Efectividad del Policlínico Antitabaco en Red del Servicio de Salud de Talcahuano (2002 – 2004)

The anti-smoking clinic network is created with the aim of providing support to patients and staff of the Health Service establishments Talcahuano, owing to the need for specialized care in attempting smoking cessation, as evidenced on the occasion of the Competition "Chile 2000 Quit and Win". Objective: To measure the effectiveness of anti-smoking clinic at the health service network of Talcahuano between June 2002 and May 2004. Material and Method: Descriptive study of patients admitted to anti-smoking treatment clinic networking between June 2002 and May 2004. Of the total of 325 patients attended, were considered in the analysis patients who met the inclusion criteria (age ≥18 years, smoker and have motivation to try to quit smoking and need help in smoking cessation process). Results: Of the 191 patients, 44.5% remained abstinent from smoking for more than three months, the abstinence of 29.3% over 6 months and 14.1% abstinent for more than 1 year. 35.6% of patients experienced relapse during the treatment period.El policlínico antitabaco en red se crea con el objetivo de otorgar apoyo a los pacientes y funcionarios de los establecimientos del Servicio de Salud Talcahuano, debido a la necesidad de contar con atención especializada en el intento de cesación del hábito tabáquico, evidenciada con ocasión del Concurso "Déjalo y Gana Chile 2000". Objetivo: Medir la efectividad del Policlínico Antitabaco en Red del Servicio de Salud de Talcahuano entre junio de 2002 y mayo de 2004.Material y Metodo: Estudio descriptivo de pacientes que ingresaron a tratamiento en policlínico antitabaco en red entre junio de 2002 y mayo de 2004. Del total de 325 pacientes consultantes, se consideraron en el análisis los pacientes que cumplieron con los criterios de inclusión (edad igual o superior a 18 años, fumador habitual y tener motivación para intentar dejar de fumar y requerir ayuda en proceso de cesación tabáquica).Resultados: De los 191 pacientes, el 44,5% se mantuvo con abstinencia tabáquica durante más de tres meses; el 29,3% con abstinencia de más de seis meses y el 14,1% con abstinencia por más de un año. El 35,6% de los pacientes sufrió recaída durante el periodo de tratamiento. Conclusión: El resultado del Policlínico Antitabaco en Red se debería a la existencia, en nivel primario, de un equipo multidisciplinario capacitado y sensibilizado en la atención de estos pacientes, así como haber contado con los recursos terapéuticos y el apoyo de atención secundaria

Considerations for an urban health perspective in Chile from the “Quiero Mi Barrio” program

OBJECTIVES To explore the perceptions of residents regarding their health and well-being in areas of personal and collective life, in relation to the experience of urban transformation originated by the Program for the Recovery of Neighborhoods in Chile “Quiero mi Barrio” (PQMB). METHODS Qualitative study conducted in eight neighborhoods, which were subject to interventions between 2012–2015, located in seven communes of Chile: Arica, Renca, Padre Las Casas, Villarrica, Castro, Ancud. Eighteen focus groups and 27 interviews were conducted between 2018 and 2019. A content analysis was carried out following the social determinants of health approach. RESULTS Material conditions of neighborhood infrastructure and psychosocial determinants were the main emerging and predominant categories in the residents’ narratives. The new or improved infrastructure enhances sports and playing practices, as well as contributes to the feeling of safety and to the improvement of walkable spaces, support networks, socialization and dynamization of social organization. However, neglected aspects were visualized. The program had limitations of structural character that operate locally, such as aging, individual lifestyles that limit participation, and contexts of insecurity, especially in neighborhoods victims of drug trafficking. CONCLUSIONS The urban changes originated by the PQMB included improvements in neighborhood infrastructure and in the psychosocial environment, which are perceived by residents as beneficial aspects and promoters of collective wellbeing. However, global phenomena, and those related to the program, limit its scope and have repercussions on the perception of overall wellbeing of the residents in the neighborhoods. To go deeper into how this or other state neighborhood programs may or may not favor equitable access of different social groups, or which works may be better used by the groups, is an aspect that enhances the integral action with other sectors and local actors in the territories

Propuesta para una política de desarrollo profesional continuo del recurso médico de la atención primaria de Chile

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Family health model in Chile and greater resoluteness of primary health care: contradictory or complementary?

Desde 1978 y por medio de la Declaración de Alma Ata, se describe que la atención primaria de salud (APS) debe entenderse como parte integrante del sistema completo de asistencia sanitaria y del espíritu de justicia social del desarrollo. Se ha demostrado en el tiempo que esta estrategia puede adaptarse a una amplia variedad de contextos políticos, sociales, culturales y económicos. Luego de 25 años la Organización Panamericana de la Salud (OPS) sugirió la revisión y adopción de una estrategia renovada para la APS, que incluyera desafíos epidemiológicos, nuevos conocimientos e instrumentos de mejores prácticas y su contribución en la efectividad de la atención primaria, además del reconocimiento de que la APS es una estrategia para fortalecer la capacidad de la sociedad y reducir las inequidades en salud. En el presente análisis se describe la realidad de Chile, considerando los valores, principios y elementos esenciales en un sistema de salud basado en la atención primaria y las reformas necesarias para reorientar los sistemas sanitarios hacia la salud.Since 1978 and through the Alma Ata Declaration, describes the primary health care (PHC) should be understood as part of comprehensive health care system and the spirit of social justice development. It has been proven over time that this strategy can be adapted to a wide variety of political, social, cultural and economic. After 25 years, the Pan American Health Organization (PAHO) suggested the review and adoption of a renewed strategy for the APS, which would include epidemiological challenges, new tools and knowledge of best practices and their contribution to the effectiveness of primary care, and recognition that PHC is a strategy to strengthen the capacity of society and reduce health inequities. This analysis describes the reality of Chile, considering the values, principles and essential elements in a health system based on primary care and the reforms necessary to refocus health systems towards health

Efectividad del Policlínico Antitabaco en Red del Servicio de Salud de Talcahuano (2002 – 2004)

The anti-smoking clinic network is created with the aim of providing support to patients and staff of the Health Service establishments Talcahuano, owing to the need for specialized care in attempting smoking cessation, as evidenced on the occasion of the Competition "Chile 2000 Quit and Win". Objective: To measure the effectiveness of anti-smoking clinic at the health service network of Talcahuano between June 2002 and May 2004. Material and Method: Descriptive study of patients admitted to anti-smoking treatment clinic networking between June 2002 and May 2004. Of the total of 325 patients attended, were considered in the analysis patients who met the inclusion criteria (age ≥18 years, smoker and have motivation to try to quit smoking and need help in smoking cessation process). Results: Of the 191 patients, 44.5% remained abstinent from smoking for more than three months, the abstinence of 29.3% over 6 months and 14.1% abstinent for more than 1 year. 35.6% of patients experienced relapse during the treatment period.El policlínico antitabaco en red se crea con el objetivo de otorgar apoyo a los pacientes y funcionarios de los establecimientos del Servicio de Salud Talcahuano, debido a la necesidad de contar con atención especializada en el intento de cesación del hábito tabáquico, evidenciada con ocasión del Concurso "Déjalo y Gana Chile 2000". Objetivo: Medir la efectividad del Policlínico Antitabaco en Red del Servicio de Salud de Talcahuano entre junio de 2002 y mayo de 2004.Material y Metodo: Estudio descriptivo de pacientes que ingresaron a tratamiento en policlínico antitabaco en red entre junio de 2002 y mayo de 2004. Del total de 325 pacientes consultantes, se consideraron en el análisis los pacientes que cumplieron con los criterios de inclusión (edad igual o superior a 18 años, fumador habitual y tener motivación para intentar dejar de fumar y requerir ayuda en proceso de cesación tabáquica).Resultados: De los 191 pacientes, el 44,5% se mantuvo con abstinencia tabáquica durante más de tres meses; el 29,3% con abstinencia de más de seis meses y el 14,1% con abstinencia por más de un año. El 35,6% de los pacientes sufrió recaída durante el periodo de tratamiento. Conclusión: El resultado del Policlínico Antitabaco en Red se debería a la existencia, en nivel primario, de un equipo multidisciplinario capacitado y sensibilizado en la atención de estos pacientes, así como haber contado con los recursos terapéuticos y el apoyo de atención secundaria

Considerations for an urban health perspective in Chile from the “Quiero Mi Barrio” program

Objectives: To explore the perceptions of residents regarding their health and well-being in areas of personal and collective life, in relation to the experience of urban transformation originated by the Program for the Recovery of Neighborhoods in Chile "Quiero mi Barrio" (PQMB). Methods: Qualitative study conducted in eight neighborhoods, which were subject to interventions between 2012-2015, located in seven communes of Chile: Arica, Renca, Padre Las Casas, Villarrica, Castro, Ancud. Eighteen focus groups and 27 interviews were conducted between 2018 and 2019. A content analysis was carried out following the social determinants of health approach. Results: Material conditions of neighborhood infrastructure and psychosocial determinants were the main emerging and predominant categories in the residents' narratives. The new or improved infrastructure enhances sports and playing practices, as well as contributes to the feeling of safety and to the improvement of walkable spaces, support networks, socialization and dynamization of social organization. However, neglected aspects were visualized. The program had limitations of structural character that operate locally, such as aging, individual lifestyles that limit participation, and contexts of insecurity, especially in neighborhoods victims of drug trafficking. Conclusions: The urban changes originated by the PQMB included improvements in neighborhood infrastructure and in the psychosocial environment, which are perceived by residents as beneficial aspects and promoters of collective wellbeing. However, global phenomena, and those related to the program, limit its scope and have repercussions on the perception of overall wellbeing of the residents in the neighborhoods. To go deeper into how this or other state neighborhood programs may or may not favor equitable access of different social groups, or which works may be better used by the groups, is an aspect that enhances the integral action with other sectors and local actors in the territories

Improving equity in access to early diagnosis of cancer in different healthcare systems of Latin America: protocol for the EquityCancer-LA implementation-effectiveness hybrid study

Introduction Healthcare fragmentation, a main cause for delay in cancer diagnosis and treatment, contributes to high mortality in Latin America (LA), particularly among disadvantaged populations. This research focuses on integrated care interventions, which have been limitedly implemented in the region. The objective is to evaluate the contextual effectiveness of scaling-up an integrated care intervention to improve early diagnosis of frequent cancers in healthcare networks of Chile, Colombia and Ecuador.Methods and analysis This research is two pronged: (A) quasi-experimental design (controlled before and after) with an intervention and a control healthcare network in each LA country, using an implementation-effectiveness hybrid approach to assess the intervention process, effectiveness and costs; and (B) case study design to analyse access to diagnosis of most frequent cancers. Focusing on the most vulnerable socioeconomic population, it develops in four phases: (1) analysis of delays and barriers to early diagnosis (baseline); (2) intervention adaptation and implementation (primary care training, fast-track referral pathway and patient information); (3) intracountry evaluation of intervention and (4) cross-country analysis. Baseline and evaluation studies adopt mixed-methods qualitative (semistructured individual interviews) and quantitative (patient questionnaire survey) methods. For the latter, a sample size of 174 patients with cancer diagnosis per healthcare network and year was calculated to detect a proportions difference of 15%, before and after intervention (α=0.05; β=0.2) in a two-sided test. A participatory approach will be used to tailor the intervention to each context, led by a local steering committee (professionals, managers, policy makers, patients and researchers).Ethics and dissemination This study complies with international and national legal stipulations on ethics. It was approved by each country’s ethical committee and informed consent will be obtained from participants. Besides the coproduction of knowledge with key stakeholders, it will be disseminated through strategies such as policy briefs, workshops, e-tools and scientific papers