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1.
Rev Esp Salud Publica ; 952021 Mar 05.
Artículo en Español | MEDLINE | ID: mdl-33664220

RESUMEN

OBJECTIVE: The irruption of SARS-CoV-2 and its different incidence on the regional mortality rate could be revealing the effects of the change in the paradigm of health justice, initiated in Spain in 2010 and applied, more or less enthusiastically, by the different autonomous communities. The objective of this work was to look for if the socio-economic conditions and the policy of budgetary expenditure followed by the different Spanish autonomous communities have incidence, by themselves, on the mortality rate caused by the SARS-CoV-2. METHODS: Econometric research based on Multiple Linear Regression to determine the direct cause-effect relationship between the dependent variable, mortality associated with COVID-19, with explanatory variables of the health budget and socio-economic type. RESULTS: The number of deaths caused by COVID-19 has a positive relationship with the rate of GDP per capita and inversely with expenditure on hospital and specialized services, teaching and IRMs and with the resources allocated to health over the last nine years. A reduction in any of these health budget variables leads to an increase in mortality caused by COVID-19. CONCLUSIONS: The COVID-19 mortality rate has hit the wealthiest autonomous communities hardest but, above all, has hit those that, although richer, applied more restrictive budgetary measures in the period 2010-2018.


Asunto(s)
COVID-19/mortalidad , Gastos en Salud , COVID-19/economía , Costos de la Atención en Salud , Humanos , Modelos Econométricos , Pandemias/economía , Salud Pública/economía , Análisis de Regresión , España/epidemiología
2.
Rev. saúde pública (Online) ; 54: 22, 2020. tab, graf
Artículo en Inglés | LILACS | ID: biblio-1094420

RESUMEN

ABSTRACT OBJECTIVES This study examined the purchases of eculizumab, a high-cost monoclonal antibody used in the treatment of rare diseases by Brazilian federal agencies, in terms of purchased quantities, expenditures, and prices. METHODS Eculizumab purchases made between March 2007 and December 2018 were analyzed, using secondary data extracted from the Federal Government Purchasing System (SIASG in Portuguese). The following aspects were assessed: number of purchases, purchased quantities, number of daily doses defined per 1,000 inhabitants per year, annual expenditures, and prices. The prices were adjusted by the National Broad Consumer Price Index for December 2018. Linear regression was used for trend analysis. RESULTS All acquisitions by federal agencies were made by the Brazilian Ministry of Health. The purchases began in 2009 with tender waiver to comply with legal demand. There was an increasing trend in the number of purchases and quantities acquired over time. Two hundred and eighty-three purchases were made, totaling 116,792 units purchased, 28.2% of them in 2018. The adjusted total expenses summed more than R$ 2.44 billion. After market approval by the Brazilian Health Regulatory Agency, the weighted average price fell approximately 35%, to values under the Medicines Market Chamber of Regulation established prices. CONCLUSION Eculizumab represented extremely significant expenditures for the Brazilian Ministry of Health during the period. All purchases were made to meet demands from lawsuits, outside the competitive environment. The market approval of eculizumab promoted an important price reduction. This study indicates the relevance of licensing and the need for permanent monitoring and auditing of drug purchases to meet legal demands.


RESUMO OBJETIVOS O estudo examinou as aquisições de eculizumabe, um anticorpo monoclonal de alto custo utilizado no tratamento de doenças raras, pelos órgãos federais brasileiros, em termos das quantidades compradas, gastos e preços. MÉTODOS Foram analisadas compras de eculizumabe realizadas entre março de 2007 e dezembro de 2018, por meio de dados secundários extraídos do sistema de compras do governo federal (Siasg). Foram examinados o número de compras, quantidades adquiridas, número de doses diárias definidas por 1.000 habitantes por ano, gastos anuais e preços praticados. Os preços foram corrigidos pelo índice nacional de preços ao consumidor amplo para dezembro de 2018. Regressão linear foi utilizada para análises de tendência. RESULTADOS Todas as aquisições por órgãos federais foram realizadas pelo Ministério da Saúde. As compras se iniciaram em 2009, sendo efetuadas por dispensa de licitação e para atendimento de demanda judicial. Houve tendência crescente no número de compras e quantidades adquiridas ao longo do tempo. Foram realizadas 283 compras, totalizando 116.792 unidades adquiridas, 28,2% compradas em 2018. Os gastos totais contratados corrigidos somaram mais de R$ 2,44 bilhões. Após a aprovação do registro pela Agência Nacional de Vigilância Sanitária, o preço médio ponderado caiu aproximadamente 35%, para valores abaixo dos preços estabelecidos pela Câmara de Regulação do Mercado de Medicamentos. CONCLUSÃO O eculizumabe representou gastos extremamente significativos para o Ministério da Saúde no período. Todas as compras foram feitas para atendimento de demandas judiciais, fora do ambiente competitivo. Seu registro promoveu queda importante nos preços praticados. O estudo aponta a relevância do registro sanitário e da necessidade de monitoramento e auditoria permanentes das compras de medicamentos para atendimento de demandas judiciais.


Asunto(s)
Humanos , Gastos en Salud , Gobierno Federal , Anticuerpos Monoclonales Humanizados/economía , Brasil , Control de Medicamentos y Narcóticos/legislación & jurisprudencia , Inactivadores del Complemento , Inactivadores del Complemento/economía , Agencias Gubernamentales
3.
Rev. urug. enferm ; 14(2): 7-14, dic. 2019.
Artículo en Español | LILACS, BDENF - Enfermería, BNUY, BNUY-Enf | ID: biblio-1051251

RESUMEN

La tuberculosis continúa siendo uno de los problemas de salud pública más importantes a nivel mundial. La estrategia "Fin a la Tuberculosis" desarrollada por la Organización Mundial de la Salud busca acabar con la epidemia mundial para el año 2035, para lo cual los países deben fortalecer sus programas nacionales. Uruguay en 2016 presentó una incidencia de tuberculosis pulmonar de 22 por 100 mil habitantes, con una tendencia de la velocidad en ascenso desde 2005. Objetivos: Describir la situación epidemiológica de la tuberculosis en el departamento de Maldonado-Uruguay, tomando como fuente primaria, la base de datos del Registro Nacional de Tuberculosis, brindada por la Comisión Honoraria de Lucha Antituberculosa y Enfermedades Prevalentes de Uruguay, en el período comprendido entre el 2012 al 2016. Materiales y Métodos: Estudio descriptivo a partir de la revisión de datos proporcionados por el Registro Nacional de Tuberculosis, sobre notificaciones de casos pulmonares y extrapulmonares confirmados y no confirmados, brindado por la Comisión Honoraria de Lucha Antituberculosa y Enfermedades Prevalentes del Ministerio de Salud Pública de Uruguay. Resultados: En el año 2016 la tasa de casos confirmados en el departamento de Maldonado fue de 34 por 100 mil habitantes, siendo el departamento de Uruguay que presentó en ese año la mayor tasa por 100 mil habitantes de casos confirmados pulmonares bacilíferos. Se evidencia una baja cobertura de quimioprofilaxis a contactos declarados. Conclusiones: La tasa de casos por departamento fue mayor que la cifra para el total país, siendo esa diferencia de tasas estadísticamente significativa. La tuberculosis evidencia un problema de salud pública esencial, la vulnerabilidad social y la baja cobertura de quimioprofilaxis de los contactos son dos dimensiones importantes en el abordaje de este problema. Es necesario implementar una propuesta de descentralización supervisada del diagnóstico, tratamiento y profilaxis en Maldonado-Uruguay.


Tuberculosis continues to be one of the most important public health problems worldwide. The "End of Tuberculosis" strategy developed by the World Health Organization seeks to end the global epidemic by 2035, for which countries must strengthen their national programs. Uruguay in 2016 presented an incidence of pulmonary tuberculosis of 22 per 100 thousand inhabitants, with a tendency of the speed in ascent since 2005. Objectives: To describe the epidemiological situation of tuberculosis in the department of Maldonado-Uruguay, using as a primary source, the database of the National Registry of Tuberculosis, provided by the Honorary Commission of Antituberculosis and Prevalent Diseases of Uruguay, in the period included between 2012 to 2016. Materials and Methods: Descriptive study based on the review of data provided by the National Registry of Tuberculosis, on notifications of confirmed and unconfirmed pulmonary and extrapulmonary cases, provided by the Honorary Commission for Antituberculosis and Prevalent Diseases of the Ministry of Public Health of Uruguay. Results: In 2016 the rate of confirmed cases in the department of Maldonado was 34 per 100 thousand inhabitants, being the department of Uruguay that presented in that year the highest rate per 100 thousand inhabitants of confirmed pulmonary smear-positive cases. Tere is evidence of low coverage of chemoprophylaxis at declared contacts. Conclusions: The case rate per department was greater than the figure for the total country, this difference being statistically signifi cant. Tuberculosis evidences an essential public health problem, social vulnerability and low coverage of chemoprophylaxis of contacts are two important dimensions in the approach to this problem. It is necessary to implement a proposal of supervised decentralization of diagnosis, treatment and prophylaxis in Maldonado-Uruguay.


TB continua a ser um dos problemas mais importantes de saúde pública global. A estratégia "Stop Tuberculose", desenvolvido pela Organização Mundial da Saúde busca acabar com a epidemia global até o ano de 2035, para os quais os países devem fortalecer seus programas nacionais. Uruguai em 2016 mostrou uma incidência de tuberculose pulmonar de 22 por 100 mil habitantes, com uma tendência de velocidade subindo desde 2005. Objetivos: descrever a situação epidemiológica da tuberculose no departamento de Maldonado--Uruguay, tomando-se como um banco de dados fonte primária do Registro Nacional de Tuberculose, fornecidos pelo Comitê Honorário de Luta contra a Tuberculose e Doenças Prevalentes do Uruguai, no período 2012-2016. Materiais e Métodos: Estudo descritivo com base na revisão dos dados fornecidos pelo Instituto Nacional de Tuberculose Register, as notificações de casos pulmonar e extrapulmonar confirmados e não confirmados de que o Comitê Honorário de Luta contra a Tuberculose e Doenças Prevalentes, Ministério da Saúde Pública Uruguai. Resultados: Em 2016 a taxa de casos confirmados no departamento de Maldonado foi de 34 por 100 mil habitantes, departamento Uruguai nesse ano apresentou a maior taxa por 100 mil habitantes de casos pulmonares com baciloscopia positiva confirmados. baixa cobertura da quimioprofilaxia para os contatos declarou evidências. Conclusões: A taxa por departamento foi maior do que a figura para todo o país, com a diferença de taxas estatisticamente significativas. Tuberculose evidenciar um problema de saúde pública essencial, vulnerabilidade social e baixa cobertura da quimioprofilaxia dos contatos são duas dimensões importantes na resolução deste problema. Você precisa implementar uma proposta de descentralização supervisionada de diagnóstico, tratamento e profilaxia em Maldonado-Uruguay.


Asunto(s)
Humanos , Infecciones Bacterianas , Tuberculosis Pulmonar , Uruguay , Salud Pública , Epidemiología , Incidencia , Interpretación Estadística de Datos , Quimioprevención
4.
Rev Esp Salud Publica ; 932019 Feb 22.
Artículo en Español | MEDLINE | ID: mdl-30783077

RESUMEN

OBJECTIVE: The Spanish economic crisis began in 2008 and according to the Ministry of Economy, Industry and Compe- titiveness it concluded in 2014. During the crisis the main macroeconomic indicators had an adverse evolution and the effects have lasted for more than six years to the present. Aim: To assess the influence on public spending (health and pharmaceutical) that the governing policies have had and the time of crisis suffered. METHODS: Public expenditure per inhabitant (health and pharmaceutical) is compared according to the study period (pre, crisis and post), the political ideology of the ruling party (conservative/ progressive) and each autonomous community in reference to GDP per inhabitant in each of they respect the national average (poor, average or rich) according to the quartiles. The sources of the data have been the National Statistics Institute (GDP and inhabitants of each Autonomous Community and study period) and the Ministry of Health, Social Services and Equality (public health and pharmaceutical expenditure). The statistical procedures (SPSS v24) included descriptive and inferential analysis for public healthcare and pharmaceutical expenditure according to the period of study and ideology. There was also a regression fit to know the relative importance of predictor varibles. RESULTS: During the crisis period there were differences in public health expenditure per inhabitant in the different types of Autonomous Communities (poor / medium / rich) and according to political ideology (p <0.05). Public pharmaceutical expenditure was € 327 / inhab (pre-crisis) to € 366 / inhabitant in the final period of the study. There were statistically significant differences in pharmaceutical expenditure according to the different types of CCAA. Likewise, differences were found in per capita pharmaceutical expenditure between the Autonomous Communities run by conservatives and type of Autonomous Communities throughout the study period. CONCLUSIONS: The community pharmaceutical expenditure per capita has decreased by more than 13% since 2006 until 2017, while the hospital pharmaceutical expenditure has increased by more than 84%. Rich regions invest more in the health care costs and the poor more than drugs.


Asunto(s)
Recesión Económica , Gastos en Salud/tendencias , Política de Salud/economía , Disparidades en Atención de Salud/tendencias , Política de Salud/tendencias , Disparidades en Atención de Salud/economía , Humanos , Salud Pública/economía , Salud Pública/tendencias , Análisis de Regresión , España
5.
Rev. esp. salud pública ; 93: 0-0, 2019. tab, graf
Artículo en Español | IBECS | ID: ibc-189522

RESUMEN

OBJETIVO: La crisis económica española se inició en el año 2008 y según el Ministerio de Economía, Industria y Competitividad concluyó en el año 2014. Durante la crisis los principales indicadores macroeconómicos tuvieron una evolución adversa y los efectos se han prolongado durante más de seis años hasta la actualidad. El objetivo de este trabajo fue valorar la influencia en el gasto público (sanitario y farmacéutico) que han tenido las políticas gobernantes y el tiempo de crisis sufrido. MÉTODOS: Se compara el gasto público por habitante (sanitario y farmacéutico) según el período de estudio (pre, crisis y post), la ideología política del partido gobernante (conservador/ progresista) y cada comunidad autónoma en referencia al PIB por habitante en cada una de ellas respecto de la media nacional (pobres, en la media o ricas) según los cuartiles. Las fuentes de los datos han sido el INE (PIB y habitantes de cada CCAA y periodo de estudio) y del Ministerio de Sanidad, Servicios Sociales e Igualdad (gasto público sanitario y farmacéutico). El examen estadístico (SPSS 24) incluyó análisis descriptivo e inferencial del gasto sanitario y farmacéutico publico según el período de estudio e ideología, también se realizó un ajuste de regresión para conocer la importancia relativa de las variables predictoras. RESULTADOS: Durante el período de crisis hubo diferencias en el gasto sanitario público por habitante en los distintos tipos de CCAA (pobres/medias/ricas) y según ideología política gobernante (p <0,05). El gasto farmacéutico público pasó de 327 €/hab (pre-crisis) a 366 €/hab en el período final del estudio. Hubo diferencias estadísticamente significativas en el gasto farmacéutico según los distintos tipos de CCAA. De igual forma se encontraron diferencias en el gasto farmacéutico por habitante entre las CCAA regentadas por conservadores y tipo de CCAA a lo largo de todo el período de estudio. CONCLUSIONES: El gasto farmacéutico comunitario por habitante ha disminuido en más del 13% desde 2006 hasta 2017, mientras que el gasto farmacéutico hospitalario se ha incrementado en más del 84%. Las CCAA ricas invierten más en gasto sanitario y las pobres más de medicamentos


OBJECTIVE: The Spanish economic crisis began in 2008 and according to the Ministry of Economy, Industry and Competitiveness it concluded in 2014. During the crisis the main macroeconomic indicators had an adverse evolution and the effects have lasted for more than six years to the present. AIM: To assess the influence on public spending (health and pharmaceutical) that the governing policies have had and the time of crisis suffered. METHODS: Public expenditure per inhabitant (health and pharmaceutical) is compared according to the study period (pre, crisis and post), the political ideology of the ruling party (conservative/ progressive) and each autonomous community in reference to GDP per inhabitant in each of they respect the national average (poor, average or rich) according to the quartiles. The sources of the data have been the National Statistics Institute (GDP and inhabitants of each Autonomous Community and study period) and the Ministry of Health, Social Services and Equality (public health and pharmaceutical expenditure). The statistical procedures (SPSS v24) included descriptive and inferential analysis for public healthcare and pharmaceutical expenditure according to the period of study and ideology. There was also a regression fit to know the relative importance of predictor varibles. RESULTS: During the crisis period there were differences in public health expenditure per inhabitant in the different types of Autonomous Communities (poor / medium / rich) and according to political ideology (p <0.05). Public pharmaceutical expenditure was € 327 / inhab (pre-crisis) to € 366 / inhabitant in the final period of the study. There were statistically significant differences in pharmaceutical expenditure according to the different types of CCAA. Likewise, differences were found in per capita pharmaceutical expenditure between the Autonomous Communities run by conservatives and type of Autonomous Communities throughout the study period. CONCLUSIONS: The community pharmaceutical expenditure per capita has decreased by more than 13% since 2006 until 2017, while the hospital pharmaceutical expenditure has increased by more than 84%. Rich regions invest more in the health care costs and the poor more than drugs


Asunto(s)
Humanos , Recesión Económica , Gastos en Salud/tendencias , Política de Salud/economía , Disparidades en Atención de Salud/tendencias , Política de Salud/tendencias , Disparidades en Atención de Salud/economía , Salud Pública/economía , Salud Pública/tendencias , Análisis de Regresión
6.
Comun. ciênc. saúde ; 28(2): 149-157, abr. 2017. ilus, map, graf, tab
Artículo en Portugués | LILACS | ID: biblio-972655

RESUMEN

INTRODUÇÃO: A leishmaniose canina coexiste com a doença humana e costuma precedê-la, sendo os cães o principal reservatório doméstico. São escassos os estudos sobre a vigilância e epidemiologia das Leishmanioses no Brasil, inclusive no Distrito Federal (DF). OBJETIVO: Descrever a vigilância da Leishmaniose Visceral no DF, quanto ao arranjo organizacional, situação epidemiológica e medidas intersetoriais para prevenção e controle da doença. MÉTODOS: Estudo descritivo utilizando dados dos sites oficiais do Ministério da Saúde e da Secretaria de Estado e Saúde do DF, complementados por consulta à Diretoria de Vigilância Ambiental. Foram investigados os marcos históricos, a estrutura e as ações desenvolvidas, além da distribuição dos casos de Leishmaniose Visceral humana (LVH) e canina (LVC) por ano e região administrativa. RESULTADOS: O histórico da evolução da vigilância da leishmaniose no DF e seu arranjo organizacional atual evidenciam a contínua ampliação e fortalecimento deste sistema. No período de 2004 a 2015, foram registrados 321 casos confirmados de LVH, dos quais 4,8% evoluíram para óbito, além de 6.608 casos de LVC. O aumento do número de casos de LVC precedeu o aumento de número de casos de LVH. Para enfrentamento desta zoonose, foram desenvolvidas e fortalecidas ações intersetoriais entre Diretoria de Vigilância Epidemiológica, Diretoria de Vigilância Ambiental em Saúde e o Laboratório Central do DF. CONCLUSÃO: Faz-se necessária uma avaliação contínua da estrutura e capacidade de resposta do sistema territorial de vigilância da LVC, como componente fundamental da política nacional de saúde pública de combate às leishmanioses.


INTRODUCTION: Canine leishmaniasis coexists with human disease andusually precedes it, with dogs being the main domestic reservoir. Thereare few studies on the surveillance and epidemiology of Leishmaniasisin Brazil, including in the Federal District (DF). OBJECTIVE: To describe the surveillance of Visceral Leishmaniasis in DF,regarding the organizational arrangement, epidemiological situationand intersectoral measures for prevention and control of the disease. METHODS: Descriptive study using data from the official websites of the Ministry of Health and the Department of Health and Health of theFederal District, complemented by consultation with the Environmental Monitoring Board. The historical milestones, structure and actions developed, as well as the distribution of cases of human Visceral Leishmaniasis (LVH) and canine (LVC) per year and administrativeregion were investigated. RESULTS: The history of the evolution of leishmaniasis surveillance in theFederal District and its current organizational arrangement evidences thecontinuous expansion and strengthening of this system. From 2004 to2015, there were 321 confirmed cases of LVH, of which 4.8% died, and6,608 cases of LVC. The increase in the number of cases of LVC precededthe increase in the number of cases of LVH. In order to cope with thiszoonosis, intersectorial actions were developed and strengthened between the Epidemiological Surveillance Board, the Environmental Health Surveillance Directorate and the Central Laboratory of the Federal District. CONCLUSION: A continuous assessment of the structure and responsiveness of LVC’s territorial surveillance system is necessary as afundamental component of the national public health policy to combatleishmaniasis.


Asunto(s)
Humanos , Perros , Leishmaniasis , Monitoreo Epidemiológico , Leishmaniasis Visceral , Salud Pública , Educación en Salud , Promoción de la Salud , Capacitación Profesional
7.
Artículo en Español | PAHO-IRIS | ID: phr-34003

RESUMEN

Objetivo. Determinar la viabilidad y puesta en marcha de un sistema de telediagnóstico para dar asistencia sanitaria a poblaciones remotas y dispersas del Paraguay. Métodos. El estudio fue realizado en todos los hospitales regionales, generales y principales hospitales distritales de las 18 regiones sanitarias del Paraguay. En el sistema se registraron los datos clínicos y las imágenes tomográficas, ecográficas y trazados electrocardiográficos del paciente que precisaba de un diagnóstico por parte de un médico especialista. Esta información se transmitió a los especialistas en imagenología y en cardiología para su diagnóstico remoto y posterior envío del informe a los hospitales conectados al sistema. Se analizó el costo-beneficio e impacto de la herramienta de telediagnóstico desde la perspectiva del Sistema Nacional de Salud. Resultados. Entre enero de 2014 y mayo de 2015 se realizaron 34 096 telediagnósticos distribuidos en 25 hospitales a través del Sistema de Telemedicina del Ministerio de Salud. El costo unitario promedio del diagnóstico remoto fue de USD 2,6 (dólares estadounidenses) para electrocardiograma (ECG), tomografía y ecografía, mientras que el costo unitario para el diagnóstico “cara a cara” fue de UDS 11,8 para ECG; USD 68,6 para tomografía y USD 21,5 para ecografía. La reducción del costo mediante el diagnóstico remoto fue de 4,5 veces para ECG; 26,4 veces para tomografía y de 8,3 veces para ecografía. En términos monetarios, la implementación del sistema de telediagnóstico, durante los 16 meses del estudio, significó un ahorro promedio de USD 2 420 037. Conclusión. Paraguay cuenta con un sistema de telediagnóstico para electrocardiografía, tomografía y ecografía aplicando las tecnologías de la información y comunicación (TIC) de bajo costo, basadas en software libre y escalable a otros tipos de estudios diagnósticos a distancia; de interés para la salud pública. Con una aplicación práctica del telediagnóstico, se contribuyó al fortalecimiento de la red integrada de servicios y programas de salud, lo que permitió maximizar el tiempo del profesional y su productividad, mejorar la calidad, aumentar el acceso y la equidad, y disminuir los costos.


Objective. Determine the viability of a remote diagnosis system implemented to provide health care to remote and scattered populations in Paraguay. Methods. The study was conducted in all regional and general hospitals in Paraguay, and in the main district hospitals in the country’s 18 health regions. Clinical data, tomographic images, sonography, and electrocardiograms (ECGs) of patients who needed a diagnosis by a specialized physician were entered into the system. This information was sent to specialists in diagnostic imaging and in cardiology for remote diagnosis and the report was then forwarded to the hospitals connected to the system. The cost-benefit and impact of the remote diagnosis tool was analyzed from the perspective of the National Health System. Results. Between January 2014 and May 2015, a total of 34 096 remote diagnoses were made in 25 hospitals in the Ministry of Health’s telemedicine system. The average unit cost of remote diagnosis was US$2.6 per ECG, tomography, and sonography, while the unit cost of “face-to-face” diagnosis was US$11.8 per ECG, US$68.6 per tomography, and US$21.5 per sonography. As a result of remote diagnosis, unit costs were 4.5 times lower for ECGs; 26.4 times lower for tomography, and 8.3 times lower for sonography. In monetary terms, implementation of the remote diagnosis system during the 16 months of the study led to average savings of US$2 420 037. Conclusion. Paraguay has a remote diagnosis system for electrocardiography, tomography, and sonography, using low-cost information and communications technologies (ICTs) based on free software that is scalable to other types of remote diagnostic studies of interest for public health. Implementation of remote diagnosis helped to strengthen the integrated network of health services and programs, enabling professionals to optimize their time and productivity, while improving quality, increasing access and equity, and reducing costs.


Objetivo. Avaliar a viabilidade e a implementação de um sistema de telediagnóstico destinado a oferecer assistência de saúde a populações remotas e dispersas do Paraguai. Métodos. O estudo foi realizado em todos os hospitais regionais e gerais e nos principais hospitais distritais das 18 regiões sanitárias do Paraguai. Foram registrados no sistema os dados clínicos, as imagens tomográficas e ecográficas e os traçados eletrocardiográficos de pacientes que precisavam de um diagnóstico por parte de um médico especialista. Estas informações foram transmitidas a especialistas em diagnóstico por imagem e cardiologia para que fizessem o diagnóstico remoto e enviassem então os laudos aos hospitais conectados ao sistema. Analisou-se a relação custo- benefício e o impacto da ferramenta de telediagnóstico da perspectiva do Sistema Nacional de Saúde. Resultados. Entre janeiro de 2014 e maio de 2015, foram realizados 34.096 telediagnósticos em 25 hospitais através do Sistema de Telemedicina do Ministério da Saúde. O custo unitário médio do diagnóstico remoto foi de US$ 2,6 (dólares americanos) para eletrocardiografia (ECG), tomografia e ecografia, enquanto que o custo unitário para o diagnóstico presencial foi de US$ 11,8 para ECG, US$ 68,6 para tomografia e US$ 21,5 para ecografia. A redução do custo pelo uso do diagnóstico remoto foi de 4,5 vezes para ECG, 26,4 vezes para tomografia e 8,3 vezes para ecografia. Em termos monetários, a implementação do sistema de telediagnóstico, ao longo dos 16 meses do estudo, representou uma economia média de US$ 2.420.037. Conclusão. O Paraguai conta com um sistema de telediagnóstico para eletrocardiografia, tomografia e ecografia que utiliza tecnologias da informação e comunicação (TIC) de baixo custo, baseadas em software livre e ampliáveis a outros tipos de exames diagnósticos à distância que são de interesse para a saúde pública. A aplicação prática do telediagnóstico contribuiu para o fortalecimento da rede integrada de serviços e programas de saúde, o que permitiu maximizar o tempo dos profissionais e sua produtividade, melhorar a qualidade, aumentar o acesso e a equidade e reduzir os custos.


Asunto(s)
Salud Pública , Tecnología Biomédica , Telemedicina , Ingeniería Sanitaria , Radiología , Telerradiología , Tecnología de la Información , Tecnología Biomédica , Telemedicina , Ingeniería Sanitaria , Radiología , Tecnología de la Información
8.
Evid. actual. práct. ambul ; 20(2): 58-58, 2017.
Artículo en Español | LILACS | ID: biblio-1128538

RESUMEN

La enfermedad invasiva por meningococo trae aparejada una alta morbimortalidad. Se presenta habitualmente en forma de casos aislados o brotes epidémicos y afecta en la Argentina a 200 a 300 casos por año, principalmente en niños menores de cinco años de edad. Actualmente en nuestro país se encuentran disponibles dos vacunas que cubren los serotipos A, C, Y, W del meningococo (Menactra® y Menveo®). A partir de Marzo de 2015, el Ministerio de Salud de la Nación Argentina incorporó la vacunación universal contra meningococo, estableciendo un esquema con una dosis a los tres y cinco meses y un refuerzo a los 15 meses de vida; y una dosis única para los adolescentes, a los 11 años de edad. (AU)


Invasive meningococcal disease results in high morbidity and mortality. It usually occurs in the form of isolated cases of epidemic outbreaks and affects 200 to 300 cases per year in Argentina, especially in children under five years of age. Vaccines covering meningococcal serotypes A, C, Y, W (Menactra® and Menveo®) are currently available in our country. Since March 2015, the Argentine's Ministry of Health incorporated the universal vaccination against meningococcus, establishing a scheme with two doses at three and five months and a booster at 15 months of life; and a single dose for adolescents, at 11 years of age. (AU)


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Vacunas Meningococicas/uso terapéutico , Infecciones Meningocócicas/prevención & control , Argentina , Salud Pública , Programas de Inmunización , Infecciones Meningocócicas/etiología , Infecciones Meningocócicas/virología
9.
Rev. panam. salud pública ; 41: e74, 2017. tab, graf
Artículo en Español | LILACS | ID: biblio-845687

RESUMEN

RESUMEN Objetivo Determinar la viabilidad y puesta en marcha de un sistema de telediagnóstico para dar asistencia sanitaria a poblaciones remotas y dispersas del Paraguay. Métodos El estudio fue realizado en todos los hospitales regionales, generales y principales hospitales distritales de las 18 regiones sanitarias del Paraguay. En el sistema se registraron los datos clínicos y las imágenes tomográficas, ecográficas y trazados electrocardiográficos del paciente que precisaba de un diagnóstico por parte de un médico especialista. Esta información se transmitió a los especialistas en imagenología y en cardiología para su diagnóstico remoto y posterior envío del informe a los hospitales conectados al sistema. Se analizó el costo-beneficio e impacto de la herramienta de telediagnóstico desde la perspectiva del Sistema Nacional de Salud. Resultados Entre enero de 2014 y mayo de 2015 se realizaron 34 096 telediagnósticos distribuidos en 25 hospitales a través del Sistema de Telemedicina del Ministerio de Salud. El costo unitario promedio del diagnóstico remoto fue de USD 2,6 (dólares estadounidenses) para electrocardiograma (ECG), tomografía y ecografía, mientras que el costo unitario para el diagnóstico “cara a cara” fue de UDS 11,8 para ECG; USD 68,6 para tomografía y USD 21,5 para ecografía. La reducción del costo mediante el diagnóstico remoto fue de 4,5 veces para ECG; 26,4 veces para tomografía y de 8,3 veces para ecografía. En términos monetarios, la implementación del sistema de telediagnóstico, durante los 16 meses del estudio, significó un ahorro promedio de USD 2 420 037. Conclusión Paraguay cuenta con un sistema de telediagnóstico para electrocardiografía, tomografía y ecografía aplicando las tecnologías de la información y comunicación (TIC) de bajo costo, basadas en software libre y escalable a otros tipos de estudios diagnósticos a distancia; de interés para la salud pública. Con una aplicación práctica del telediagnóstico, se contribuyó al fortalecimiento de la red integrada de servicios y programas de salud, lo que permitió maximizar el tiempo del profesional y su productividad, mejorar la calidad, aumentar el acceso y la equidad, y disminuir los costos.


ABSTRACT Objective Determine the viability of a remote diagnosis system implemented to provide health care to remote and scattered populations in Paraguay. Methods The study was conducted in all regional and general hospitals in Paraguay, and in the main district hospitals in the country’s 18 health regions. Clinical data, tomographic images, sonography, and electrocardiograms (ECGs) of patients who needed a diagnosis by a specialized physician were entered into the system. This information was sent to specialists in diagnostic imaging and in cardiology for remote diagnosis and the report was then forwarded to the hospitals connected to the system. The cost-benefit and impact of the remote diagnosis tool was analyzed from the perspective of the National Health System. Results Between January 2014 and May 2015, a total of 34 096 remote diagnoses were made in 25 hospitals in the Ministry of Health’s telemedicine system. The average unit cost of remote diagnosis was US$2.6 per ECG, tomography, and sonography, while the unit cost of “face-to-face” diagnosis was US$11.8 per ECG, US$68.6 per tomography, and US$21.5 per sonography. As a result of remote diagnosis, unit costs were 4.5 times lower for ECGs; 26.4 times lower for tomography, and 8.3 times lower for sonography. In monetary terms, implementation of the remote diagnosis system during the 16 months of the study led to average savings of US$2 420 037. Conclusion Paraguay has a remote diagnosis system for electrocardiography, tomography, and sonography, using low-cost information and communications technologies (ICTs) based on free software that is scalable to other types of remote diagnostic studies of interest for public health. Implementation of remote diagnosis helped to strengthen the integrated network of health services and programs, enabling professionals to optimize their time and productivity, while improving quality, increasing access and equity, and reducing costs.


RESUMO Objetivo Avaliar a viabilidade e a implementação de um sistema de telediagnóstico destinado a oferecer assistência de saúde a populações remotas e dispersas do Paraguai. Métodos O estudo foi realizado em todos os hospitais regionais e gerais e nos principais hospitais distritais das 18 regiões sanitárias do Paraguai. Foram registrados no sistema os dados clínicos, as imagens tomográficas e ecográficas e os traçados eletrocardiográficos de pacientes que precisavam de um diagnóstico por parte de um médico especialista. Estas informações foram transmitidas a especialistas em diagnóstico por imagem e cardiologia para que fizessem o diagnóstico remoto e enviassem então os laudos aos hospitais conectados ao sistema. Analisou-se a relação custo-benefício e o impacto da ferramenta de telediagnóstico da perspectiva do Sistema Nacional de Saúde. Resultados Entre janeiro de 2014 e maio de 2015, foram realizados 34.096 telediagnósticos em 25 hospitais através do Sistema de Telemedicina do Ministério da Saúde. O custo unitário médio do diagnóstico remoto foi de US$ 2,6 (dólares americanos) para eletrocardiografia (ECG), tomografia e ecografia, enquanto que o custo unitário para o diagnóstico presencial foi de US$ 11,8 para ECG, US$ 68,6 para tomografia e US$ 21,5 para ecografia. A redução do custo pelo uso do diagnóstico remoto foi de 4,5 vezes para ECG, 26,4 vezes para tomografia e 8,3 vezes para ecografia. Em termos monetários, a implementação do sistema de telediagnóstico, ao longo dos 16 meses do estudo, representou uma economia média de US$ 2.420.037. Conclusão O Paraguai conta com um sistema de telediagnóstico para eletrocardiografia, tomografia e ecografia que utiliza tecnologias da informação e comunicação (TIC) de baixo custo, baseadas em software livre e ampliáveis a outros tipos de exames diagnósticos à distância que são de interesse para a saúde pública. A aplicação prática do telediagnóstico contribuiu para o fortalecimento da rede integrada de serviços e programas de saúde, o que permitiu maximizar o tempo dos profissionais e sua produtividade, melhorar a qualidade, aumentar o acesso e a equidade e reduzir os custos.


Asunto(s)
Salud Pública , Telemedicina/métodos , Evaluación del Impacto en la Salud , Paraguay
10.
Rev. salud pública ; 18(6): 871-879, nov.-dic. 2016. tab, graf
Artículo en Español | LILACS | ID: biblio-962029

RESUMEN

RESUMEN Objetivos Realizar una aproximación al análisis multidimensional de las capacidades funcionales en salud ambiental del Ministerio de Ambiente y Desarrollo Sostenible, con base en el modelo del PNUD de interacciones entre problemas centrales y capacidades funcionales. Método Se utilizaron como fuentes de información los resultados institucionales obtenidos por medio de encuestas, b) información de fuentes secundarias, proveniente de las CAR y las autoridades ambientales, sobre las políticas, estrategias, planes de acción, planes de gestión ambiental regional - PGAR, normativas, actividades y rendición de cuentas. Resultados La consolidación de los resultados institucionales, con respecto a los problemas centrales y capacidades, muestran una heterogeneidad importante. Conclusión El liderazgo público y el empoderamiento social, constituyen un círculo virtuoso que permite fortalecer las capacidades en proyectos de alto interés social. En el marco de este encadenamiento es posible fortalecer las otras capacidades como el logro de compromisos y las de tipo institucional y técnico (diseño de políticas, implementación, evaluación, etc.). Se presentan tres alternativas que permiten la implementación de capacidades en salud ambiental.(AU)


ABSTRACT Objectives To approach the multidimensional analysis of functional capacities in environmental health in the Ministry of Environment and Sustainable Development, based on the UNDP model of interactions between central problems and functional capabilities. Method Individual institutional results obtained through surveys and information from secondary sources, CAR (Autonomous Regional Corporations) and environmental authorities on policies, strategies, action plans, regional environmental management plans, regulations, activities, and accountabilities related to environmental health during the period 2012-2015 were used as sources of information. Results The consolidation of results per corporation about core issues and functional capabilities, in terms of the level of response, shows a significant heterogeneity. Conclusions Public leadership and social empowerment constitute a virtuous circle that allows strengthening capacities in projects of high social interest. Moreover, other capacities such as achieving commitments and institutional and technical capacities (policy design, implementation, evaluation, etc.) can be strengthened as well. Three alternatives for environmental health capabilities implementation have been proposed.(AU)


Asunto(s)
Política Pública , Planificación Social , Salud Ambiental/organización & administración , Gestión Ambiental , Colombia
11.
Rev Salud Publica (Bogota) ; 18(6): 871-879, 2016.
Artículo en Español | MEDLINE | ID: mdl-30137170

RESUMEN

OBJECTIVES : To approach the multidimensional analysis of functional capacities in environmental health in the Ministry of Environment and Sustainable Development, based on the UNDP model of interactions between central problems and functional capabilities. METHOD : Individual institutional results obtained through surveys and information from secondary sources, CAR (Autonomous Regional Corporations) and environmental authorities on policies, strategies, action plans, regional environmental management plans, regulations, activities, and accountabilities related to environmental health during the period 2012-2015 were used as sources of information. RESULTS: The consolidation of results per corporation about core issues and functional capabilities, in terms of the level of response, shows a significant heterogeneity. CONCLUSIONS: Public leadership and social empowerment constitute a virtuous circle that allows strengthening capacities in projects of high social interest. Moreover, other capacities such as achieving commitments and institutional and technical capacities (policy design, implementation, evaluation, etc.) can be strengthened as well. Three alternatives for environmental health capabilities implementation have been proposed.

12.
Rev. esp. salud pública ; 90: 0-0, 2016. ilus, tab
Artículo en Español | IBECS | ID: ibc-152927

RESUMEN

El calendario de vacunación en España es una herramienta dinámica de salud pública que ha ido incorporando cambios en función de la situación epidemiológica y la evidencia científica. La Ponencia del Programa y Registro de Vacunaciones, órgano científico-técnico del Consejo Interterritorial del Sistema Nacional de Salud, realiza evaluaciones y propone modificaciones que se incorporan en el calendario de vacunación de las comunidades autónomas (CCAA). Este artículo está dividido en dos partes y presenta la evaluación realizada para proponer un nuevo esquema de vacunación frente a difteria, tétanos, tosferina, poliomielitis, hepatitis B y enfermedad invasora por Haemophilus influenzae tipo b, centrándose esta primera parte en la exposición de motivos, el repaso a la política de vacunación en España y su impacto así como en la revisión de los calendarios de vacunación en países de nuestro entorno (AU)


The immunization schedule is a dynamic public health tool that has incorporated different changes over the years influenced by the epidemiologic situation and the scientific evidence. The Immunization Advisory Committee [Ponencia de Programa y Registro de Vacunaciones], as the Interterritorial Council scientific and technical advisory body, carries out assessments of different programmes and vaccines and proposes changes that after approval will be introduced in the Regions schedule. This article is divided into two parts presenting the rationale followed to propose a new schedule for the immunization against diphtheria, tetanus, pertussis, hepatitis B and invasive disease by Haemophilus influenzae type b. This first part is focused in the reasoning to undertake the assessment, the review of the immunization policy and the impact of immunization in Spain, as well as a review of the immunization schedules in similar countries (AU)


Asunto(s)
Humanos , Masculino , Femenino , Programas de Inmunización/métodos , Programas de Inmunización/normas , Programas de Inmunización , Política de Salud/legislación & jurisprudencia , Difteria/epidemiología , Difteria/inmunología , Tétanos/epidemiología , Tétanos/inmunología , Vacuna contra Difteria, Tétanos y Tos Ferina/inmunología , Bordetella/inmunología , Programas de Inmunización/economía , Programas de Inmunización/organización & administración , Programas de Inmunización/estadística & datos numéricos , España/epidemiología , Sistemas Nacionales de Salud , Hepatitis B/inmunología , Vacunas contra Haemophilus/inmunología , Haemophilus influenzae tipo b/inmunología , Salud Pública/métodos
13.
CoDAS ; 26(2): 148-154, Mar-Apr/2014. tab, graf
Artículo en Inglés | LILACS | ID: lil-711131

RESUMEN

PURPOSE: To analyze the structure of the Centers for Supporting the Family Health (NASF), in 2010, identify the satisfaction degree of speech language pathologists who work in this area and compare the model proposed by the Brazilian Ministry of Health with practice. METHODS: Prospective and descriptive study, with 40 speech language pathologists inserted in NASF type one, from all Brazilian regions, in 2010. It was used a questionnaire with nine questions related to different topics (work infrastructure, NASF team, actions developed by these professionals and satisfaction about the work), sent by electronic mail to the speech language pathologists. Descriptive statistics, χ2, ANOVA and Pearson coefficient of variation were used to analyze variables. Significance level of 5% was adopted. RESULTS: The speech language pathologists reported that, in their working places (NASF), there was an average of 12.2 Health Family Teams, with 8.9 professionals and 1.6 speech language pathologists. Most of them work 40 hours per week. Routine activities cited by speech language pathologists were: promotion and health prevention actions, matricial, therapies, support to health community workers, referrals, home visits, intersectoral actions and administrative tasks. There was variability in the satisfaction score: the majority of interviewees indicated the degree "Somewhat satisfied" for work infrastructure and referrals, as well as reported "Very satisfied" degree for home visits and support for health community workers. Comparing the model proposed by the Ministry of Health with the speech language pathologists' practices, there was no significant difference. The results show that 40% of speech language pathologists consider that the NASF actions are below the proposed model. CONCLUSION: The NASF structure varied in terms of the number of Family Health Teams, professionals involved and actions performed. There was also significant ...


OBJETIVO: Analisar a estrutura dos Núcleos de Apoio à Saúde da Família (NASF), vigentes em 2010, identificar o grau de satisfação dos fonoaudiólogos que atuam nessa área e comparar o modelo proposto pela portaria 154 do Ministério da Saúde com a prática fonoaudiológica. MÉTODOS: Estudo prospectivo e descritivo, com 40 fonoaudiólogos inseridos em NASF tipo um, de todo território nacional, em 2010. Utilizou-se um questionário com nove perguntas que abordavam diferentes temas (infraestrutura de trabalho, equipe do NASF, ações desenvolvidas pelos profissionais do NASF e satisfação com o trabalho desenvolvido), enviado por correio eletrônico para os fonoaudiólogos. Para a análise das variáveis estudadas, foram utilizadas medidas descritivas, os testes do χ2, ANOVA e o coeficiente de variação de Pearson. Foi adotado o nível de significância de 5%. RESULTADOS: Os fonoaudiólogos relataram que nos NASFs em que atuavam havia em média 12,2 Equipes de Saúde da Família, 8,9 profissionais e 1,6 fonoaudiólogos por NASF, sendo a maioria com carga de 40 horas semanais. As atividades de rotina citadas pelos fonoaudiólogos foram: ações de promoção e prevenção de saúde, matriciamento, terapias, suporte aos agentes comunitários, encaminhamentos, visitas domiciliares, ações intersetoriais e atividades administrativas. Houve variabilidade na pontuação do grau de satisfação: a maioria indicou o grau "Pouco satisfeito" para infraestrutura de trabalho e encaminhamentos efetivados e "Muito satisfeito" para visitas domiciliares e suporte aos agentes comunitários de saúde. Comparando o modelo proposto com a prática dos fonoaudiólogos, não houve diferença significativa, mas 40% deles consideraram ...


Asunto(s)
Humanos , Salud de la Familia , Satisfacción en el Trabajo , Patología del Habla y Lenguaje , Actitud del Personal de Salud , Brasil , Programas Nacionales de Salud , Estudios Prospectivos , Salud Pública , Encuestas y Cuestionarios
14.
Nutr Hosp ; 28 Suppl 5: 13-20, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-24010740

RESUMEN

BACKGROUND/AIMS: The Food Consumption Survey, conducted for over 20 years by the Spanish Ministry of Agriculture, Food and Environment (MAGRAMA), is the most reliable source of data to evaluate the food consumption and dietary patterns of Spain. The aim of the present article was to review the diet trends in Spain and its evolution. Food availability assessment per capita per day, which allows the calculation of energy and nutrient intake and comparison with the Recommended Nutrient Intakes for the Spanish population is described. In addition, different markers of the quality of the diet have been also evaluated. METHODS: The sample consisted of consumption and distribution data, obtained from the nationwide representative Food Consumption Survey for the period 2000- 2012. A two-stage sampling method was applied, where in the first stage the units to be sampled were towns or local entities, and in the second stage households which were going to be part of the final sample from those entities were selected. Units consisted of towns or local entities in the national territory. The data allowed the calculation of energy and nutrient intakes, using the Food Composition Tables (Moreiras et al, 2013). The quality of the diet was also evaluated: the adequacy of the diet in meeting the recommended intakes for energy and nutrients; energy profile; dietary fat quality; dietary protein quality; nutrient density; Mediterranean diet adequacy indices. The present data were compared with previous data obtained by our research group in 1964, 1981 and 1991. RESULTS: Using the most recent data, average intake comprised: milk and derivatives (356 g/person/day), fruits (323 g/person/day), vegetables and greens (339 g/ person/day), cereals and derivatives (197 g/person/day), meat and meat products (181 g/day), fish (88,6 g/person/ day), oils and fats (41,6 g/person/day), sugar and derivatives (25,6 g/person/day), eggs (27,1 g/person/day), legumes (13,9 g/person/day) . There was also a high consumption of non-alcoholic beverages (437 g/person/day) and decreasing for alcoholic beverages (192 g/person/day) compared to previous surveys. In consequence, meat and meat product consumption was higher than the recommendations, whereas for cereals and their derivatives, vegetables and greens, fruit, and legumes and pulses, consumption was below recommendations for the Spanish population (GRUNUMUR, 2004; SENC, 2007). Some staple and traditional Mediterranean foods (bread, potatoes and olive oil) showed a dramatic decline when compared to data from Household Budget Surveys in 1964 data. Energy intake showed a marked decline when compared to the 1960's mean consumption, and show marked differences for food groups contributors. Energy profile shows too much coming from lipids vs carbohydrates and slightly higher from proteins. CONCLUSION: Food consumption patterns in Spain and energy and nutrient intakes have changed markedly in the last forty years, differing somewhat at present from the traditional and healthy Mediterranean Diet.


Asunto(s)
Encuestas sobre Dietas , Dieta , Obesidad/epidemiología , Niño , Productos Lácteos , Dieta Mediterránea/estadística & datos numéricos , Ingestión de Alimentos , Grano Comestible , Ingestión de Energía , Frutas , Humanos , España/epidemiología , Verduras
15.
Nutr. hosp ; 28(supl.5): 13-20, sept. 2013. ilus, tab
Artículo en Inglés | IBECS | ID: ibc-120664

RESUMEN

Background/Aims: The Food Consumption Survey, conducted for over 20 years by the Spanish Ministry of Agriculture, Food and Environment (MAGRAMA), is the most reliable source of data to evaluate the food consumption and dietary patterns of Spain. The aim of the present article was to review the diet trends in Spain and its evolution. Food availability assessment per capita per day, which allows the calculation of energy and nutrient intake and comparison with the Recommended Nutrient Intakes for the Spanish population is described. In addition, different markers of the quality of the diet have been also evaluated. Methods: The sample consisted of consumption and distribution data, obtained from the nationwide representative Food Consumption Survey for the period 2000-2012. A two-stage sampling method was applied, where in the first stage the units to be sampled were towns or local entities, and in the second stage households which were going to be part of the final sample from those entities were selected. Units consisted of towns or local entities in the national territory. The data allowed the calculation of energy and nutrient intakes, using the Food Composition Tables (Moreiras et al, 2013). The quality of the diet was also evaluated: the adequacy of the diet in meeting the recommended intakes for energy and nutrients; energy profile; dietary fat quality; dietary protein quality; nutrient density; Mediterranean diet adequacy indices. The present data were compared with previous data obtained by our research group in 1964, 1981 and 1991. Results: Using the most recent data, average intake comprised: milk and derivatives (356 g/person/day), fruits (323 g/person/day), vegetables and greens (339 g/ person/day), cereals and derivatives (197 g/person/day), meat and meat products (181 g/day), fish (88,6 g/person/ day), oils and fats (41,6 g/person/day), sugar and derivatives (25,6 g/person/day), eggs (27,1 g/person/day), legumes (13,9 g/person/day). There was also a high consumption of non-alcoholic beverages (437 g/person/day) and decreasing for alcoholic beverages (192 g/person/day) compared to previous surveys. In consequence, meat and meat product consumption was higher than the recommendations, whereas for cereals and their derivatives, vegetables and greens, fruit, and legumes and pulses, consumption was below recommendations for the Spanish population (GRUNUMUR, 2004; SENC, 2007). Some staple and traditional Mediterranean foods (bread, potatoes and olive oil) showed a dramatic decline when compared to data from Household Budget Surveys in 1964 data. Energy intake showed a marked decline when compared to the 1960's mean consumption, and show marked differences for food groups contributors. Energy profile shows too much coming from lipids vs carbohydrates and slightly higher from proteins. Conclusion: Food consumption patterns in Spain and energy and nutrient intakes have changed markedly in the last forty years, differing somewhat at present from the traditional and healthy Mediterranean Diet (AU)


Antecedentes/objetivos: La Encuesta de Consumo de Alimentos, realizada durante 20 años por el Ministerio de Agricultura, Alimentación y Medio Ambiente (MAGRAMA), es la fuente más fiable de datos para evaluar el consumo de alimentos y patrones dietéticos en España. El objetivo de este artículo fue revisar las tendencias dietéticas en España y su evolución. Se describe la evaluación de la disponibilidad de alimentos per cápita y día, que permite el cálculo de consumo de energía y nutrientes y su comparación con el Consumo Recomendado de Nutrientes para la población española. Además, se han evaluado diferentes marcadores de la calidad de la dieta. Métodos: La muestra consistió en los datos de consumo y distribución, obtenidos de la Encuesta Nacional de Consumo de Alimentos para el período 2000-2012. Se aplicó un método de muestreo en dos etapas en el que, en la primera etapa, las unidades que se muestreaban fueron ciudades y entidades locales y, en la segunda, se seleccionaron los hogares que conformaron la muestra final a partir de las entidades locales. Las unidades consistieron en ciudades o entidades locales del territorio nacional. Los datos permitieron el cálculo de consumo de energía y nutrientes utilizando las tablas de Consumo de Alimentos (Moreiras et al., 2013). También se evaluó la calidad de la dieta: la adecuación de la dieta para alcanzar los consumos de energía y nutrientes recomendados; perfil de energía; calidad de la grasa de la dieta; calidad de la proteína de la dieta; densidad de nutrientes; índices de adecuación de la dieta mediterránea. Los datos actuales se compararon con los datos previos obtenidos por nuestro grupo de investigación en 1964, 1981 y 1991 Resultados: Utilizando los datos más recientes, el consumo promedio comprendía: leche y derivados (356 g/persona/día), frutas (323 g/persona/día), verduras y hortalizas (339 g/persona/día), cereales y derivados (197 g/persona/día), carne y productos cárnicos (181 g/día), pescado (88,6 g/persona/día), aceites y grasas (41,6 g/persona/día), azúcar y derivados (25,6 g/persona/día), huevos (27,1 g/persona/día), legumbres (13,9 g/persona/día) . También un consumo elevado de bebidas no alcohólicas (437 g/persona/día) y un descenso del consumo de bebidas alcohólicas (192 g/persona/día) en comparación con las encuestas previas. En consecuencia, el consumo de carne y productos cárnicos fue superior al recomendado mientras que el consumo de cereales y sus derivados, verduras y hortalizas, fruta y legumbres estaba por debajo de las recomendaciones para la población española (GRUNU-MUR, 2004; SENC, 2007). Algunos alimentos mediterráneos de consumo habitual y tradicionales (pan, patatas y aceite de oliva) mostraron un declive notable en comparación con los datos de las Encuestas de Economía Doméstica de 1964. El consumo de energía mostró un marcado declive en comparación con el consumo medio de los años sesenta y mostró marcadas diferencias para los distintos grupos de alimentos contribuyentes. El perfil de energía mostró que una gran parte procedía de los lípidos, frente a los hidratos de carbono y algo superior con respecto a las proteínas. Conclusión: Los patrones de consumo de alimentos en España y los consumos de energía y nutrientes han cambiado notablemente en los últimos 40 años, difiriendo algo en la actualidad de la dieta mediterránea tradicional y saludable (AU)


Asunto(s)
Humanos , Nutrientes/análisis , Conducta Alimentaria , 24457 , Calidad de los Alimentos , Dieta Mediterránea , Dieta , Consumo de Energía/análisis , Encuestas Nutricionales , Valor Nutritivo
16.
Lima; s.n; 2013. 49 p. tab, graf.
Tesis en Español | LILACS, LIPECS | ID: lil-707820

RESUMEN

Se realizó el presente estudio para determinar el nivel de satisfacción del Usuario Interno y Externo del Servicio de Emergencia del Hospital Nacional Sergio E. Bernales de Collique de Lima. Se aplicaron dos instrumentos validados por el Ministerio de Salud, la Encuesta de Satisfacción de Usuarios Externos, y la Encuesta de Satisfacción del Personal de Salud. Se evaluó a la totalidad de 64 trabajadores del Servicio de Emergencia, y una muestra de 400 usuarios externos durante el último trimestre del año 2012. Encontramos que la mitad de trabajadores mostraron un buen nivel de satisfacción, mientras 42,2 por ciento era indiferente y 7,8 por ciento estaba poco satisfecho. De 400 usuarios encuestados el 75,3 por ciento de pacientes afirmó que se respetan sus creencias, 46,5 por ciento reconoció haber recibido información completa sobre el examen a realizársele. Sobre las oportunidades para acceder al servicio, el 73,75 por ciento manifestó sentirse satisfecho con el horario, 61,25 por ciento con la limpieza del local, y 53,25 por ciento estuvo conforme con el tiempo de demora en la atención. El trato fue percibido como bueno en 73,75 por ciento, con respeto a la privacidad en 70 por ciento, eficacia en la resolución del problema en 73,5 por ciento, y una satisfacción global del 67 por ciento. La apreciación de la atención fue muy buena en 46 por ciento de casos, buena en 17,50 por ciento, regular en 11,25 por ciento y deficiente en un 25,25 por ciento. La correlación entre la satisfacción de los usuarios internos y externos fue baja y significativa.


The present study was performed to determine the satisfaction level of Internal and External User of Emergency Service of National Hospital Sergio E. Bernales from Collique - Lima. We applied two instruments validated by Health Ministry, the Satisfaction Questionnaire for External Users, and Satisfaction Questionnaire for Health Staff. We evaluated all of the 64 workers of Emergency Service, and a sample of 400 external patients in the service during the last trimester of 2012. We found that among workers that a half of them showed a good satisfaction level, while 42.2 per cent were indifferent and 7.8 per cent was fair satisfied. From the 400 patients evaluated, 75.3 per cent felt that their believing were respected, 46.5 per cent recognized having received complete information about the procedures. About opportunities of access, 73.75 per cent were satisfied with schedule of attention, 61.25 per cent with local cleaning, and 53.25 per cent agreed with waiting time for attention. Treat was perceived as good in 73.75 per cent, with privacy respect in 70 per cent, efficacy to resolve health problem in 73.5 per cent, and a global satisfaction of 67 per cent. Satisfaction with the service was very good in 46 per cent of cases, good in 17.50 per cent, regular in 11.25 per cent and fair in 25.25 per cent. Correlation among internal and external satisfaction was low and significant.


Asunto(s)
Humanos , Masculino , Adulto , Femenino , Persona de Mediana Edad , Pacientes Ambulatorios , Salud Pública , Satisfacción del Paciente , Satisfacción en el Trabajo , Servicios Médicos de Urgencia
17.
BMC Med Res Methodol ; 12: 22, 2012 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-22390159

RESUMEN

BACKGROUND: Asthma is among the most common chronic diseases in working-aged populations and occupational exposures are important causal agents. Our aims were to evaluate the best methods to assess occurrence, public health impact, and burden to society related to occupational or work-related asthma and to achieve comparable estimates for different populations. METHODS: We addressed three central questions: 1: What is the best method to assess the occurrence of occupational asthma? We evaluated: 1) assessment of the occurrence of occupational asthma per se, and 2) assessment of adult-onset asthma and the population attributable fractions due to specific occupational exposures. 2: What are the best methods to assess public health impact and burden to society related to occupational or work-related asthma? We evaluated methods based on assessment of excess burden of disease due to specific occupational exposures. 3: How to achieve comparable estimates for different populations? We evaluated comparability of estimates of occurrence and burden attributable to occupational asthma based on different methods. RESULTS: Assessment of the occurrence of occupational asthma per se can be used in countries with good coverage of the identification system for occupational asthma, i.e. countries with well-functioning occupational health services. Assessment based on adult-onset asthma and population attributable fractions due to specific occupational exposures is a good approach to estimate the occurrence of occupational asthma at the population level. For assessment of public health impact from work-related asthma we recommend assessing excess burden of disease due to specific occupational exposures, including excess incidence of asthma complemented by an assessment of disability from it. International comparability of estimates can be best achieved by methods based on population attributable fractions. CONCLUSIONS: Public health impact assessment for occupational asthma is central in prevention and health policy planning and could be improved by purposeful development of methods for assessing health benefits from preventive actions. Registry-based methods are suitable for evaluating time-trends of occurrence at a given population but for international comparisons they face serious limitations. Assessment of excess burden of disease due to specific occupational exposure is a useful measure, when there is valid information on population exposure and attributable fractions.


Asunto(s)
Asma Ocupacional , Exposición Profesional/prevención & control , Salud Pública , Garantía de la Calidad de Atención de Salud , Lugar de Trabajo , Adulto , Asma Ocupacional/diagnóstico , Asma Ocupacional/epidemiología , Asma Ocupacional/etiología , Benchmarking , Pruebas de Provocación Bronquial , Costo de Enfermedad , Europa (Continente)/epidemiología , Investigación sobre Servicios de Salud , Humanos , Persona de Mediana Edad , Exposición Profesional/economía , Exposición Profesional/normas , Servicios de Salud del Trabajador/normas , Vigilancia de la Población , Prevalencia , Seguridad Social , Contaminación por Humo de Tabaco/legislación & jurisprudencia , Estados Unidos/epidemiología , Indemnización para Trabajadores/normas , Lugar de Trabajo/legislación & jurisprudencia , Lugar de Trabajo/normas , Organización Mundial de la Salud
18.
Rev. medica electron ; 34(1): 34-46, ene.-feb. 2012.
Artículo en Español | LILACS | ID: lil-629893

RESUMEN

Las enfermedades emergentes y reemergentes constituyen un problema de salud que preocupa a los gobiernos y a las autoridades de salud pública, por los efectos económicos y sociales que pueden ocasionar. Se realizó un estudio observacional descriptivo en la población de la provincia de Matanzas, distribuida geográficamente en sus áreas de salud, con el propósito de estratificar el riesgo para las enfermedades emergentes y reemergentes, en el período 2002-2006. Un grupo de expertos seleccionaron las enfermedades a estudiar y los indicadores, quedando definidos así: para la tuberculosis y el VIH/sida, la tasa de prevalencia y de letalidad; para el dengue y el paludismo, los casos importados y el índice de infestación; para la influenza aviar y la fiebre del Oeste del Nilo Occidental (FNO), el asentamiento de aves migratorias, el arribo de viajeros de áreas endémicas, y también para esta última, el índice de infestación. Los datos fueron obtenidos de las tarjetas de Enfermedades de Declaración Obligatoria y certificados de defunción, de la Dirección Provincial de Salud, del Centro Provincial de Higiene y Epidemiología, del sistema de vigilancia vectorial de la Unidad Provincial de Vectores y de aves migratorias de la Dirección Provincial de Medicina Veterinaria y el Ministerio de Ciencia Tecnología y Medio Ambiente (CITMA). Se obtuvo como resultado que Playa, Varadero, Agramante y Jagüey Grande fueron las áreas de salud de mayor riesgo, lo que es de vital importancia para los cuadros a diferentes niveles del sistema, ya que posibilita con una base científica la reorientación de la vigilancia, la organizar los servicios de salud e intervención oportuna.


The emergent and re-emergent diseases are a health problem worrying governments and public health authorities because of the economic and social effects they can produce. We carried out a descriptive observational study in the population of the province of Matanzas, geographically distributed in their health area, with the purpose of stratifying the risk for the emergent and re-emergent diseases, in the period 2002-2006. A group of experts selected the diseases to study and the indicators, being defined this way: for the tuberculosis and HIV/AIDS, the prevalence rate and the lethality; for dengue and malaria, the imported cases and the infestation index; for the avian flu and the West Nile fever, the migratory birds settlement and the traveler arrival from the endemic areas, and for the last one also the infestation rate. The data were collected from the cards of Obligatory Declaration Diseases and the decease certifications, from the Provincial Direction of Health, the Provincial Center of Hygiene and Epidemiology, the vectorial surveillance system of the Provincial Unit of Vectors, the Provincial Center of Veterinary Medicine, and the Ministry of Sciences, Technology and Environment. As a result we obtained that Playa, Varadero, Agramonte and Jagüey Grande were the health areas at higher risk. This is of great importance for the executives at the different levels of the system, making possible the reorientation of the surveillance, the organization of the health services and te opportune intervention on a scientific basis.


Asunto(s)
Humanos , Masculino , Femenino , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/prevención & control , Gripe Aviar/epidemiología , Gripe Aviar/prevención & control , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Epidemiología Descriptiva , Estudios Observacionales como Asunto
19.
Rev. medica electron ; 34(1)ene.-feb. 2012. mapas
Artículo en Español | CUMED | ID: cum-51345

RESUMEN

Las enfermedades emergentes y reemergentes constituyen un problema de salud que preocupa a los gobiernos y a las autoridades de salud pública, por los efectos económicos y sociales que pueden ocasionar. Se realizó un estudio observacional descriptivo en la población de la provincia de Matanzas, distribuida geográficamente en sus áreas de salud, con el propósito de estratificar el riesgo para las enfermedades emergentes y reemergentes, en el período 2002-2006. Un grupo de expertos seleccionaron las enfermedades a estudiar y los indicadores, quedando definidos así: para la tuberculosis y el VIH/sida, la tasa de prevalencia y de letalidad; para el dengue y el paludismo, los casos importados y el índice de infestación; para la influenza aviar y la fiebre del Oeste del Nilo Occidental (FNO), el asentamiento de aves migratorias, el arribo de viajeros de áreas endémicas, y también para esta última, el índice de infestación. Los datos fueron obtenidos de las tarjetas de Enfermedades de Declaración Obligatoria y certificados de defunción, de la Dirección Provincial de Salud, del Centro Provincial de Higiene y Epidemiología, del sistema de vigilancia vectorial de la Unidad Provincial de Vectores y de aves migratorias de la Dirección Provincial de Medicina Veterinaria y el Ministerio de Ciencia Tecnología y Medio Ambiente (CITMA). Se obtuvo como resultado que Playa, Varadero, Agramante y Jagüey Grande fueron las áreas de salud de mayor riesgo, lo que es de vital importancia para los cuadros a diferentes niveles del sistema, ya que posibilita con una base científica la reorientación de la vigilancia, la organizar los servicios de salud e intervención oportunaAU)


The emergent and re-emergent diseases are a health problem worrying governments and public health authorities because of the economic and social effects they can produce. We carried out a descriptive observational study in the population of the province of Matanzas, geographically distributed in their health area, with the purpose of stratifying the risk for the emergent and re-emergent diseases, in the period 2002-2006. A group of experts selected the diseases to study and the indicators, being defined this way: for the tuberculosis and HIV/AIDS, the prevalence rate and the lethality; for dengue and malaria, the imported cases and the infestation index; for the avian flu and the West Nile fever, the migratory birds settlement and the traveler arrival from the endemic areas, and for the last one also the infestation rate. The data were collected from the cards of Obligatory Declaration Diseases and the decease certifications, from the Provincial Direction of Health, the Provincial Center of Hygiene and Epidemiology, the vectorial surveillance system of the Provincial Unit of Vectors, the Provincial Center of Veterinary Medicine, and the Ministry of Sciences, Technology and Environment. As a result we obtained that Playa, Varadero, Agramonte and Jagüey Grande were the health areas at higher risk. This is of great importance for the executives at the different levels of the system, making possible the reorientation of the surveillance, the organization of the health services and te opportune intervention on a scientific basis(AU)


Asunto(s)
Humanos , Masculino , Femenino , Enfermedades Transmisibles Emergentes/epidemiología , Enfermedades Transmisibles Emergentes/prevención & control , Tuberculosis/epidemiología , Tuberculosis/prevención & control , Gripe Aviar/epidemiología , Gripe Aviar/prevención & control , Infecciones por VIH/epidemiología , Infecciones por VIH/prevención & control , Monitoreo Epidemiológico , Epidemiología Descriptiva , Estudios Observacionales como Asunto
20.
Epidemiol. serv. saúde ; 21(4): 601-616, 2012. tab
Artículo en Portugués | LILACS | ID: lil-661792

RESUMEN

OBJETIVO: determinar a prevalência dos marcadores sorológicos da infecção pelo vírus da hepatite B (VHB) entre trabalhadores de um instituto de pesquisas na Amazônia oriental, estado do Pará, Brasil. MÉTODOS: estudo descritivo, desenvolvido entre 2007 e 2009, com trabalhadores que concordaram em participar mediante entrevista e investigação dos marcadores sorológicos da hepatite B, por técnicas imunoenzimáticas. RESULTADOS: entre 528 trabalhadores pesquisados, encontrou-se prevalência de 0,4 por cento do antígeno de superfície do VHB, 8,0 por cento anticorpos contra o antígeno core do VHB/anticorpos contra o antígeno de superfície do VHB, 2,5 por cento anticorpos contra o antígeno core do VHB isolado e 28,8 por cento anticorpos contra o antígeno de superfície do VHB isolado, entre 68,4 por cento de suscetíveis ao VHB que correspondiam aos indivíduos não vacinados. CONCLUSÃO: identificou-se prevalência e soroconversão inadequadas, abaixo da média informada pelo Ministério da Saúde, em que três doses da vacina devem conferir proteção de aproximadamente 90,0 por cento em adultos.


OBJECTIVE: to determine the prevalence of serological markers of infection by hepatitis B virus (HBV) among workers at a research institute in eastern Amazon, state of Pará, Brazil. METHODS: descriptive study, carried between 2007 and 2009, with workers who agreed to participate through interview and investigation of serological markers of hepatitis B by immu-noenzymatic techniques. RESULTS: among 528 individuals surveyed, was found the prevalence of 0,4 per cent of surface antigen of HBV, 8.0 per cent of antibodies against hepatitis B core antigen/antibody against the surface antigen of VHB, 2.5 per cent antibodies against hepatitis B core isolated antigen and 28.8 per cent antibodies against surface antigen of isolated HBV, 68.4 per cent susceptible to HBV that corresponded to non-vaccinated individuals. CONCLUSION: the research identified inadequate prevalence of seroconversion below the average reported by the Ministry of Health, in which three doses of the vaccine should confer protection of approximately 90.0 per cent in adults.


Asunto(s)
Humanos , Masculino , Femenino , Hepatitis B/transmisión , Prevalencia , Vacunación , Brasil , Epidemiología Descriptiva , Salud Pública
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