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Consideraciones legales sobre las notas de evolución en odontología / Legal considerations on medical charts in dentistry
Tiol Carrillo, Agustín.
Affiliation
  • Tiol Carrillo, Agustín; UAM-Xochimilco. Xochimilco. MX
Rev. ADM ; 78(5): 280-282, sept.-oct. 2021.
Article in Spanish | LILACS | ID: biblio-1348306
Responsible library: AR29.1
RESUMEN
El expediente clínico es considerado un documento de importancia médica y legal en donde se integran los datos necesarios para registrar el diagnóstico y los tratamientos realizados en cada paciente. Uno de los elementos más importantes dentro del expediente clínico son las notas de evolución, documentos con los que el odontólogo informa sobre el estado general del paciente y los tratamientos realizados cita tras cita. Existen legislaciones específicas en México que orientan al estomatólogo sobre los componentes mínimos necesarios que una nota de evolución debe tener; sin embargo, una de las omisiones más comunes de los odontólogos es que, por desconocimiento, no se dé la debida importancia a la elaboración de una adecuada nota de evolución, aumentando el riesgo de problemas legales. El objetivo del presente artículo es analizar la importancia de las notas de evolución dentro del expediente clínico, destacando su importancia clínica y legal (AU)
ABSTRACT
The clinical file is considered a document of medical and legal importance where the data necessary to record the diagnosis and the treatments performed on each patient are integrated. One of the most important elements within the clinical records are the medical charts, documents through which de dentist reports on the general condition of the patient and the treatments performed appointment after appointment. There are specific laws in Mexico that guide the stomatologist on the minimum necessary components that a medical chart must have, however, one of the most common omissions of dentist is that, due to ignorance, due importance is not given to the preparation of an adequate medical chart, increasing the risk of legal problems. The aim of this article is to analyze the importance of the evolution charts within the clinical records, highlighting their clinical and legal importance (AU)
Subject(s)


Full text: Available Collection: International databases Database: LILACS Main subject: Dental Records / Medical Records / Forensic Dentistry Type of study: Prognostic study Limits: Female / Humans / Male Country/Region as subject: Mexico Language: Spanish Journal: Rev. ADM Journal subject: Dentistry / Orthodontics Year: 2021 Document type: Article Affiliation country: Mexico Institution/Affiliation country: UAM-Xochimilco/MX

Full text: Available Collection: International databases Database: LILACS Main subject: Dental Records / Medical Records / Forensic Dentistry Type of study: Prognostic study Limits: Female / Humans / Male Country/Region as subject: Mexico Language: Spanish Journal: Rev. ADM Journal subject: Dentistry / Orthodontics Year: 2021 Document type: Article Affiliation country: Mexico Institution/Affiliation country: UAM-Xochimilco/MX
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