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Marco-Ibáñez A, Aguilar-Palacio I, Gamba-Cabezas A, Compés-Dea ML, Aibar Remón C. [How the individual characteristics and area of residence influence the request for virtual consultations?]. Semergen 2024; 50:102296. [PMID: 39208518 DOI: 10.1016/j.semerg.2024.102296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 04/04/2024] [Accepted: 05/13/2024] [Indexed: 09/04/2024]
Abstract
INTRODUCTION The foundation of virtual consultation is to improve the cooperation and the coordination between Primary Care and other specialties. However, in its use inequities related to socioeconomic determinants have been described. The aim of this study was to identify individual and geographical factors affecting the likelihood of accessing this resource. MATERIAL AND METHODS Descriptive study of virtual and non-virtual consultations requested by Primary Care doctors from other specialists doctors in Aragon between 1 January 2020 and 31 December 2022. Characteristics of the interconsultations and variables specific to the patient treated were recorded and analyzed; and the request rate for virtual consultations by specialty and the standardized rates by age by Basic Health Zone and stratified by sex were calculated. RESULTS Progressive increase in the number of virtual consultations for the study period, being Traumatology, Neurology, Urology, General Surgery and Dermatology the specialties that received the most. The standardized rates by age and stratified by sex were higher in women and the Health Areas of Huesca, Calatayud and Alcañiz. The request was higher in 2022 and the specialized referral was the main type of response. Regarding variables of the patients treated, virtual consultations were requested more in urban and less dispersed areas, women, patients with lower adjusted morbidity and with free pharmacy, pensioners and active users with income less than €18,000/year. CONCLUSIONS Despite the rise of telemedicine and its potential advantages, it is necessary to adapt it to the needs of the local population, to mitigate inequalities in access, and to integrate it with face-to-face care.
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Affiliation(s)
- A Marco-Ibáñez
- Centro de Salud Casablanca, Servicio Aragonés de Salud, Grupo de Investigación en Servicios Sanitarios (GRISSA), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España.
| | - I Aguilar-Palacio
- Universidad de Zaragoza, Grupo de Investigación en Servicios Sanitarios (GRISSA), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
| | - A Gamba-Cabezas
- Grupo de Investigación en Servicios Sanitarios (GRISSA), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
| | - M L Compés-Dea
- Dirección General de Asistencia Sanitaria y Planificación del Departamento de Sanidad del Gobierno de Aragón. Grupo de Investigación en Servicios Sanitarios (GRISSA), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
| | - C Aibar Remón
- Universidad de Zaragoza, Grupo de Investigación en Servicios Sanitarios (GRISSA), Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, España
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Fidalgo H, da Casa C, Busto R, Vega Suárez Á, Blanco JF. Analysis of the demand of care from Primary Care to Traumatology: Proposals for the improvement of the continuous care. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:153-159. [PMID: 35452858 DOI: 10.1016/j.recot.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 02/02/2022] [Accepted: 03/15/2022] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE To analyze referrals from Primary Care consultation to Orthopaedic Surgery reference department. As a secondary objective, to establish 2referral scenarios in order to determine the impact of variability on referral. MATERIAL AND METHODS Cross-sectional observational study, analyzing referrals from Primary Care to Orthopaedic Surgery during the first half of the years 2018, 2019, and 2021. The number of referrals issued by each doctor and each Primary Care Healthcare Center was examined, according to the classification of the different Basic Healthcare Zones. RESULTS There is great variability in the number of referrals, both according to the type of Basic Healthcare Zone and by each Primary Care facultative. The referral ratios behaved uniformly over time (P<0.001). Due to a large number of referrals, 2scenarios have been constructed: In the first scenario, the referral ratio would be in the middle of the referral rate spectrum. In the second scenario, the lowest referral ratios recorded have been taken as a reference. The reduction of variability in the 2scenarios assumed provides a significant reduction in the demand for care. CONCLUSION Reducing variability would have a beneficial effect on the capacity of the Orthopaedic Surgery service to provide care.
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Affiliation(s)
- H Fidalgo
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España
| | - C da Casa
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España
| | - R Busto
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España
| | - Á Vega Suárez
- Gerencia de Atención Primaria de Salamanca, Servicio de Salud de Castilla y León (SACYL), Salamanca, España
| | - J F Blanco
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, España; Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de Salamanca, Salamanca, España.
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Fidalgo H, da Casa C, Busto R, Vega Suárez Á, Blanco JF. [Translated article] Analysis of the demand of care from Primary Care to Traumatology: Proposals for the improvement of the continuous care. Rev Esp Cir Ortop Traumatol (Engl Ed) 2023; 67:T153-T159. [PMID: 36528301 DOI: 10.1016/j.recot.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/15/2022] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To analyse referrals from Primary Care consultation to Orthopaedic Surgery reference department. As a secondary objective, to establish 2 referral scenarios in order to determine the impact of variability on referral. MATERIAL AND METHODS Cross-sectional observational study, analyzing referrals from Primary Care to Orthopaedic Surgery during the first half of the years 2018, 2019, and 2021. The number of referrals issued by each doctor and each Primary Care Healthcare Center was examined, according to the classification of the different Basic Healthcare Zones. RESULTS There is great variability in the number of referrals, both according to the type of Basic Healthcare Zone and by each Primary Care facultative. The referral ratios behaved uniformly over time (p<0.001). Due to a large number of referrals, 2 scenarios have been constructed: In the first scenario, the referral ratio would be in the middle of the referral rate spectrum. In the second scenario, the lowest referral ratios recorded have been taken as a reference. The reduction of variability in the 2 scenarios assumed provides a significant reduction in the demand for care. CONCLUSION Reducing variability would have a beneficial effect on the capacity of the Orthopaedic Surgery service to provide care.
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Affiliation(s)
- H Fidalgo
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - C da Casa
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - R Busto
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain
| | - Á Vega Suárez
- Gerencia de Atención Primaria de Salamanca, Servicio de Salud de Castilla y León (SACYL), Salamanca, Spain
| | - J F Blanco
- Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain; Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario de Salamanca, Salamanca, Spain.
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da Casa C, Suárez ÁV, Asensio N, Blanco JF. Quality assessment of orthopedic surgery referral request letters from primary care consultation: Evaluation of a Spanish healthcare area. J Family Community Med 2021; 28:189-195. [PMID: 34703379 PMCID: PMC8496696 DOI: 10.4103/jfcm.jfcm_133_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/15/2021] [Accepted: 06/29/2021] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND One of the most requested referrals for specialist consultations from primary care (PC) is orthopedic surgery (OS). The purpose of this work was to analyze the number, characteristics, and quality of PC referral request letters in a Spanish healthcare area to their OS reference department. MATERIALS AND METHODS The referral rates for 10 years were collected, and a total of 6,225 referral letters issued during the first half of 2019 were analyzed in detail. Gender, age, patient provenance, as well as priority and other process descriptors (type of pathology, suspected diagnosis, exploratory signs, imaging tests) were assessed. A scoring system was developed to evaluate the quality of the referral to an OS consultation: Quality evaluation in OS (QEOS) model. RESULTS The rate of referral to OS is rising. The mean age of the referred patient was 53 years and 59.3% were women. Degenerative pathologies justified most referral requests (65.7%), most of which related to the spine (24.2%) or the knee (23.2%). In the QEOS analysis of the referral request letters, we noted that only 36.5% described some physical exploration, 32.9% image tool request, 25.8% indicated the pharmacological treatment, and 11.2% subsequent physiotherapy, resulting in a poor average quality of PC to OS patient referral. CONCLUSION There is a growing demand for patient referral from PC to OS, however, the number, content, and quality of referral request letters varies greatly. The QEOS tool can be the germ of a simple evaluation system that would help in the improvement of the process of continuous care.
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Affiliation(s)
- Carmen da Casa
- IBSAL - Biomedical Research Institute of Salamanca, Spain.,Department of Surgery, Faculty of Medicine, USAL - University of Salamanca, Salamanca, Spain
| | - Ángel V Suárez
- Salamanca Primary Health Care Management. SACYL - Castilla y León Health Service, Salamanca, Spain
| | - Nuria Asensio
- Primary Healthcare Centre "Pizarrales", SACYL - Castilla y León Health Service, Salamanca, Spain
| | - Juan F Blanco
- IBSAL - Biomedical Research Institute of Salamanca, Spain.,Department of Surgery, Faculty of Medicine, USAL - University of Salamanca, Salamanca, Spain.,Orthopaedic Surgery and Traumatology, University Hospital of Salamanca, Salamanca, Spain
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Zamora Navas P. The result of the use of remote consultation in orthopaedic and trauma surgery during the COVID-19 pandemic. ACTA ACUST UNITED AC 2021; 65:54-62. [PMID: 33995713 PMCID: PMC7987528 DOI: 10.1016/j.recote.2020.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 06/30/2020] [Indexed: 11/30/2022]
Abstract
The COVID pandemic has made telematic consultations a basic tool in daily practice. Aims The main objective of the study is to assess the results of the application of telematic consultations to limit the mobility of patients. The operational objectives are; to propose a consultation plan, to know how attendance limits consultations and to define which pathologies benefit the most from this plan. Methods A scheme is proposed with the creation of pre-scheduled clinic to assess suitability and the possibility of carrying them out in a single non face-to-face act. Results Phone call to 5619 patients were made with a lack of response of 19% The cases of 74% of the patients that answered were resolved virtually. There is a difference between units, obtaining a higher answering rate from patients appointed to specific clinic units, OR = 0.60, or to general trauma ones, OR = 0.67. The lowest answering rate was obtained from those derived from the emergency department. Twenty per cent of the consultations were not accompanied by complementary tests that would have favored the resolution in a single act. The general trauma consultations, OR = 0.34, postoperative control, OR = 0.49, and specific unit ones, OR = 0.40, were the ones that better met this requirement. Out of the remaining patients, the general trauma consultations, OR = 0.50, and those referred to units, OR = 0.54, were the ones that had a higher resolution rate without in- person consultation. Conclusions The cases of 74% of the patients who answered the phone call were resolved virtually. Cases of 20% of the patients cannot be solved in a single act because they are derived without complementary tests. Osteosynthesis and postoperative arthroscopic follow-up consultations are the ones that need to be carried out in person the most.
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Affiliation(s)
- P Zamora Navas
- Servicio de Cirugía Ortopédica y Traumatología, Hospital Universitario Virgen de la Victoria, Málaga, Spain
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6
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Ramos-Pichardo JD, Ortega-Galán ÁM, Iglesias-López MT, Abreu-Sánchez A, Fernández-Martínez E. Why Do Some Spanish Nursing Students with Menstrual Pain Fail to Consult Healthcare Professionals? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17218173. [PMID: 33167417 PMCID: PMC7663954 DOI: 10.3390/ijerph17218173] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 11/03/2020] [Accepted: 11/04/2020] [Indexed: 12/22/2022]
Abstract
Dysmenorrhea is a problem that affects a large percentage of young women worldwide. Alarmingly, the majority of these women choose to self-medicate rather than consult a healthcare professional, despite the risks involved. The present study aimed to explore the reasons why undergraduate nursing students do not consult health care professionals regarding their menstrual pain. A qualitative study was conducted using an open question: "Why didn't you consult a healthcare professional?" within the context of a research project on primary dysmenorrhea among nursing students at the University of Huelva, Spain. The responses of 202 women were analyzed using content analysis. Three categories were identified: assessment of the pain experienced, expectations, and experiences of professional care and selfcare. We found a striking normalization of the problem; notably, students downplayed the importance of the problem, considering that it was not worth consulting a physician. Furthermore, there was a notable degree of self-medication using non-steroidal anti-inflammatories (NSAIDs). These results may be useful for orienting policies to raise social awareness of this problem and for designing health education strategies aimed at women with primary dysmenorrhea.
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Affiliation(s)
- Juan Diego Ramos-Pichardo
- Department of Nursing, University of Huelva, 21071 Huelva, Spain; (J.D.R.-P.); (Á.M.O.-G.); (A.A.-S.)
| | - Ángela María Ortega-Galán
- Department of Nursing, University of Huelva, 21071 Huelva, Spain; (J.D.R.-P.); (Á.M.O.-G.); (A.A.-S.)
| | - María Teresa Iglesias-López
- Faculty of Health Sciences, Universidad Francisco de Vitoria, Crta. Pozuelo-Majadahonda km 1800, Pozuelo de Alarcón, 28223 Madrid, Spain;
| | - Ana Abreu-Sánchez
- Department of Nursing, University of Huelva, 21071 Huelva, Spain; (J.D.R.-P.); (Á.M.O.-G.); (A.A.-S.)
| | - Elia Fernández-Martínez
- Department of Nursing, University of Huelva, 21071 Huelva, Spain; (J.D.R.-P.); (Á.M.O.-G.); (A.A.-S.)
- Correspondence:
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7
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Zamora Navas P, Montañez Heredia E, Nieto Orellana J, Gónzalez García C, Cano Obando L, Cárdenas Rebollo L, Abderrachid Al Chaid Y, Saadouli Arco M, Rodríguez Delourme I, Díez Izquierdo M, Prado Martín de Lucía LF, Durán Garrido J, Fernández Hijano M, Víquez da Silva R, Olofsson Suárez-Bárcena C, Jiménez Garrido C, García Vera JJ, Pérez Cardeña J, Irízar Jiménez S, Esteban Del Castillo JL, García Píriz M, Gómez Palomo JM, Fernández Martín FJA, Huertas Segador P, Santos de la Fuente J, Serrano Fernández J, Estades Rubio F, Fernández de Rota A, García Herrera JM, Leiva Gea A, Lombardo Torre M, Mariscal Lara J, Martín Castilla B, Urbano Labajos V, Sánchez García A, Quirante Sánchez V, Cañada Oya S, Rodríguez Jiménez M, Delgado Rufino B, Queipo de Llano Temboury A, Barón Romero M, López Hermoso MD, Benavente Casajús M, Loring Caffarena T, Chaparro Villar MA, de la Torre Solís F. Result of the implementation of telematic consultations in orthopaedic surgery and traumatology during COVID-19 laparoscopic surgery. Rev Esp Cir Ortop Traumatol (Engl Ed) 2020; 65:54-62. [PMID: 33277229 PMCID: PMC7556806 DOI: 10.1016/j.recot.2020.06.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/21/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022] Open
Abstract
La pandemia COVID ha hecho de las consultas telemáticas una herramienta básica en la práctica diaria. El objetivo principal del estudio es valorar los resultados de la aplicación de consultas telemáticas para limitar la movilidad de los pacientes. Son objetivos operativos: proponer un plan de consultas, conocer cómo limita la asistencia a las consultas, definir qué patologías se benefician más con este plan. Material y métodos Se propone un esquema con la creación de consultas previas a las agendadas para valorar idoneidad y posibilidad de realizarla en acto único no presencial. Resultados Se han realizado 5.619 consultas con una falta de respuesta telefónica del 19%. El 74% de los pacientes fueron resueltos de forma virtual. Existe diferencia entre unidades, siendo más probable la respuesta telefónica para las consultas de unidad, OR = 0,60 o de traumatología general, OR = 0,67 y menos para los derivados desde urgencias. El 20% de las consultas no se acompañaban de pruebas complementarias. Las consultas de traumatología general, OR = 0,34, control postoperatorio, OR = 0,49, y unidades, OR = 0,40, cumplieron mejor este requisito. De los pacientes restantes, las consultas de traumatología general, OR = 0,50, y las derivadas a unidades, OR = 0,54 fueron las que más se resolvieron sin acudir presencialmente. Conclusiones Se han resuelto de forma no presencial el 74% de los pacientes que atendieron a la llamada telefónica. El 20% de los pacientes acuden a la visita sin pruebas complementarias. Las consultas de seguimiento de osteosíntesis y postoperatorio de cirugía artroscópica son las que más precisan de ser realizadas de forma presencial.
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Affiliation(s)
- P Zamora Navas
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España.
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- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - E Montañez Heredia
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J Nieto Orellana
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - C Gónzalez García
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - L Cano Obando
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - L Cárdenas Rebollo
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - Y Abderrachid Al Chaid
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M Saadouli Arco
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - I Rodríguez Delourme
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M Díez Izquierdo
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - L F Prado Martín de Lucía
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J Durán Garrido
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M Fernández Hijano
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - R Víquez da Silva
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - C Olofsson Suárez-Bárcena
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - C Jiménez Garrido
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J J García Vera
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J Pérez Cardeña
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - S Irízar Jiménez
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J L Esteban Del Castillo
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M García Píriz
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J M Gómez Palomo
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - F J A Fernández Martín
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - P Huertas Segador
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J Santos de la Fuente
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J Serrano Fernández
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - F Estades Rubio
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - A Fernández de Rota
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J M García Herrera
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - A Leiva Gea
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M Lombardo Torre
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - J Mariscal Lara
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - B Martín Castilla
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - V Urbano Labajos
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - A Sánchez García
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - V Quirante Sánchez
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - S Cañada Oya
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M Rodríguez Jiménez
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - B Delgado Rufino
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - A Queipo de Llano Temboury
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M Barón Romero
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M D López Hermoso
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M Benavente Casajús
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - T Loring Caffarena
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - M A Chaparro Villar
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
| | - F de la Torre Solís
- Servicio de Cirugía Ortopédica y Traumatología. Hospital Universitario Virgen de la Victoria, Málaga, España
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Cisneros Luján AI, Cinta Loaiza DM, Sánchez Bandala MA, González Rojas V. Percepción sobre la coordinación de la atención: el caso de las redes de servicios de salud de Xalapa y Veracruz, México, en el periodo 2014-2016. ACTA ACUST UNITED AC 2020. [DOI: 10.11144/javeriana.rgps19.pcac] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Una limitada coordinación asistencial impide garantizar una atención integrada, eficiente y de calidad. El objetivo del estudio fue explorar la percepción de profesionales de salud sobre la coordinación entre niveles de atención y los factores que la influyen. Se realizó un estudio cualitativo mediante el análisis de contenido de 54 entrevistas semiestructuradas y 11 grupos focales con personal de dos redes de servicios de salud en Xalapa y Veracruz, México. Los entrevistados refirieron dificultades para el seguimiento de los pacientes, desacuerdos respecto a los criterios de referencia, barreras de acceso a la atención especializada, baja calidad de los formatos de referencia, escasa recepción de los formatos de contrarreferencia y dificultades para seguir los circuitos de referencia. Atribuyeron estos problemas a la insuficiencia de recursos, la cobertura limitada del Seguro Popular, la sobrecarga de trabajo, falta de supervisión, deficiente formación de los médicos generales y limitada comunicación entre profesionales. Estos resultados coinciden con otros estudios en la región, por lo que se señala la necesidad de reforzar los mecanismos basados en la normalización, introducir estrategias basadas en la adaptación mutua y modificar rasgos de la estructura y cultura organizacional para lograr una coordinación de la atención efectiva, que contribuya a la integración de las redes.
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Bécares Martínez C, Arroyo Domingo MM, López Llames A, Marco Algarra J, Morales Suárez-Varela MM. Vertigo and Dizziness in Hospital: Attendance, Flow and Characteristics of Patients. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2018. [DOI: 10.1016/j.otoeng.2017.08.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Vertigo and dizziness in hospital: Attendance, flow and characteristics of patients. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2017; 69:219-225. [PMID: 29033126 DOI: 10.1016/j.otorri.2017.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 07/26/2017] [Accepted: 08/07/2017] [Indexed: 11/23/2022]
Abstract
INTRODUCTION AND OBJECTIVES Vertigo and dizziness as symptoms are frequent in the population. They are present in a wide range of pathologies and it is usually difficult to make an accurate diagnosis. The general objective of this study is to obtain the information to evaluate vertigo and dizziness in the hospital setting. The specific objectives are: to estimate the burden of these symptoms at the hospital; to study patients' conditions and to detail the flow of these patients inside the hospital. METHODS Observational descriptive study. We made a search of the referral proposals made in 2011 and 2012 to the hospital because of vertigo symptoms. The patients' demographic and clinical characteristics, and the administrative details of the referrals were analysed. RESULTS A total of 558 proposals were analysed corresponding to 494 patients. Vertigo accounted for 0.5% of all referrals made from Primary Care to the hospital. Sixty-three percent of the sample were women; the average age was 58 years. Eighty-eight percent of the patients were evaluated by Otorhinolaryngology, 24% by Neurology. Thirty point eight percent consulted on 3 or more occasions for the symptom. Sixteen percent were assessed for psychiatric conditions in the hospital. CONCLUSIONS Vertigo as a symptom is a significant burden in the hospital setting. The patients who suffer it consult on several occasions and are assessed by different specialties. This implies in some cases an excessive and ineffective flow of patients. In our setting, otorhinolaryngology is the main department to treat vertigo and dizziness patients.
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[Use of ineffective practices in Primary Health Care: professional opinions]. ACTA ACUST UNITED AC 2014; 29:220-8. [PMID: 24928717 DOI: 10.1016/j.cali.2014.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2014] [Revised: 04/10/2014] [Accepted: 04/11/2014] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To estimate the frequency of ineffective practices in Primary Health Care (PHC) based on the opinions of clinical professionals from the sector, and to assess the significance, implications and factors that may be contributing to their continuance. MATERIAL AND METHODS An on line survey of opinion from a convenience sample of 575 professionals who had published articles over the last years in Atención Primaria and Semergen medical journals. RESULTS A total of 212 professionals replied (37%). For 70.6% (95% confidence interval [CI] 64.5 to 73.3) the problem of ineffective practices is frequent or very frequent in PHC, and rate their importance with an average score of 7.3 (standard deviation [SD]=1.8) out of 10. The main consequences would be endangering the sustainability of the system (48.1%; 95% CI, 41.2 to 54.9) and harming patients (32.1%; 95% CI, 25.7 to 38.5). These ineffective practices are the result of the behaviour of the patients themselves (28%; 95% CI, 22.6 to 35.0) workload (26.4%; 95% CI, 20.3 to 32.5), and the lack of the continuous education (19.3%; 95% CI, 13.9 to 24.7). Clinical procedures of greatest misuse are the prescribing of antibiotics for certain infections, the frequency of cervical cancer screening, rigorous pharmacological monitoring of type 2 diabetes in patients over 65 years, the use of psychotropic drugs in the elderly, or the use of analgesics in patients with hypertension or renal failure. CONCLUSIONS The use of ineffective procedures in PHC is considered a very important issue that negatively affects many patients and their treatment, and possibly endangering the sustainability of the system and causing harm to patients.
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Sobre la gestión de las interconsultas entre atención primaria y especializada. Semergen 2014; 40:114-5. [DOI: 10.1016/j.semerg.2013.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2013] [Accepted: 03/19/2013] [Indexed: 11/24/2022]
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