Interpersonal violence in Spain through national hospital discharge survey.

[ES] Describir la epidemiología de la violencia interpersonal en España. Estudio descriptivo de los casos de pacientes con diagnóstico secundario de agresión registrados en el Conjunto Mínimo Básico de Datos de altas hospitalarias, entre 1999 y 2011, utilizando los códigos E960 a E969 de la Clasificación Internacional de Enfermedades (CIE-9). Se describe la distribución por sexo, edad y tipo de alta y de atención requerida, morbilidad asociada, mortalidad y comunidad autónoma. Se estudia la calidad del registro en función de su variación temporal. El perfil de agresión en hombres (85%) es el de un paciente de entre 15 y 44 años, que en un 93,7% de los casos precisa atención urgente y cuya gravedad es moderada (95% alta a domicilio). El 2,5% de los pacientes reingresa, y se produce la muerte en el 1,1% de las ocasiones. El perfil en las mujeres (15%) difiere ligeramente: edad comprendida entre 31 y 52 años, el 94% requiere atención urgente (si bien el 96% tiene una gravedad moderada), el 3% reingresa y en el 1,7% de las ocasiones la paciente muere. Aunque necesitan ser mejorados para evitar ciertas limitaciones, los sistemas de información sanitaria constituyen una riquísima fuente de datos que pueden ser utilizados para la investigación en salud y, a través de sus resultados, para el desarrollo de planes de prevención e intervención sociosanitaria en temas de violencia. [EN] To describe the epidemiology of interpersonal violence in Spain. Descriptive study of the cases of patients with secondary diagnosis of aggression registered on a national hospital discharge database, between 1999 and 2011, using the codes from E960 to E969 of the ICD-9. The distribution by sex, age and type of discharge, associated morbidity, mortality and by autonomous community is described. The quality of the record is studied according to its temporal variation. The case profile of aggression in men (85%) is of a patient between 15 and 44 years old, who in 93.7% of cases requires urgent care and whose severity is moderate (95% discharge home). Two point five percent of patients are readmitted and death occurs in1.1%. The profile in women (15%) differs slightly, with an age between 31 and 52 years, 94% require urgent attention, although 96% have moderate severity; 3% are readmitted and 1.7% die. Although they need to be improved to avoid certain limitations, health information systems are a rich source of data that can be used for research in health and, through their results, for the development of prevention plans and intervention in matters of violence.S

Approach to the causes of discharge and health needs of transgender people through the National Hospital Discharge Survey in Spain during the period 2001 to 2013

OBJECTIVE: The health of transgender people is a little studied topic and hospital records can be an opportunity to make an approach. The aim of this study was to describe the cause for admission and the associated comorbidities of transgender people in Spain between 2001 and 2013. METHODS: Retrospective observational study with population-based administrative records (Minimum Basic Data Set). The discharges generated by the transgender in Spanish public and private hospitals were selected using one of the following ICD-9-CM codes in any diagnostic field: Trans-sexualism (302.5), Disorders of psychosexual identity (302.6) and Gender identity disorder in adolescents or adults (302.85). The causes of admission and comorbidity according were described. The qualitative variables were described in their frequency distribution according to their number(n) and proportion(%) and the quantitative variables according to their mean and standard deviation (SD) or median (MD) and interquartile range (RIQ) according to their distribution. RESULTS: A total of 2,010 highs were recorded corresponding to 1,878 patients. The mean age was 33 years (SD = 10). 51% were male, 46% female and 3% undetermined or unspecified. The discharges were motivated in 59% by the process of body modification, followed by HIV (4%) and personality disorders (3%). The most common comorbidities were those associated with body modification (49%), mental health problems (40%) and infectious diseases (15%). CONCLUSIONS: It is necessary to address the health of transgender people in a comprehensive way that takes into account their specific health needs, including bodily modification, mental health, HIV and other infections, through strategies that include improve research, tailor health information systems and develop guidelines and training of healthcare providers in this transgender health.S

Hate violence in the emergency rooms of third level hospitals. First data in Spain

To describe the cases of hate violence attended in emergency services. A cross-sectional study of a series of cases of aggression treated in the emergency rooms of two hospitals in Madrid, between April 2015 and March 2018. The cases of hate violence are described in terms of their sociodemographic, clinical-epidemiological and incident data and compared with other types of violence within the study. A total of 147 patients were included and 49% reported having been victims of hate violence. Among the victims, 61% were men, the average age was 36 years and 48% had a medium-high level of education. The most frequent motivations were physical appearance, nationality and ethnic origin. The place of aggression was the street in 50%, and in 61% of the cases it was perpetrated by more than one person (83% by men). The most common injury was contusion (71%) and the most frequent location the head and neck (71%). Only 8% required admission. The surveillance of hate violence would foster more accurate knowledge of the real magnitude and characteristics of this health problem and improve the quality of care for victims.Este estudio ha sido financiado por la Acción Estratégica en Salud (PI13/02267) y cofinanciado con fondos FEDER.S

Preparation of a questionnaire to detect cases of hate violence in emergency rooms.

In the context of the SIVIVO project, the development of a tool to facilitate the detection, recording and description of cases of hate violence and its consequences on health was proposed. A two-round Delphi method was used with experts from clinical-care, public health, epidemiological, academic, administration and non-governmental organizations to assess the relevance of different items using a Likert scale, presenting the results with medians and coefficients of variation. The best evaluated questions, with scores equal to or greater than 4, and which make up the final version of the questionnaire are the relative socio-demographic characteristics of the victim, the injuries, description of the incident, the motivations perceived by the aggrieved person, possible evidence of hatred, the intention to denounce and the perception of the health personnel of the motive for the aggression. The piloting showed the adequacy of the questions that were finally selected. The systematic incorporation of this tool can help us to learn the magnitude and characteristics of hate violence and its impact on health. This information would allow the elaboration of prevention and intervention strategies aimed, specifically, at the sectors of the population most exposed to this type of violence.Acción Estratégica en Salud 2013: PI13/02267. Cofinanciado con fondos FEDER.S

Elaboración de una herramienta para la vigilancia de indicadores de calidad de la docencia en la formación especializada de Medicina Preventiva y Salud Pública

En este trabajo se describe el proceso de creación de una herramienta para evaluar la satisfacción con la calidad de la docencia recibida en las rotaciones de la especialidad de Medicina Preventiva y Salud Pública. Para ello se adaptó la Encuesta de Satisfacción de la Formación Especializada por parte de un panel de expertos formado por 23 residentes de nueve comunidades autónomas, que valoraron y adaptaron la encuesta a las rotaciones de la especialidad mediante una escala de Likert de 5 puntos y la inclusión de nuevas dimensiones e ítems. Las dimensiones mejor valoradas fueron la planificación y la consecución de objetivos específicos, la supervisión, la delegación de responsabilidades, los recursos y el ambiente laboral del dispositivo, la valoración personal, el estímulo, el apoyo recibido y la productividad de la rotación. El desarrollo y la utilización de esta herramienta permitirán la elección informada del itinerario formativo de los residentes de Medicina Preventiva y Salud Pública

Información accesible y de calidad para una elección informada en la residencia de Medicina Preventiva y Salud Pública

Resumen: Introducción: La elección de especialidad y unidad docente (UD) es un momento importante en la trayectoria profesional médica. La Asociación de Residentes de Medicina Preventiva y Salud Pública detectó necesidades de información de los aspirantes no cubiertas por las UD. Por este motivo se evaluó la accesibilidad y la calidad de las páginas web de las UD. Métodos: La accesibilidad se consideró como el orden de aparición de la página de cada UD entre los resultados de las búsquedas realizadas en Google. La calidad se midió mediante un cuestionario ad hoc realizado a partir del análisis de las consultas a la Asociación de Residentes de Medicina Preventiva y Salud Pública de los aspirantes, cuya puntuación varía de 0, mínima calidad, a 100, máxima calidad. Resultados: De las 24 UD 13 presentan página web accesible. La mediana de calidad es 30,5 puntos y solamente una UD tiene una puntuación superior a 50 puntos. Conclusiones: Las necesidades de los opositores están parcialmente cubiertas. Es necesario aumentar la accesibilidad y mejorar la calidad de la información de las webs de las UD. Abstract: Introduction: Choosing a specialty and a teaching unit (TU) is an important time in a medical career. The Association of Preventive Medicine and Public Health Residents has detected the information needs of candidates that are not met by TUs. The aim of this article is to evaluate the accessibility and quality of TU websites. Methods: Accessibility was measured by the order of appearance of the TU website in the results of a Google search. Quality was measured by an ad hoc questionnaire based on the analysis of queries made by candidates to Association of Preventive Medicine and Public Health Residents. The scores in this questionnaire ranged from 0, minimum quality, to 100, maximum quality. Results: Of the 24 TUs evaluated, only 13 had websites. The median of the quality questionnaire was 30.5 points, and only one TU had a score higher than 50 points. Conclusion: The needs of candidates are partly met, but it is necessary to improve the accessibility and the quality of the information in TU websites. Palabras clave: Internado y residencia, Medicina preventiva, Educación en salud pública profesional, Mejoramiento de la calidad, Información, Internet, Keywords: Internship and residency, Preventive medicine, Public health professional Education, Quality improvement, Information, Interne

Public health interventions against hate violence

Acción Estratégica en Salud 2013: PI13/0226

Causes of hospital admission and morbidity according to gender identity in the Autonomous Community of Madrid.

The objective was to identify differences in health between transgender (trans) and cisgender (cis) people using the hospital discharge survey from the Autonomous Community of Madrid. Their characteristics, causes of admission and morbidities were described, comparing them by prevalence ratio and confidence interval (95% CI). One hundred and twelve trans vs 1,043,621 cis discharges were studied. The main differences were that more frequently trans people had been attended in a single center (55.4 vs. 9.3%), were under 49 years old (75.9 vs. 37.1%) and had used private health services (2.7 vs. 0.4%). Admissions related to mental health problems (23.96; 95% CI: 17.41-32.78) and HIV morbidity (11.26 95% CI: 5.46-20.93) were more frequent among trans discharges. Information is limited beyond body modification, mental health, and HIV. It is necessary to improve the knowledge about trans population's health.S