Revisión de intervenciones con nuevas tecnologías en el control de las enfermedades crónicas

El objetivo principal de este informe es investigar la efectividad de la inclusión de las TIC en el control de las enfermedades crónicas.RESUMEN INAHTA STRUCTURED SUMMARY LISTA DE LAS ABREVIATURAS MÁS UTILIZADAS 1. INTRODUCCIÓN 2. OBJETIVOS 3. MÉTODO 4. RESULTADOS 5. DISCUSIÓN 6. CONCLUSIONES ANEXO I: RESUMEN DESCRIPTIVO DE LOS ESTUDIOS INCLUIDOS ANEXO II: ESTRATEGIA DE BÚSQUEDA REFERENCIAS BIBLIOGRÁFICA

A systematic review of the use of health services by immigrants and native populations

Background: Changes in migration patterns that have occurred in recent decades, both quantitative, with an increase in the number of immigrants, and qualitative, due to different causes of migration (work, family reunification, asylum seekers and refugees) require constant u pdating of the analysis of how immigrants access health services. Understanding of the existence of changes in use patterns is necessary to adapt health services to the new socio-demographic reality. The aim of this study is to describe the scientific evidence that assess the differences in the use of health services between immigrant and native populations. Methods: A systematic review of the electronic database MEDLINE (PubMed) was conducted with a search of studies published between June 2013 and February 2016 that addressed the use of health services and compared immigrants with native populations. MeSH terms and key words comprised Health Services Needs and Demands/Accessibility/Disparities/Emigrants and Immigrants/Native/Ethnic Groups. The electronic search was supplemented by a manual search of grey literature. The following information was extracted from each publication: context of the study (place and year), characteristics of the included population (definition of immigrants and their sub-groups), methodological domains (design of the study, source of information, statistical analysis, variables of health care use assessed, measures of need, socio-economic indicators) and main results. Results: Thirty-six publications were included, 28 from Europe and 8 from other countries. Twenty-four papers analysed the use of primary care, 17 the use of specialist services (including hospitalizations or emergency care), 18 considered several levels of care and 11 assessed mental health services. The characteristics of immigrants included country of origin, legal status, reasons for migration, length of stay, different generations and socio-demographic variables and need. In general, use of health services by the immigrants was less than or equal to the native population, although some differences between immigrants were also identified. Conclusions: This review has identified that immigrants show a general tendency towards a lower use of health services than native populations and that there are significant differences within immigrant sub-groups in terms of their patterns of utilization. Further studies should include information categorizing and evaluating the diversity within the immigrant population.The study was funded by the Institute of Health Carlos III and REDISSEC Thematic NetworkS

Cooperación para el desarrollo descentralizada en Salud y Medio Ambiente: Evaluación de barreras y oportunidades

OBJETIVOS Describir las barreras y oportunidades percibidas tanto por organismos financiadores como por ONGs solicitantes, referentes a la eficiencia de cooperación para el desarrollo descentralizada de la comunidad de Madrid. Describir las barreras y oportunidades percibidas tanto por financiadores como por financiados, para aplicar el enfoque Ecosalud en los proyectos de cooperación para el desarrollo. Describir las características (en términos de pertinencia y diseño, eficacia, eficiencia, impacto y sostenibilidad, así como de aplicación del enfoque Ecosalud) de los proyectos sobre salud y medio ambiente subvencionados por organismos financiadores como por ONGs de la Comunidad de Madri

Detection of the Frail Elderly at Risk of Postoperative Sepsis.

With the increase in the elderly population, surgery in aged patients is seeing an exponential increase. In this population, sepsis is a major concern for perioperative care, especially in older and frail patients. We aim to investigate the incidence of sepsis in elderly patients receiving diverse types of surgical procedures and explore the predictive capacity of the Hospital Frailty Risk Score (HFRS) to identify patients at high risk of incidence of postoperative sepsis. This study relies on information from the Spanish Minimum Basic Data Set, including data from nearly 300 hospitals in Spain. We extracted records of 254,836 patients aged 76 years and older who underwent a series of surgical interventions within three consecutive years (2016-2018). The HFRS and Elixhauser comorbidity index were computed to determine the independent effect on the incidence of sepsis. Overall, the incidence of postoperative sepsis was 2645 (1.04%). The higher risk of sepsis was in major stomach, esophageal, and duodenal (7.62%), followed by major intestinal procedures (5.65%). Frail patients are at high risk of sepsis. HFRS demonstrated a high predictive capacity to identify patients with a risk of postoperative sepsis and can be a valid instrument for risk stratification and vigilant perioperative monitoring for the early identification of patients at high risk of sepsis.S

Sistemas de Ajuste de Riesgo en Evaluación de Servicios de Salud

El objetivo es explorar, identificar y exponer modelos de ajuste de riesgo originales generados con el fin de describir, evaluar y comparar la efectividad de los servicios de salud, y detectar aquellas áreas de la asistencia sanitaria donde podría resultar prioritario desarrollar sistemas o modelos de ajuste de riesgo

An Update on Resources, Procedures and Healthcare Provision in Pain Units: A Survey of Spanish Practitioners

Multidisciplinary pain treatment units are recommended to provide comprehensive diagnosis and treatment of chronic pain, a complex clinical syndrome and one of the leading causes of disability worldwide. The objective of this study was to provide updated results on the situation of pain treatment units in Spain and to determine compliance with recommendations proposed by de Spanish Ministry of Health (SMH). A cross-sectional, prospective, multicenter survey was performed, collecting data on resources, procedures and healthcare provision. Between March and May 2019, the Spanish Pain Society sent an invitation letter to 183 pain units with a link to the questionnaire. Sixty-nine units from 13 regions agreed to participate. According to the International Association for the Study of Pain criteria, only 12 units were classified as multidisciplinary pain centers. Most (95.7%) were in hospitals, 82.6% from the public sector, and 46.4% had protocols to coordinate with primary care. Interviewees rated the adequacy of facilities at 6.3 (from 0 to 10). Moreover, 67% of interviewees found that there were insufficient staff, with no mental health professionals, physical therapists or social workers in 49.3%, 87.0% and 97.1% units, respectively. Only 24 pain units had a day hospital, 44.9% offered psychological interventions, and 79.7% supported teaching and research activities. Results suggest that a small proportion of Spanish pain units meet the national standards for multidisciplinary pain units proposed by the SMH

Revisión de intervenciones en Atención Primaria para mejorar el control de las enfermedades crónicas

El objetivo principal de este informe es investigar la efectividad de las diferentes estrategias destinadas a mejorar la calidad y resultados de las intervenciones que se llevan a cabo para el manejo de cuatro enfermedades crónicas: asma, diabetes, hipertensión e insuficiencia cardiaca

Challenges of audit of care on clinical quality indicators for hypertension and type 2 diabetes across four European countries

BACKGROUND: The purpose of the study was to measure clinical quality by doing an audit of clinical records and to compare the performance based on clinical quality indicators (CQI) for hypertension and type 2 diabetes across seven European countries: Estonia, Finland, Germany, Hungary, Italy, Lithuania and Spain. METHODS: Two common chronic conditions in primary care (PC), hypertension and type 2 diabetes, were selected for audit. The assessment of CQI started with a literature review of different databases: Organization for Economic Co-operation and Development, World Health Organization, European Commission European Community Health Indicators, US National Library of Medicine. Data were collected from clinical records. RESULTS: Although it was agreed to obtain the clinical indicators in a similar way from each country, the specific data collection process in every country varied greatly, due to different traditions in collecting and keeping the patients' data, as well as differences in regulation regarding access to clinical information. Also, there was a huge variability across countries in the level of compliance with the indicators. CONCLUSIONS: Measurement of clinical performance in PC by audit is methodologically challenging: different databases provide different information, indicators of quality of care have insufficient scientific proof and there are country-specific regulations. There are large differences not only in quality of health care across Europe but also in how it is measured.EU primecare project was funded under the European Commission’s 7th Framework Programme (grant no. 241595).S

Could we call frequent attenders to patients because of their high frequency of attendance?

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Monkeypox: Is the world ready for another pandemic?

As the world continues to endure the impact of the COVID-19 pandemic, an outbreak of Monkeypox occurs and continues to spread unabatedly. The double-stranded DNA monkeypox virus is a sylvatic zoonosis, which occasionally infects humans and is a member of the genus Orthopoxviruses. Although scientists believed the virus to have low transmissibility, the speed and degree with which it spreads is alarming and could land one in a hospital or even kill one. Additionally, the fact that unusual transmissions are occurring among people without travel history to endemic regions suggests undetected transmissions, raising concerns about our preparedness for another pandemic. Contrary to the COVID-19 pandemic, there is a vaccine that could offer some protection against the monkeypox virus. Therefore, there is a need for coordinated efforts among authorities concerned and community-based organizations to raise awareness of the potential pandemic of monkeypox, activate surveillance systems and laboratory capacity, and heighten contact tracing and vaccination of at-risk individuals to stem the outbreak while there is still the opportunity to prevent it from becoming a pandemic