Evaluation of the Medical Assistance to Patients with Arterial Hypertension in Four Urban Áreas

Foundation: improving the quality of assistance is a challenge for all in charge of providing health services. It is no enough to know what happens but also to modify unsatisfactory results. Objective: to evaluate the quality of the medical assistance which patients with hypertension receive by means of the program observance in four health areas during 2013. Methods: a research of the health systems and services was done, using a two stage conglomerate sample. The variables studied were related to the coverage and quality of human resources, the availability of material resources, the compliance of the main activities set for the process of assistance. Various instruments approved by experts were applied to hypertensive population. More than 85 % of clinical records were audited. For collecting and analyzing data statistic packages Access 2000 and SPSS 15, 0 were used. Results: the evaluation of structure, process and results dimensions was not satisfactory in the studies area, because the proposed standards were not achieved. Conclusion: the assistance received by these patients is not appropriate since there were difficulties in the program compliance, which influenced in the quality provided

Morbidity, utilization of curative care and service entry point preferences in metropolitan Centro Habana, Cuba

Pol De Vos - ORCID: 0000-0002-1672-6469 https://orcid.org/0000-0002-1672-6469First-line health services with a primary health care approach are a strong trigger for adequate health-care-seeking behavior. Research on the association between prevalence of chronic diseases and acute illnesses and use of health services emphasizes the importance of socioeconomic determinants in such patterns of utilization. In a cross-sectional study of 408 families in Centro Habana, Cuba, home interviews were conducted between April and June 2010 to analyze socio-demographic determinants of acute and chronic health problems and use of formal health services. Bivariate and logistic regression models were used. 529 persons reported a chronic disease. During the previous month, 155 of the latter reported an exacerbation and 50 experienced an unrelated acute health problem. 107 persons without chronic diseases reported acute health problems. Age was the strongest determinant of chronic disease prevalence. Adult women and the elderly were more likely to report acute problems. Acute patients with underlying chronic disease used formal services more often. No socio-demographic variable was associated with services use or consultation with the family physician. While the family physician is defined as the system's entry-point, this was the case for only 54% of patients that had used formal services, thus compromising the physician's role in counseling patients and summarizing their health issues. The importance of chronic diseases highlights the need to strengthen the family physician's pivotal role. New economic policies in Cuba, stimulating self-employment and private initiative, may increase the strain on the exclusively public health care system. Still, the Cuban health system has demonstrated its ability to adapt to new challenges, and the basic premises of Cuba's health policy are expected to be preserved.Paper adds to the growing body of evidence that children can acquire phonological systems before they are able to master the phonetic skills needed to convey the contrasts in that systemsch_iih32pub5025e00108914pub1

Use of medical services in a health area

De Vos, Pol - ORCID 0000-0002-1672-6469 https://orcid.org/0000-0002-1672-6469Introducción: en la utilización de los servicios de salud convergen no solo la necesidad de atención de la población en términos de enfermedad, sino sus creencias y aspectos culturales; pero, sobre todo, el complejo contexto en que se da la prestación de servicios. Objetivo: exponer las características sociodemográficas y las enfermedades o sintomatologías más frecuentes en la población del área de salud "Marcio Manduley", del municipio Centro Habana, y los que hicieron uso de los servicios de salud durante el período abril - junio de 2010. Métodos: estudio descriptivo transversal. Se seleccionó una muestra poblacional representativa del área; se tomó en consideración el total de viviendas. Como se desconoce la prevalencia del factor bajo estudio, se maximizó la muestra tomando como prevalencia el 50 %, la precisión en 10 % y una posible caída muestral del 10 %. El tamaño muestral fue de 408 familias. Se aplicaron cuestionarios a todos los integrantes de las familias seleccionadas y en particular a aquellos individuos que durante los últimos 30 días enfermaron e hicieron uso de algún servicio de salud. Resultados: se obtuvieron datos de 1 244 personas; de ellas enfermaron 25,1 % en los últimos 30 días y el 17,7 % hizo uso de servicios formales de salud. Las enfermedades más frecuentes fueron respiratorias, cardiovasculares y osteomioarticular. La puerta de entrada al sistema de salud más utilizada fue el consultorio médico (54,1 %). Conclusiones: en nuestro estudio los factores del individuo que influyen en la utilización de los servicios de salud son el nivel de enfermedad percibida o necesidad de salud y el sexo.Introduction: use of health services is determined not only by the need of health care in case of illness, but also by beliefs and cultural views, and above all by the complex environment in which services are rendered. Objective: present the sociodemographic characteristics and the most common conditions and symptoms in Marcio Manduley health area, municipality of Centro Habana, and describe the use of health services in the period from April to June 2010. Methods: descriptive cross-sectional study of a representative sample of the population in the area, taking into consideration the total number of households. Since the prevalence of the factor under study is unknown, the sample was maximized to a prevalence of 50%, an accuracy of 10% and a potential sample dropout rate of 10%. The sample size was 408 households. Questionnaires were given to all members of the households selected, particularly to those who had been ill in the previous 30 days and had made use of any health service. Results: data were obtained about 1 244 persons, of whom 25.1% had been ill in the previous 30 days and 17.7% had made use of formal health services. The most frequent conditions were respiratory, cardiovascular and osteoarticular. Family doctors' offices were the most common entrance door to the health care system (54.1%). Conclusions: according to our study, the factors exerting the greatest influence on the use of health services by the population are the level of perceived severity of the illness or need of medical care, and gender.http://ref.scielo.org/wvhcr551pubpub

Calidad de vida relativa a salud en la población urbana de Cuba

Se realizó un estudio descriptivo y transversal durante el 2010, de 5 936 personas de 15 años y más como muestra representativa del país, con muestreo por conglomerado en varias etapas, con vistas a determinar la calidad de vida relativa a salud en la población urbana de Cuba. Las variables sociodemográficas utilizadas resultaron ser: edad, sexo y color de la piel; las del cuestionario genérico EuroQol: movilidad, cuidado personal, actividades cotidianas, dolor/malestar y ansiedad/depresión. La mayoría de las personas presentaron movilidad, cuidado personal y actividades cotidianas conservadas. Se concluye que los mestizos del sexo masculino menores de 45 años, mostraron mayor calidad de vida relativa a salud y que dicho cuestionario puede ser válido para describir este indicador en la citada población

Results of an Intervention for Improving Arterial Hypertension Control in Four Health Areas

Foundation: non-transmissible diseases represent one of the highest challenges for health and development in the XXI century. Arterial hypertension is a disease and a key risk factor fro developing other diseases. Objective: to show the results after the implementation of an educative intervention from promoting the control and management of arterial tension in four health areas. Methods: it was used a case and control study post- intervention during 2014 in four health areas, two belonging to the Santiago de Cuba municipality and two of Cardenas. A number of 1404 patients older than 18 years were studied, who were selected by bi-stage conglomerate sampling. Socio-demographic variables such as health area, age, sex, skin color, level of schooling, marital status and occupation were analyzed. The clinical variables analyzed were control of arterial tension, treatment compliance, and perception of the health condition, so as knowledge of the disease. The information was calculated in absolute numbers, percentages and confidence intervals of 95 %. It was evaluated the possible association among variables by the existence of the statistic significance (α= 0,05) by the Square-chi Pearson Test. Results: a higher percentage of controlled hypertensive patients was achieved (65,0 %) and with treatment compliance (64,9 %), the level of knowledge about the disease was increased (50,9 %) so as the perception of good health condition (67,2 %) in comparison to 2013. The results were more encouraging in the groups which were intervened. Conclusion: the program of intervention demonstrated to be effective at achieving the increase of levels of treatment compliance and patient controls

Results of an Intervention for Improving Arterial Hypertension Control in Four Health Areas

Foundation: non-transmissible diseases represent one of the highest challenges for health and development in the XXI century. Arterial hypertension is a disease and a key risk factor fro developing other diseases. Objective: to show the results after the implementation of an educative intervention from promoting the control and management of arterial tension in four health areas. Methods: it was used a case and control study post- intervention during 2014 in four health areas, two belonging to the Santiago de Cuba municipality and two of Cardenas. A number of 1404 patients older than 18 years were studied, who were selected by bi-stage conglomerate sampling. Socio-demographic variables such as health area, age, sex, skin color, level of schooling, marital status and occupation were analyzed. The clinical variables analyzed were control of arterial tension, treatment compliance, and perception of the health condition, so as knowledge of the disease. The information was calculated in absolute numbers, percentages and confidence intervals of 95 %. It was evaluated the possible association among variables by the existence of the statistic significance (α= 0,05) by the Square-chi Pearson Test. Results: a higher percentage of controlled hypertensive patients was achieved (65,0 %) and with treatment compliance (64,9 %), the level of knowledge about the disease was increased (50,9 %) so as the perception of good health condition (67,2 %) in comparison to 2013. The results were more encouraging in the groups which were intervened. Conclusion: the program of intervention demonstrated to be effective at achieving the increase of levels of treatment compliance and patient controls

Información sobre prevención de accidentes que poseen adultos y niños a su cuidado

Se realizó un estudio descriptivo transversal, con el objetivo de identificar la información recibida sobre prevención de accidentes en un universo de 5 370 personas responsables en el hogar de los niños menores que 10 a, en el municipio Regla, durante 1996-1997. La muestra estuvo integrada por 1 156 adultos que cuidaban a éstos en sus hogares, seleccionados en muestreo por conglomerado monoetápico en el que cada consultorio del médico de la familia representó un conglomerado. Para la recolección de los datos se realizaron entrevistas estructuradas, en las que se aplicaron cuestionarios y para el análisis de los resultados se calcularon porcentajes. Hubo referencias de haber recibido información sobre prevención de accidentes en poco más del 80,0 % de las personas y los niños a su cuidado. Las vías para hacer llegar esta información sobre la prevención de accidentes a la población no fueron empleadas con eficiencia.A descriptive cross-sectional study was conducted aimed at identifying the information about the prevention of accidents received by 5 370 persons responsible for children under 10 at home, in Regla muinicipality, during 1996-1997. The sample was composed of 1 156 adults that took care of their children at home and that were selected by single-stage cluster sampling, in which evey family physcian’s office represented a cluster. Structured interviews were made for the collection of data. Questionnaires were applied and percentages were calculated to analyze the results. More than 80 % of the persons and the children they took care of reported having received information about the prevention of accidents. The ways used to give information on the prevention of accidents to the population were not efficient

Gaps in the Management of Type 2 Diabetic Patients in a Metropolitan Area of Havana

Foundation: there are flaws in diabetic patient management this makes it difficult to develop intervention strategies to improve the quality of their medical care. Objective: to identify the main gaps which affected the comprehensive management of diabetic people, in a metropolitan area of Havana during 2016. Methods: a cross-sectional descriptive investigation was carried out. Sample selection was made by bi periodic conglomerate sampling, it consisted of 580 people, to whom an instrument made for this purpose was applied. Number variables were presented with central tendency and dispersion measures. Categorical variables were shown as frequencies and percentages. Results: 96.4 % of the interviewees needed medical attention in the last year. Out of them, 90.5 % attended primary health care. There were difficulties with attention due to organizational problems and lack of resources, although 85 % of the patients were satisfied with the received care. The main gap was follow-up, with only 69.7 % of the patients consulted in the last year. 68.3 % have indicated pharmacological treatment, and of these 77.5 % is adhered to according to the Morinsky test 83.4 % had their blood glucose levels checked. Conclusions: gaps related to health services access are a direct consequence of the instability of health personnel. This affects the patient control due to noncompliance in the schedule and periodicity of follow-up medical consultations

Condiciones ambientales riesgosas para las infecciones respiratorias agudas en escolares de primaria Risky environmental conditions for acute respiratory infections in primary school students

Introducción: el deterioro de las condiciones ambientales contribuye de forma importante a los procesos de la enfermedad, porque expone a la población urbana a enfermedades y riesgos muy bien identificados y conocidos. Objetivos: identificar las condiciones ambientales riesgosas en los hogares, las escuelas y sus entornos para la prevalencia de las infecciones respiratorias en educandos, en el curso escolar 2006-2007. Métodos: se realizó un estudio descriptivo transversal en los educandos de 1ro. a 6to. grado del universo de las escuelas primarias del consejo popular Cayo Hueso, del municipio Centro Habana. Se aplicó a las madres un cuestionario con preguntas al respecto, y se realizó la evaluación de las condiciones ambientales de las escuelas y sus entornos, según las orientaciones de guías preelaboradas. Resultados: la prevalencia de infecciones respiratorias agudas fueron obtenidas de los educandos que asisten a las escuelas "Pedro Carbó Serviá", "Salvador Cisneros Betancourt", "Fernández Roig" y "República de Bolivia", y coincidió con que son las que tienen más factores de riesgo del ambiente y/o las que tienen mayores frecuencias de educandos con condiciones ambientales riesgosas de sus hogares, escuelas o entorno.Introduction: deterioration of environmental conditions contributes in a very important way to disease processes because of to expose to urban population to diseases and risks very well identified and well known. Objective: to identify the risky environmental conditions at homes, schools and its surroundings for prevalence of respiratory infections in the students during 2006-1007 courses. Methods: a cross-sectional and descriptive study was conducted in students from 1st to sixth degrees from the universe of primary schools of "Cayo Hueso" popular council of the Centro Habana municipality. In mothers a questionnaire was distributed with related questions and the environmental conditions of schools and its surroundings were assessed according to the guidances of previously drew up guides. Results: prevalence of acute respiratory infections was achieved from the students of the "Pedro Carbó Serviá", "Salvador Cisneros Betancourt", "Fernández Roig" and "República de Bolivia" schools which have more environmental risk factors and/or those with great frequencies of students with risky environmental conditions at home, school and surroundings