplicó un cuestionario a 145 niñas, niños y adolescentes y 23 entrevistas a mediadores de la implementación de las medidas del sistema nacional de bienestar familiar. Resultados. Las medidas de salud pública no farmacológicas implementadas no difieren por departamento; las más complejas para aplicar fueron el distanciamiento físico y la restricción de las visitas familiares. Conclusiones. En los centros de protección de la infancia y la adolescencia de Antioquia y la Guajira, las medidas de salud pública no farmacológicas contribuyeron a mitigar la propagación del virus en entornos considerados de riesgo.

[ABSTRACT]. Objective. Analyze facilitating processes, obstacles, and effects of the implementation of non-pharmacologi- cal public health measures for the prevention of COVID-19 in child and adolescent protection centers in two departments (Antioquia and La Guajira) in Colombia during the period 2020–2021. Methods. Mixed methods study with a convergent parallel design in 13 residential child/adolescent protection facilities in Colombia (11 in Antioquia and two in La Guajira). A questionnaire was given to 145 children and adolescents, and 23 interviews were held with persons responsible for the implementation of measures in the national family welfare system. Results. The implemented non-pharmacological public health measures did not differ by department; the most complex to implement were physical distancing and restriction of family visits. Conclusions. In centers for the protection of children and adolescents in Antioquia and La Guajira, non-phar- macological public health measures helped mitigate the spread of the virus in environments considered at-risk.

[RESUMO]. Objetivo. Analisar os processos que facilitam e dificultam a implementação de medidas não farmacológi- cas de saúde pública para a prevenção da COVID-19 em centros de proteção de crianças e adolescentes em dois departamentos (Antioquia e La Guajira) da Colômbia, e os efeitos de tal implementação, durante o período 2020-2021. Métodos. Estudo de métodos mistos com delineamento paralelo convergente em 13 internatos para a proteção de crianças e adolescentes na Colômbia (11 em Antioquia e 2 em La Guajira). Foi aplicado um questionário a 145 crianças e adolescentes, e foram realizadas 23 entrevistas com os responsáveis pela implementação das medidas do sistema nacional de bem-estar familiar. Resultados. As medidas não farmacológicas de saúde pública implementadas não diferiram por departa- mento. As mais complexas de serem aplicadas foram o distanciamento físico e a restrição de visitas familiares. Conclusões. Nos centros de proteção de crianças e adolescentes de Antioquia e La Guajira, medidas não farmacológicas de saúde pública contribuíram para mitigar a propagação do vírus em ambientes considera- dos de risco.

Condiciones de salud enfermedad bucal en adolescentes embarazadas indígenas y no indígenas de Maracaibo-Venezuela / Health conditions oral disease in indigenous and non-indigenous pregnant adolescents from Maracaibo- Venezuela

RESUMEN Objetivo : Comparar las condiciones de salud enfermedad bucal en adolescentes embarazadas indígenas y no indígenas de Maracaibo-Venezuela. Material y Métodos : Fue un estudio epidemiológico, transversal con un diseño de campo, no experimental. La muestra fue de 121 adolescentes embarazadas de la consulta prenatal del Hospital Materno Infantil "Eduardo Soto Peña" y de la Maternidad "Dr. Armando Castillo Plaza" de Maracaibo. Se realizó examen clínico según los criterios de la Organización Mundial de la Salud, se midieron los índices CPO, ISC, IHO-S e IPC. Para procesar los datos se utilizó el software SPSS® versión 25 y se aplicó tanto prueba de t para muestras independientes como Chi cuadrado. Resultados : La experiencia de caries fue 91,7%, el índice CPO fue de 6,84±4,173 y el ISC 11,42±2,374. Para la condición periodontal, el 41,3% presentó condición sana, un 53,7% tenía gingivitis y el 5% presentó periodontitis. El grupo de embarazadas no indígenas tuvo un índice CPO más alto 7,19±4,066 en comparación con un 5,52±4,398 para las indígenas. Respecto a la condición periodontal consolidada, el 52% del grupo de indígenas presentó gingivitis y el resto resultó sana y entre las no indígenas el 54% presentó gingivitis, el 6% tenía periodontitis y el 40% estaba sana. Conclusiones : En este estudio, no se observaron diferencias entre las condiciones de salud enfermedad bucal de las adolescentes embarazadas indígenas y no indígenas. Sin embargo, es necesario dar prioridad a la atención del componente bucal de las adolescentes durante el embarazo.

ABSTRACT Objective: Compare the oral disease health conditions in indigenous and non-indigenous pregnant adolescents from Maracaibo-Venezuela. Material and Methods : It was an epidemiological, cross-sectional study with a field design, not experimental. The sample was 121 pregnant adolescents from the prenatal consultation of the Maternal and Child Hospital "Eduardo Soto Peña" and the Maternity "Dr. Armando Castillo Plaza" in Maracaibo. Clinical examination was performed according to the criteria of the World Health Organization, DMFT, SCI, SOH-I and PCI indexes were measured. SPSS® version 25 software was used to process the data and both the t-test for independent samples and Chi square were applied. Results : the caries experience was 91.7%, the DMFT index was 6.84 ± 4.173 and the SCI was 11.42 ± 2.374. For the periodontal condition, 41.3% had a healthy condition, 53.7% had gingivitis and 5% had periodontitis. The group of non-indigenous pregnant women had a higher DMFT index of 7.19 ± 4.066 compared to 5.52 ± 4.398 for indigenous women. Regarding the consolidated periodontal condition, 52% of the indigenous group presented gingivitis and the rest were healthy and among the non-indigenous 54% presented gingivitis, 6% had periodontitis and 40% was healthy. Conclusion : In this study, no differences were observed between the oral disease health conditions of indigenous and non-indigenous pregnant adolescents. However, it is necessary to give priority to the attention of the oral component of adolescent girls during pregnancy.

Barreras y opciones de política para el acceso a los servicios de salud mental de adolescentes y jóvenes de los pueblos indígenas de la provincia de Condorcanqui. Amazonas, Perú 2021

[Prológo]. En la provincia peruana de Condorcanqui, ubicada en la región Amazonas, los y las adolescentes de las comunidades indígenas enfrentan diversos obstáculos para acceder a los servicios de salud mental. Para una mayor comprensión de estas barreras y un efectivo diseño e implementación de políticas para superarlas, la OPS en colaboración con la Dirección Regional de Salud (DIRESA) Amazonas y la Red de Salud de Condorcanqui, ha conducido un análisis y un posterior proceso participativo de identificación de opciones de política. Esperamos que los hallazgos presentados resulten de utilidad para la toma de decisiones por parte de las autoridades de salud y sus socios estratégicos en todos los niveles, en particular para la planificación de políticas que permitan mejorar el acceso a los servicios de salud mental por parte de las poblaciones más vulnerables. Cabe añadir que esta iniciativa se enmarca en el largo historial de colaboración entre la OPS y el Ministerio de Salud de Perú, para fortalecer el sistema sanitario del país y mejorar el acceso a los servicios de salud en toda la región de las Américas.

Barreras y opciones de política para el acceso a los servicios de salud mental de adolescentes y jóvenes de los pueblos indígenas de la provincia de Condorcanqui. Amazonas, Perú 2021 / Barriers and policy options for access to mental health services for adolescents and young people of the indigenous peoples of the province of Condorcanqui. Amazon, Peru 2021

En la provincia peruana de Condorcanqui, ubicada en la región Amazonas, los y las adolescentes de las comunidades indígenas enfrentan diversos obstáculos para acceder a los servicios de salud mental. Para una mayor comprensión de estas barreras y un efectivo diseño e implementación de políticas para superarlas, la OPS en colaboración con la Dirección Regional de Salud (DIRESA) Amazonas y la Red de Salud de Condorcanqui, ha conducido un análisis y un posterior proceso participativo de identificación de opciones de política. Esperamos que los hallazgos presentados resulten de utilidad para la toma de decisiones por parte de las autoridades de salud y sus socios estratégicos en todos los niveles, en particular para la planificación de políticas que permitan mejorar el acceso a los servicios de salud mental por parte de las poblaciones más vulnerables. Cabe añadir que esta iniciativa se enmarca en el largo historial de colaboración entre la OPS y el Ministerio de Salud de Perú, para fortalecer el sistema sanitario del país y mejorar el acceso a los servicios de salud en toda la región de las Américas

Precocidad de inicio del consumo de sustancias psicoactivas y su relación con otros comportamientos de riesgo para la salud en adolescentes chilenos / Association between early onset of psychoactive drug use and health risk behaviors in chilean adolescents

BACKGROUND: Adolescents are more prone to develop health risk behaviors. Among these, early consumption of psychoactive drugs is relevant. AIM: To assess the association between early consumption of illicit drugs, tobacco and alcohol, suicide behaviors, risky sexual behaviors, eating habits and physical activity in school age adolescents from Valparaiso, Chile. MATERIAL AND METHODS: The online world survey of scholar health to identify the health risk behaviors was answered by 550 adolescents aged 15 to 18 years, from a public educational institution at Valparaiso, Chile. Results: Early consumption of alcohol, smoking and illicit drug use was reported by 59, 57 and 44% of respondents, respectively. The frequency of psychoactive drug consumption during the last month, risky sexual behaviors and missing breakfast was higher among those with an early onset of alcohol and illicit drug consumption and smoking. The frequency of suicidal risk behaviors and low consumption of fruits and vegetables was higher among those with an early onset of illicit drug use and smoking. A low physical activity level was associated with early smoking onset. Health risk behaviors were associated with early onset of alcohol and illicit drug consumption and smoking. CONCLUSIONS: Early onset of alcohol and illicit drug consumption and smoking is associated with health risk behaviors in Chilean adolescents.

Embarazo en la adolescencia y los indicadores de salud materna y perinatal / Adolescent pregnancy and maternal and perinatal health indicators

Introducción: El embarazo en la adolescencia es un problema de salud pública, con reconocida influencia en los aspectos socioeconómicos y psicoemocionales de la gestante, que puede influir en los indicadores de salud materna. Objetivo: Determinar el impacto del embarazo adolescente sobre los indicadores de salud materna y perinatal. Material y Métodos: Estudio retrospectivo y descriptivo, en una población de 5 920 gestantes atendidas en el Hospital San Juan de Lurigancho durante el año 2018, para la determinación de indicadores de salud materna, como la tasa de mortalidad y morbilidad materna (TMM y TMbM) y perinatal (TMP y TMbP), considerando dos grupos de análisis, mujeres gestantes entre 10 y 19 años y mayores de 19 años de edad. Resultados: Se atendieron 14,5 por ciento partos de mujeres adolescentes entre 10 y 19 años de edad, grupo en el cual se presentaron TMbM y TMbP de 10,8 y 80,3 respectivamente, en contraposición a las tasas de 8,8 y 43,3 en el grupo de mujeres gestantes mayores de 19 años. La TMP fue de 6,9 y 10,4 en los grupos de gestantes adolescentes y mujeres adultas, respectivamente, mientras que la TMM fue de 19,9 en mujeres adultas. No se registró fallecimiento de pacientes adolescentes. Conclusiones: El embarazo en la adolescencia influyó significativamente en el indicador de salud materna TMbP, probablemente debido a la falta de control prenatal temprano, además de la inmadurez y la estructura ósea de la pelvis, siendo factores que pueden determinar problemas de salud en los neonatos(AU)

Introduction: Adolescent pregnancy is a public health problem with recognized influence on the socioeconomic and psycho-emotional aspects of the pregnant woman, which can influence maternal health indicators. Objective: To determine the impact of adolescent pregnancy on maternal and perinatal health indicators. Material and Methods: A retrospective and descriptive study was conducted in a population of 5 920 pregnant women attended at the Hospital San Juan de Lurigancho during 2018 to determine maternal health indicators such as maternal mortality and morbidity rate (MMR and MMR) and perinatal (MMR and PMR), considering two groups of analysis that included pregnant women between 10 and 19 years of age and those older than 19 years of age. Results: There were 14,5 percent of deliveries in adolescent women between 10 and 19 years of age, a group in which MMR and PMR were 10,8 and 80,3 respectively, in contrast to the rates of 8,8 and 43,3 in the group of pregnant women older than 19 years of age. The PMR was 6,9 and 10,4 in the groups of pregnant adolescent women and adult women, respectively, while the MMR was 19,9 in adult women. No deaths were recorded in adolescent patients. Conclusions: Adolescent pregnancy significantly influenced the maternal health indicator PMR, probably due to the lack of early prenatal control, as well as the immaturity and the bony structure of the pelvis, being factors that can determine health problems in neonates(AU)

[Association between early onset of psychoactive drug use and health risk behaviors in chilean adolescents]. / Precocidad de inicio del consumo de sustancias psicoactivas y su relación con otros comportamientos de riesgo para la salud en adolescentes chilenos.

BACKGROUND: Adolescents are more prone to develop health risk behaviors. Among these, early consumption of psychoactive drugs is relevant. AIM: To assess the association between early consumption of illicit drugs, tobacco and alcohol, suicide behaviors, risky sexual behaviors, eating habits and physical activity in school age adolescents from Valparaiso, Chile. MATERIAL AND METHODS: The online world survey of scholar health to identify the health risk behaviors was answered by 550 adolescents aged 15 to 18 years, from a public educational institution at Valparaiso, Chile. RESULTS: Early consumption of alcohol, smoking and illicit drug use was reported by 59, 57 and 44% of respondents, respectively. The frequency of psychoactive drug consumption during the last month, risky sexual behaviors and missing breakfast was higher among those with an early onset of alcohol and illicit drug consumption and smoking. The frequency of suicidal risk behaviors and low consumption of fruits and vegetables was higher among those with an early onset of illicit drug use and smoking. A low physical activity level was associated with early smoking onset. Health risk behaviors were associated with early onset of alcohol and illicit drug consumption and smoking. CONCLUSIONS: Early onset of alcohol and illicit drug consumption and smoking is associated with health risk behaviors in Chilean adolescents.

[Compliance with the Dietary Guidelines in Chilean adolescents: a cross-sectional study of the Chilean National Health Survey 2016-2017]. / Cumplimiento de las Guías Alimentarias en adolescentes chilenos: un estudio transversal de la Encuesta Nacional de Salud 2016-2017.

In Chile, compliance with the Food-Based Dietary Guidelines (GABA) ensures an adequate and ba lanced diet. OBJECTIVE: To determine compliance with five GABA recommendations and their asso ciations with anthropometric, lifestyle, and metabolic variables, in adolescents aged between 15 and 19 years who participated in the Chilean National Health Survey 2016-2017. SUBJECTS AND METHOD: Cross-sectional study including 355 adolescents. Participants were divided into four groups (fulfilled 0, 1, 2, or ≥ 3 recommendations) using five messages from the GABA (consumption of legumes, fish, dairy products, water, and fruits and vegetables). Associations between GABA and outcome variables (weight, body mass index, waist circumference, physical activity, sleep, and metabolic variables) were investigated using linear regression analyses adjusted by sociodemographic confounders. RESULTS: 5.6% of the adolescents met three or more GABA recommendations. Of the recommendations mea sured, the consumption of water (85%) and legumes (78.7%) presented greater compliance, showing differences between women and men regarding the consumption of legumes (58.6% vs. 86.4%), wa ter (69.6% vs. 91%), and dairy products (92.9% vs. 39.1%). Adolescents with higher compliance with GABA had a better concentration of lower glycemia (p = 0.025). There were no other significant asso ciations between lifestyle and anthropometric measurements. CONCLUSIONS: Adolescents who partici pated in this study presented difficulties in adhering to GABA recommendations, thus compromising the maintenance of healthy lifestyles.

Medidas de salud pública en instituciones de protección a la infancia y la adolescencia en dos departamentos de Colombia durante la pandemia de COVID-19 / Public health measures during the COVID-19 pandemic in institutions for the protection of children and adolescents in two departments in Colombia / Medidas de saúde pública em instituições de proteção de crianças e adolescentes em dois departamentos da Colômbia durante a pandemia de COVID-19

RESUMEN Objetivo. Analizar los procesos facilitadores y obstaculizadores y los efectos de la implementación de las medidas de salud pública no farmacológicas para la prevención de la COVID-19 en los centros de protección de la infancia y la adolescencia de dos departamentos (Antioquia y la Guajira) de Colombia durante el período 2020-2021. Métodos. Estudio de métodos mixtos con un diseño paralelo convergente en 13 internados de protección de la infancia y adolescencia de Colombia (11 en Antioquia y 2 en La Guajira). Se aplicó un cuestionario a 145 niñas, niños y adolescentes y 23 entrevistas a mediadores de la implementación de las medidas del sistema nacional de bienestar familiar. Resultados. Las medidas de salud pública no farmacológicas implementadas no difieren por departamento; las más complejas para aplicar fueron el distanciamiento físico y la restricción de las visitas familiares. Conclusiones. En los centros de protección de la infancia y la adolescencia de Antioquia y la Guajira, las medidas de salud pública no farmacológicas contribuyeron a mitigar la propagación del virus en entornos considerados de riesgo.

ABSTRACT Objective. Analyze facilitating processes, obstacles, and effects of the implementation of non-pharmacological public health measures for the prevention of COVID-19 in child and adolescent protection centers in two departments (Antioquia and La Guajira) in Colombia during the period 2020-2021. Methods. Mixed methods study with a convergent parallel design in 13 residential child/adolescent protection facilities in Colombia (11 in Antioquia and two in La Guajira). A questionnaire was given to 145 children and adolescents, and 23 interviews were held with persons responsible for the implementation of measures in the national family welfare system. Results. The implemented non-pharmacological public health measures did not differ by department; the most complex to implement were physical distancing and restriction of family visits. Conclusions. In centers for the protection of children and adolescents in Antioquia and La Guajira, non-pharmacological public health measures helped mitigate the spread of the virus in environments considered at-risk.

RESUMO Objetivo. Analisar os processos que facilitam e dificultam a implementação de medidas não farmacológicas de saúde pública para a prevenção da COVID-19 em centros de proteção de crianças e adolescentes em dois departamentos (Antioquia e La Guajira) da Colômbia, e os efeitos de tal implementação, durante o período 2020-2021. Métodos. Estudo de métodos mistos com delineamento paralelo convergente em 13 internatos para a proteção de crianças e adolescentes na Colômbia (11 em Antioquia e 2 em La Guajira). Foi aplicado um questionário a 145 crianças e adolescentes, e foram realizadas 23 entrevistas com os responsáveis pela implementação das medidas do sistema nacional de bem-estar familiar. Resultados. As medidas não farmacológicas de saúde pública implementadas não diferiram por departamento. As mais complexas de serem aplicadas foram o distanciamento físico e a restrição de visitas familiares. Conclusões. Nos centros de proteção de crianças e adolescentes de Antioquia e La Guajira, medidas não farmacológicas de saúde pública contribuíram para mitigar a propagação do vírus em ambientes considerados de risco.

Hospitalización domiciliaria en niños y adolescentes con necesidades especiales de atención en salud (NANEAS): perspectivas financieras en hospital de alta complejidad, Chile / Home hospitalization in children and youth with special health care needs (cyshcn): financial perspectives in hospital de alta complexidad, Chile

Introducción. La ausencia de hospitalización domiciliaria (HD) de niños y adolescentes con necesidades especiales en salud de alta complejidad (NANEAS) genera hospitalizaciones prolongadas en la atención cerrada (AC). Objetivo: Comparar el gasto estimado de HD de NANEAS de alta complejidad versus costo real del mismo paciente en AC y su impacto en la producción hospitalaria. Métodos: Estudio descriptivo y comparativo entre costos de ambas modalidades de hospitalización de NANEAS de alta complejidad. De enero a diciembre 2016 se registraron hospitalizaciones NANEAS no oncológicos del Servicio de Pediatría (SP) según norma del Ministerio de Salud-Chile (MINSAL). Se clasificó para grupos clínicos y consumos similares de recursos según grupos relacionados al diagnóstico (GRD). Para evaluar el impacto en la producción hospitalaria la estancia fue ajustada y se realizó un análisis financiero de ambas modalidades (AC) y (HD). Resultados: De 3690 egresos, 126 (3,4%) se relacionaron a 27 NANEAS, la edad promedio fue 4,6 años (± 5 DS) con dependencias tecnológicas para vivir. La estancia media NANEAS fue 16 días, comparada con 5,9 de los pacientes sin necesidades especiales en salud. Las estancias NANEAS llegaron a 2017 días (8,6%). Prescindir de los egresos NANEAS hubiera aportado 320 egresos adicionales y su HD habría ahorrado US $15/día por paciente, que para el total de estancias consumidas habría sido un ahorro anual de US $ 29 170. Conclusiones: La HD tiene un costo estimado menor a la AC de NANEAS de alta complejidad, mejora la productividad hospitalaria y libera camas críticas con inversión financieramente viable.

Introduction. The absence of home hospitalization (HH) of children and youth with special health care needs (CYSHCN) generates prolonged hospitalizations in closed care (CC). Objective: To compare the estimated cost of HH of high complexity CYSHCN versus the actual cost of the same patient in CC and its impact on hospital production. Methods: Descriptive and comparative study between costs of both hospitalization modalities of high complexity CYSHCN. From January to December 2016, non-oncological CYSHCN hospitalizations were registered by the Pediatric Service (PS) according to the Ministry of Health-Chile (MINSAL) norm. It was classified for clinical groups and similar consumption of resources according to groups related to diagnosis (DRG). The stay was adjusted, and financial analysis of both modalities (CC) and (HH) was performed to evaluate the impact on hospital production. Results: Of 3690 discharges, 126 (3.4%) were related to 27 CYSHCN, the average age was 4.6 years (± 5 SD) with technological dependencies to live. The mean CYSHCN stay was 16 days, compared with 5.9 for patients without special health needs. CYSHCN stays reached 2017 days (8.6%). Disregarding the CYSHCN discharges would have contributed 320 additional discharges, and his HH would have saved US $ 15 / day per patient, which for the total number of stays consumed would have been an annual saving of US $ 29170. Conclusion: HH has an estimated cost lower than the CA of high complexity CYSHCN, improves hospital productivity, and frees critical beds with financially viable investment.