Un análisis bibliométrico de la literatura sobre el gasto de bolsillo en salud en América Latina

Objetive: perform a bibliometric analysis of the scientific production on out-of-pocket expense (OOPE) published in Latin America from the period 2002 to 2020 is conducted. The study: we use the Scopus database to select related articles about OOPE in Latin America. Bibliometric indicators were analyzed using Bibliometrix and Biblioshiny R packages. Findings: we identified 207 documents and 828 authors during the period 2002-2020. The number of publications increased (12.62% annual growth rate). “Salud Publica de Mexico” was the leading journals in number of publications. The majority of publications came from developing country collaboration with developed countries such as United States or United Kingdom. Mexico was the most productive and cited country in OOPE in Latin America. Conclusions: the documents published in journals related to OOPE in Latin America are increasing, being Mexico the most productive and cited country in out-of-pocket expense fields in the region.Objetivo: realizar un análisis bibliométrico de la producción científica sobre gasto de bolsillo publicada en América Latina desde el período 2002 al 2020. El estudio: se utilizó la base de datos Scopus para seleccionar artículos relacionados con gasto de bolsillo en América Latina. Los indicadores bibliométricos se analizaron utilizando los paquetes Bibliometrix y Biblioshiny R. Hallazgos: se identificaron 207 documentos y 888 autores durante el período 2002-2020. El número de publicaciones aumentó (tasa de crecimiento anual del 12,62%). “Salud Pública de México” fue la revista líder en número de publicaciones. La mayoría de las publicaciones provinieron de la colaboración de países en desarrollo con países desarrollados como Estados Unidos o Reino Unido. México fue el país más productivo y citado en OOPE en América Latina. Conclusiones: los documentos publicados en revistas relacionadas con OOPE en Latinoamérica van en aumento, siendo México el país más productivo y citado en rubros de gasto de bolsillo en la región

Ampliación de plazas del residentado médico: ¿nuestros hospitales están preparados?

Following a report by the Ministry of Health (MOH) to realize the lack of specialists at national level (1), the National Commission of Medical Residency (CONAREME) expanded the number of vacancies for residentado throughout the country, so that even it extended to two admission processes last year. If it is true, the lack of specialists demanded concrete measures to improve the coverage of health care in Peru, is also true that they must go hand in hand with an adequate planning of growth in terms of quality of training, so that ensure that the education received by the new residents is with minimum quality standards (2).A raíz de un informe del Ministerio de Salud (MINSA) que daba cuenta de la falta de especialistas a nivel nacional (1), la Comisión Nacional de Residentado Médico (CONAREME) amplió el número de vacantes para el residentado en todo el país, de tal forma que incluso se amplió a dos los procesos de admisión el año pasado. Si bien es cierto, la falta de especialistas exigía medidas concretas para mejorar la cobertura de atención de salud en Perú, también es cierto que estas deben ir de la mano de un adecuado planeamiento del crecimiento en términos de calidad de adiestramiento, de tal forma que se asegure que la educación recibida por los nuevos residentes sea con estándares mínimos de calidad (2)

Tendencia de la prevalencia de anemia en niños de 6 a 35 meses en el Perú durante el período 2014-2019

Introduction: In Peru, 4 out of 10 children under 3 years of age suffer from anemia. Objective: to determine the trend in the prevalence of anemia in children aged 6 to 35 months, during the period 2014-2019. The study: We perform a secondary analysis of repeated annual cross sections for the period. We used the chi-square test of joint significance for each category of exposure variables. Findings: The main results show a decrease in the prevalence of childhood anemia during the 2014-2019 period from 46.92% to 40.33%, specifically in girls and boys aged 12 to 24 months. Conclusions: The decrease was greater in rural areas, in the natural regions of Sierra and Selva, among the children of mothers with a higher level of education and households with the highest wealth quintile. The Puno region presents the smallest decrease in childhood anemia during the period analyzed.Introducción: En el Perú, 4 de cada 10 niños menores de 3 años padecen de anemia. Objetivo: determinar la tendencia de la prevalencia de anemia en niños de 6 a 35 meses, durante el período 2014-2019. El estudio: realizamos un análisis secundario de secciones transversales anuales repetidas para el período. Usamos la prueba chi-cuadrado de significancia conjunta para cada categoría de variables de exposición. Hallazgos: los principales resultados muestran una disminución de la prevalencia de anemia infantil durante el período 2014-2019 del 46,92% al 40,33%, específicamente en niñas y niños de 12 a 24 meses. Conclusiones: la disminución fue mayor en las áreas rurales, en las regiones naturales de Sierra y Selva, entre los hijos de madres con mayor nivel de educación y los hogares con mayor quintil de riqueza. La región de Puno presenta la menor disminución de anemia infantil durante el período analizado

Educación médica durante la pandemia del COVID -19: Iniciativas mundiales para el pregrado y el residentado médico

The pandemic of COVID-19 infection is a challenge for the various strata of society, and medical education has been no exception. Globally, universities have proposed various initiatives that in the undergraduate can be summarized in: virtualization of part of their curricular content; curriculum modification and the student’s activities and incorporation of students of the last years to the management of COVID-19 patients. In medical residency, surgical specialties and those that base their learning on procedures are the most affected. Residents of different specialties have been incorporated into healthcare tasks different from their specialty and some of their learning activities have been virtualized. Peru must make an evaluation of these strategies and the possible adaptation to our reality.La pandemia de la infección por el SARS-CoV-2 ha planteado diversos retos para los diversos estamentos de la sociedad y la educación médica no ha sido la excepción. A nivel mundial, las universidades han planteado diversas iniciativas que en el pregrado se pueden resumir en: la virtualización de parte de su contenido curricular; la modificación del currículo y las actividades de los estudiantes y la incorporación de estudiantes de los últimos años a las actividades asistenciales. En el residentado médico, las especialidades quirúrgicas y las que basan su aprendizaje en procedimientos son las más afectadas. Se ha incorporado residentes de distintas especialidades a labores asistenciales diferentes a su especialidad y se ha virtualizado algunas de sus actividades de aprendizaje. El Perú debe hacer una evaluación de estas estrategias y la posible adaptación a nuestra realida

Sobre la escasa transparencia en los documentos técnicos para el tratamiento de pacientes con COVID-19 en Perú

El Ministerio de Salud peruano (MINSA) ha publicado resoluciones ministeriales (RM) con el objetivo de normar el tratamiento de personas afectadas por la COVID-19. Estas RM incluyen el uso de fármacos específicos para la COVID-19, como tocilizumab, corticoides, enoxaparina, hidroxicloroquina e ivermectina. Estos lineamientos no dejan claro qué proceso se siguió para tomar decisiones, cómo se justificó cada una de estas decisiones, ni quiénes son sus autores ni sus potenciales conflictos de interés. Resulta importante hacer un esfuerzo por transparentar estos datos, especialmente en un tema en el cual aún no se cuenta con mucha evidencia como es el caso de COVID-19. En el presente artículo presentamos controversias sobre el uso de fármacos específicos para la COVID-19 establecidos por el MINSA, así como recomendaciones sobre el proceso de toma de decisiones

Exposure to arsenic as associated factor of the high mortality attributed to renal failure in Puno

Cartas al editorRevisión por pare

Sobre la escasa transparencia en los documentos técnicos para el tratamiento de pacientes con COVID-19 en Perú

The Peruvian Ministry of Health (MINSA, in Spanish) has published ministerial resolutions (RM) with the aim of regulating the treatment of people affected by COVID-19. The last RM published on April 29 includes the use of tocilizumab, corticosteroids, and enoxaparin. These guidelines do not make clear what process was followed to make decisions, how each of these decisions was justified, nor who their authors are or their potential conflicts of interest. It is important to make an effort to promptly make these data transparent, especially in a subject in which there is not yet much evidence, such as COVID-19. In this article, we present controversies on the tocilizumab, corticosteroids, and enoxaparin established by the MINSA, as well as recommendations on the decision-making process.El Ministerio de Salud del Perú (MINSA) ha publicado resoluciones ministeriales (RM) con el objetivo de normar el tratamiento de personas afectadas por COVID-19. La última RM publicada el 29 de abril incluye el uso de tocilizumab, corticoides y enoxaparina. Estos lineamientos no dejan claro qué proceso se siguió para tomar decisiones, cómo se justificó cada una de estas decisiones, ni quiénes son sus autores ni sus potenciales conflictos de interés. Resulta importante hacer un esfuerzo por transparentar prontamente estos datos, especialmente en un tema en el cual aún no se cuenta con mucha evidencia como es el COVID-19. En el presente artículo presentamos controversias sobre el tocilizumab, corticoides y enoxaparina establecido por el MINSA, así como recomendaciones sobre el proceso de toma de decisiones

Perception of physicians about medical education received during their Nephrology residency

Introduction: In Peru there are different hospitals and university programs for training of specialists in nephrology. Objective: To assess the perception of physicians who attend such programs. Methods: We carried out a descriptive cross-sectional national-level study in physicians who were in the last two years of nephrology training during February 2012 and who had graduated from it in 2010 and 2011. A self-applied questionnaire was developed along with the Peruvian Society of Nephrology based on international standards. The questionnaire evaluated: mentoring, clinical training, procedures, external rotations, research and global perception. Results: Forty doctors were surveyed nationwide. 82.5% had tutors, 22.5% of them said their support was poor. A 27.5% described their theoretical formation as deficient. The practical training was perceived as acceptable globally; however, improvements in training on peritoneal dialysis and reading kidney transplant biopsies are necessary. A 90% have national external rotations and 65% reported to have an international rotation. In the assessment of research, 77.5% thought this is deficient. In addition, 82.5% believed that residency should last four years. However, 60% reported that their residency training was good. There is a decrease in the positive perception of the aspects studied among residents regarding graduates. Conclusion: The overall perception of nephrology residency training was considered good; however, areas of tutoring, and academic and research activities on average were deficient.Revisión por pare

Characteristics of theses Characteristics of theses for physician graduation: a cross-sectional study in Peru

Introduction Research in Peru presents several barriers that impede its development and that also affects the theses to graduate as physician. Our objective was to characterize the theses for obtaining a medical degree in Peru. Methods An observational and descriptive study evaluating the theses for obtaining a medical degree of 2019, evaluated in January 2022 from 22 universities that are full members of the Peruvian Association of Faculties of Medicine. Characteristics of the universities and theses were evaluated, including the evaluation of a institutional research ethics committee , the aligment with a national research priority, and publication status in a scientific journal. The absolute and relative frequencies of the study variables were described. Results A total of 1838 theses were evaluated. Most of the theses were written by a single student (66.16%). The most common study design was the descriptive cross-sectional type (42.33%). We found that 53.86% of the theses responded to a national research priority, the most common being "maternal, perinatal and neonatal health" (26.01%). Of the total, 56.75% did not indicate whether they had the approval of an institutional research ethics committee. Only 40 theses (2.19%) were published in a scientific journal (14 in indexed journals). Conclusion Two-thirds of the theses conducted by medical students in Peru are descriptive studies. Half respond to national research priorities. Four out of ten theses were approved by an institutional research ethics committee. The number of published theses is low. The results show shortcomings in university institutional policies that encourage ethical compliance and research development