Comparative study of paediatric prescription drug utilization between the spanish and immigrant population

<p>Abstract</p> <p>Background</p> <p>The immigrant population has increased greatly in Spain in recent years to the point where immigrants made up 12% of the infant population in 2008. There is little information available on the profile of this group with regard to prescription drug utilization in universal public health care systems such as that operating in Spain. This work studies the overall and specific differences in prescription drug utilization between the immigrant and Spanish population.</p> <p>Methods</p> <p>Use was made of the Aragonese Health Service databases for 2006. The studied population comprises 159,908 children aged 0-14 years, 13.6% of whom are foreign nationals. Different utilization variables were calculated for each group. Prescription-drug consumption is measured in Defined Daily Doses (DDD) and DDD/1000 persons/day/(DID).</p> <p>Results</p> <p>A total of 833,223 prescriptions were studied. Utilization is lower for immigrant children than in Spanish children for both DID (66.27 v. 113.67) and average annual expense (€21.55 v. €41.14). Immigrant children consume fewer prescription drugs than Spanish children in all of the therapy groups, with the most prescribed (in DID) being: respiratory system, anti-infectives for systemic use, nervous system, sensory organs. Significant differences were observed in relation to the type of drugs and the geographical background of immigrants.</p> <p>Conclusion</p> <p>Prescription drug utilization is much greater in Spanish children than in immigrant children, particularly with reference to bronchodilators (montelukast and terbutaline) and attention-disorder hyperactivity drugs such as methylphenidate. There are important differences regarding drug type and depending on immigrants' geographical backgrounds that suggest there are social, cultural and access factors underlying these disparities.</p

Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

<p>Abstract</p> <p>Background</p> <p>There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden.</p> <p>Methods</p> <p>This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System^®).</p> <p>Results</p> <p>The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix.</p> <p>Conclusions</p> <p>Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain.</p

La vacunación infantil en los viajes internacionales. ¿Estamos preparados?

According to United Nations World Tourism Organization every year 900 millions of people travel around the world; children are thought to be 7% of them.The most important risks described among international travellers are infectious diseases. Although vaccine-preventable diseases could be prevented, these conditions are reported among travellers very often.Travel is a good opportunity for Paediatricians to review the immunization status of infants and children. If the international travel children is badly immunized should be offered to start or complete the routine immunization schedule, in addition to those needed for travel.Vaccination offers the possibility of avoiding a number of dangerous diseases that may be encountered abroad. Families should be advised to consult 4-8 weeks before departure in order to allow enough time for optimal immunization schedules to be completed. Vaccines for travellers can be divided into 3 categories: those used for routine preventive health, those that may be required for travel and those that are recommended according to risk for disease acquisition.The most common vaccines used in travellers are: Hepatitis A,Typhoid fever,Yellow fever and Meningococcal infection. Other considerations have to be in account such as provision of advice about prevention and management of travel-related diseases.Según la Organización Mundial del Turismo cada año 900 millones de personas viajan por el mundo; se estima que el 7% de ellos son niños.Las enfermedades infecciosas son el riesgo más importante descrito en viajeros internacionales. Aunque las enfermedades prevenibles por inmunización pueden ser evitadas, estas condiciones son descritas muy frecuentemente entre viajeros. El viaje es una buena oportunidad para los pediatras para revisar la situación vacunal. Si el niño viajero está incorrectamente vacunado, se le debe ofrecer la oportunidad de iniciar o completar la vacunación sistemática,además de las vacunas que precise para el viaje.La vacunación brinda la oportunidad de evitar gran número de enfermedades peligrosas que pueden presentarse en el exterior. Se aconsejará a las familias consultar 4-8 semanas antes de la salida para proporcionar un tiempo suficiente para una inmunización adecuada. Las vacunas para viajeros se dividen en tres categorías: sistemáticas del calendario habitual, exigidas en los viajes y las recomendadas según el riesgo de adquirir enfermedades. Las vacunas más usadas en viajeros son: Hepatitis A, Fiebre tifoidea, Fiebre amarilla e Infección meningocócica. Se debe tener en cuenta otras consideraciones como proporcionar consejos sobre la prevención y manejo de enfermedades relacionadas con el viaje

Mutilación genital femenina. ¿Cómo estamos abordando el problema desde las consultas de Atención Primaria?

Female genital mutilation (FGM) is a procedure which damages the girls human rights and endangers both their health and life. There is a Protocol in Aragon for Prevention and Intervention in FGM. This protocol sets out an interdisciplinary approach in which the Pediatrics’ team plays the main role. Targets of this study are the assessment of the knowledge and implementation of this Protocol in Primary Care (PC) as well as the detection of difficulties and failures in its implementation. In order to achieve them, a descriptive study was performed from the data obtained in an electronic survey answered by Aragon Primary Care pediatricians. 80% of the professionals who have filled in this survey do preventive activities against (FGM). 80% out of them do it on a regular basis and the rest only before an upcoming travel to their origin countries. They all talk to their patient's arents about the legal consequences of this practice and most of them about the consequences on their daughter's alth. 83% offer the preventive commitment and there is a 24 % that does not schedule a visit upon the return from their patients. 74% enters the information in OMIap and practically all of them think it is necessary to enhance the data entering protocol.La mutilación genital femenina (MGF) es una práctica que vulnera los derechos humanos de las niñas y pone en riesgo la salud y la vida de las mismas. En Aragón existe un Protocolo de Prevención y Actuación ante la MGF. Dicho protocolo plantea un abordaje interdisciplinar en el que los equipos de pediatría tienen un papel central. Los objetivos de este estudio han sido evaluar el conocimiento e implementación de este protocolo en las consultas de Atención Primaria (AP), y detectar las dificultades y deficiencias en la aplicación del mismo. Para ello se realizó un estudio descriptivo a partir de los datos obtenidos de una encuesta electrónica cumplimentada por pediatras de AP de Aragón. El 80 % de los pediatras que han contestado la encuesta realizan actividades preventivas en MGF. De ellos, el 80% lo hacen de forma rutinaria, y el resto solo ante un viaje inminente. Todos hablan sobre las consecuencias legales, y la mayoría sobre las consecuencias para la salud. El 83% ofrecen el compromiso preventivo y hay un 24% que no programa visita a la vuelta del viaje. El 74% registra la actividad enOMIap y prácticamente todos ellos cree, conveniente mejorar el protocolo de registr

Abordaje de la prevención de las mutilaciones genitales femeninas desde las consultas de Atención Primaria

Immigration has strongly increased in the last few years in Spain. Nowadays, 12% of the children who live in Aragon areimmigrants. In response to this fact, pediatricians have had to learn how to deal with the new situations involved in the careof these children. Female genital mutilation (FGM) in girls from Sub-Saharan Africa is one of these.According to the information provided by Database Users of Aragonese Health System (BDU), there are 1,151 girls whocome from countries where mutilation is undergone and, therefore, are at risk of being subjected to this practice when theyreturn to their native countries.Due to the large impact of this practice in the girls’lives,professionals are obliged to implement a set of preventive measuresfrom their surgery and in collaboration with others organisms.The ultimate goal of this article is to revise the problem of female genital mutilation, its legal framework, as well as to showthe new prevention protocol published by the Aragonese government.Los últimos años en España hemos asistido a un gran aumento de la población inmigrante. En la actualidad el 12%de los niños que viven en Aragón lo son.Como respuesta a este hecho, los pediatras hemos tenido que formarnos en problemas y situaciones nuevas quenos ha planteado la atención a estos niños.Una de estas situaciones nuevas que es importante conocer y saber abordar es la prevención de las mutilacionesgenitales femeninas (MGF) en niñas procedentes sobre todo de África.En Aragón en este momento,según datos del Registro de Usuarios del Sistema de Salud de Aragón (BDU),hay 1.151niñas que proceden de países en los que se practican las MGF,y por lo tanto están en riesgo de ser sometidas a estapráctica aprovechando un viaje a su país.La gran trascendencia y repercusión que tiene en la vida de las niñas esta práctica nos obliga a hacer un adecuadoabordaje preventivo desde nuestras consultas en coordinación con otros organismos implicados.El objetivo principal de este artículo es revisar el tema de las mutilaciones genitales femeninas, conocer el marcolegal y dar a conocer a los pediatras el nuevo protocolo de prevención de las MGF, elaborado por el Gobierno deAragón

Additional file 1: of Global healthcare use by immigrants in Spain according to morbidity burden, area of origin, and length of stay

Distribution of nationalities across immigrant groups. (DOCX 22 kb