Crónica de un México que nunca fue (Spanish Edition)


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Cronica de Un Mexico Que Nunca Fue - AbeBooks - Rodrigo Borja Torres:

A transversal retrospective and correlational study was done. It was obtained an N sample for diabetes of , for hypertension , obesity and dyslipidemia with a total of n representative n of 3, cases. To select the representative number of clinical records to be reviewed, it was done a stratified sampling by stages Figure 1. First, proportional to the frequency of different pathologies and their distribution in the 13 sanitarian regions, where the number of records to be reviewed was defined. Second, the selection of medical units was made randomly and by list of the strata units and the units by health region resulting in units to be reviewed.

The selection criteria of the medical units were the following: they must have a record of patients with chronic diseases SIC; to have the number of registered patients for the sample of the records and assigned pathologies. It was decided to note down the day of the register and the calculation of the samples because the data of the SIC is modified every day.

Finally, the selection of the revised records was done randomly using a list of random numbers. The selection of the units where the records were revised, was based on the total of n registered in the SIC health units and by the proportion of the diseases records by medical units of the health regions. This selection was convenient and had the following criteria: they must have access, a place to check the records randomly selected according to the prevalence of the chronic diseases NCCD. This format was designed to be able to change the values to qualitative ones and then do a correlated analysis.

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The variables assessed for diabetes mellitus were: the number of subsequently consultation in the last 60 days; register of glycated hemoglobin in the last 12 months; the register of how many intakes he had a year; the report on the value of glycated hemoglobin with HbA1C less that 7, between 7 and 9 and greater than 9 ; demographic data stratification by age and gender group, years of treatment and gender, and comorbidity and gender.

The quality care was determined by the percentage of the basic measurements in the last consultation like weight, waist circumference, blood pressure BP , glucose and foot examination, and the pharmacological treatment. In the case of obesity, if they had consultation in the last 60 days; if they have the register of the body mass index BMI ; patients with BMI in control and with BMI not controlled.

The data analysis was done using descriptive statistics, correlation of parametric data. The non parametric data was categorized correlating the frequency values reported in the Information System on Chronic Diseases SIC with the actions done based on the record. The correlation was used to explore the relation between the pathology recorded in the Information System on Chronic Diseases SIC , also the appropriate register and the medical record, the management indicators in each pathology were reviewed.

To check the validity of the data in terms of the quality care, it was reviewed the excellence in the chronic disease care; this also ensures the validity and reliability of the collected data. In order to do this, the following indicators were evaluated: completeness, which validated the empty fields in crucial variables like birth date, and affiliation number to the Popular Health Insurance.

The data consistency validated that the prescribed treatment was consistent with the patient pathology. The data accuracy validated the non duplicity of patients and of the personal values like the affiliation number and address. The congruency was validated with the measurements to each patient. There were a total of 4, pathologies which were diabetes mellitus type 2, hypertension, obesity and dyslipidemia; the division of the reviewed records by pathology was like this: diabetes mellitus type 2 ; hypertension ; obesity ; dyslipidemia The result of the records reviewed was as follows: diabetes mellitus type 2 The basic measurements in the revision card were reviewed, they show that The diabetes mellitus prevalence was as follows In the case of obesity Patients with dyslipidemia The reviewed records were segmented into patients with two, three or four pathologies, this demonstrated that the diabetes mellitus type 2 and hypertension patients were from which A comparative analysis of records to be reviewed 3, was done, it was proved that the referred pathologies were in fact the ones reported in the record.

The diagram 2 shows how the quality, veracity and excellence indicators are automatically plotted for comparative purposes of the 32 Mexican states and with average results nationally. The diagram 3 summarizes the control model and the follow up of the chronic diseases indicators which are registered every day and for each patient, and which is reported in culmed medical units. This study shows the importance of having and electronic record system of the chronic diseases to control and manage them in a dynamic way and with data quality indicators.

It was able to determine the consistency chronic pathologies electronic record, like diabetes, obesity, hypertension and dyslipidemia and their management; as well as the information in the clinical records of the medical units that offer a first level care for the chronic diseases which gives quality and valid data. This report rectifies the gap in the health information systems of the chronic diseases with validated indicators that can be found in other health systems. This electronic health information consists of four important categories which are: general characteristics, quality care, disease control and pharmacological treatment; it also includes the immediate report of the forth mentioned characteristics in the tables and figures and the indicators report on the quality, veracity and excellence evaluation nationally and between the 32 Mexican states.

This indicators help in the assessment and functionality of an information system for the policies, planning, institutions and human resources, and in the financing and infrastructure. It also helps to promote heterogeneity of the data and facilitates the comparison by regions, states and with other countries, especially in Latin-America where in previous studies an analysis of the health systems was carried out. It showed that even when the Latin-American systems are heterogeneous in their indicators, Mexico and Costa Rica had higher indicators. The importance of having the data in an electronic way in all the country, is that we will have the opportunity of making data comparisons with other information sources like the Latin-American Network for the Strengthening of the Health Information System known as RELACSIS 8 in Spanish, which is a longitudinal Latin-American repository, generated in one or more medical care encounters.

The electronic record includes demographic data of the patient, the evolution or case notes, problem lists, or diagnosis, drugs, vital signs, lab result similar to the reported in this system among others. This will help the comparison of the patient care quality, the doctor management; it will help in decision making based on evidence, quality management and the report of the clinical care results.

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Having an electronic system in health care has implications and benefits in at least three basic points: 1 Gives essential elements for the diagnosis to the health policy makes, 2 to the professionals in health care and 3 their patients and their management. For the policy makers in health issues, it can be used as an exclusive surveillance system in important public health problems as the chronical diseases are, also as a demonstration of the qualities and risks of having a record, for example it was able to prove the existence of a sub record of pathologies, because there were more pathologies found in the medical units than in the ones registered in the system.

With this is possible to maintain a quality in the data. The other advantage is that it can be consulted by anyone because is an open system, it gives transparency and it is easy to be monitored by the health staff. This will help to the responsible managing the chronic disease patients that are being checked based on the quality care model defined by the number of consultations and basic measurements in the last consultation that are at least five in the chronic diseases plus HbA1C in diabetes patients and the drug treatment offered to the patient Scheme2. These measurements have been reported as indicators of an adequate technical quality of the attention and good control of the chronic diseases.

The second strength that involves the health care professionals is the evaluation of the quality care using as an indicator the number of consultations a patient had. This is key, because one of the criteria of quality was established by the number of consultations the patient had and the quality of them based on the basic measurements that the doctor or the health staff took from the patient. Moreover, is one of the essential indicators because the periodic consultation is a bilateral interest, major control and above all a bigger chance of offering education, motivation and support which will allow having a better control of the disease, also its prevention.

It will gradually change from more consultations to have more control to fewer consultations with the controlled patient.

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This will be an indicator not only of the quality care but also in the medical care costs staff working hours, supplies, drugs, etc. In this sense, previous analysis claim that the total of consultations has been reported as an indicator of the technological efficiency of the patient care, it was even reported that together with a patient from the metropolitan area the efficiency in service provision was favored regardless the patients attributes or the age of the doctor.

The third strength in the patients management is that it helps indirectly to improve the treatment adherence understanding by it, the active collaboration between the healthcare professional and the patient in the decision making that affects his own health and which is based on patients consent. Based on this definition the agreed recommendations with the health care professional in this system were the basic measurements taken and reported like weight, waist circumference, BP, glucose, foot examination and glycated hemoglobin.

To evaluate more precisely the adherence it is required to record more indicators of an active collaboration of the patient in the management like the follow up of the diet and the changes in his life style; as well as the evaluation of other essential factors of the adherence that are related to the patient, to the drug, to the disease itself and to the health care professionals. It is worth pointing out, that in this review only one element of the adherence promotion is addressed, but there are many other factors that determine the adherence like educational, behavioural, technical, of social and family support as it has been cited previously.

Specific perception and assessment indicators are already reported in the satisfaction elements such as the facilities, organization and health staff and medical performance. All the reflections agree that considering the healthcare quality as a strategic practice, specifically focused on actions and achievements, where the medical practice could be benefited facing the challenges that emerge in the daily tasks in the treatment adherence of chronic diseases non communicable, which is a serious worldwide problem that has two direct consequences: a decreasing in the healthcare results and an increase of the healthcare costs.

To be clear, if we want the patient to have a good perception of the healthcare attention, it is important to give the appropriate treatment, and even if this is not possible for any other reason, make the patient feel properly taken care of, he will leave the healthcare center satisfied and consequently his treatment adherence will improve. A last operational strength is that in the country the system already has a regulation for the electronic record of health data, 14 , 15 which immediately gives a legal framework and allows it to be established as an official program that all states can follow and it also ensures its application.

A part from the regulation this program has veracity, quality and excellence indicators that are given automatically and are shown immediately and comparatively. There were several constraints in the study. In the operational aspect, there were some difficulties with the speed of the updates and selection of the information registered electronically which had been slower than the Health Information System HIS , previously established.

This has depended on the electronic system and the updates of their operational versions. Having an electronic system in health care has implications and benefits in at least three basic points: 1 Gives essential elements for the diagnosis to the health policy makes, 2 to the professionals in health care and 3 their patients and their management. For the policy makers in health issues, it can be used as an exclusive surveillance system in important public health problems as the chronical diseases are, also as a demonstration of the qualities and risks of having a record, for example it was able to prove the existence of a sub record of pathologies, because there were more pathologies found in the medical units than in the ones registered in the system.

With this is possible to maintain a quality in the data. The other advantage is that it can be consulted by anyone because is an open system, it gives transparency and it is easy to be monitored by the health staff.

Revista Musical de México (Mexico City, )

This will help to the responsible managing the chronic disease patients that are being checked based on the quality care model defined by the number of consultations and basic measurements in the last consultation that are at least five in the chronic diseases plus HbA1C in diabetes patients and the drug treatment offered to the patient Scheme2. These measurements have been reported as indicators of an adequate technical quality of the attention and good control of the chronic diseases. The second strength that involves the health care professionals is the evaluation of the quality care using as an indicator the number of consultations a patient had.

This is key, because one of the criteria of quality was established by the number of consultations the patient had and the quality of them based on the basic measurements that the doctor or the health staff took from the patient. Moreover, is one of the essential indicators because the periodic consultation is a bilateral interest, major control and above all a bigger chance of offering education, motivation and support which will allow having a better control of the disease, also its prevention.

It will gradually change from more consultations to have more control to fewer consultations with the controlled patient. This will be an indicator not only of the quality care but also in the medical care costs staff working hours, supplies, drugs, etc. In this sense, previous analysis claim that the total of consultations has been reported as an indicator of the technological efficiency of the patient care, it was even reported that together with a patient from the metropolitan area the efficiency in service provision was favored regardless the patients attributes or the age of the doctor.

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The third strength in the patients management is that it helps indirectly to improve the treatment adherence understanding by it, the active collaboration between the healthcare professional and the patient in the decision making that affects his own health and which is based on patients consent. Based on this definition the agreed recommendations with the health care professional in this system were the basic measurements taken and reported like weight, waist circumference, BP, glucose, foot examination and glycated hemoglobin.

To evaluate more precisely the adherence it is required to record more indicators of an active collaboration of the patient in the management like the follow up of the diet and the changes in his life style; as well as the evaluation of other essential factors of the adherence that are related to the patient, to the drug, to the disease itself and to the health care professionals.

It is worth pointing out, that in this review only one element of the adherence promotion is addressed, but there are many other factors that determine the adherence like educational, behavioural, technical, of social and family support as it has been cited previously. Specific perception and assessment indicators are already reported in the satisfaction elements such as the facilities, organization and health staff and medical performance. All the reflections agree that considering the healthcare quality as a strategic practice, specifically focused on actions and achievements, where the medical practice could be benefited facing the challenges that emerge in the daily tasks in the treatment adherence of chronic diseases non communicable, which is a serious worldwide problem that has two direct consequences: a decreasing in the healthcare results and an increase of the healthcare costs.

To be clear, if we want the patient to have a good perception of the healthcare attention, it is important to give the appropriate treatment, and even if this is not possible for any other reason, make the patient feel properly taken care of, he will leave the healthcare center satisfied and consequently his treatment adherence will improve. A last operational strength is that in the country the system already has a regulation for the electronic record of health data, 14 , 15 which immediately gives a legal framework and allows it to be established as an official program that all states can follow and it also ensures its application.

A part from the regulation this program has veracity, quality and excellence indicators that are given automatically and are shown immediately and comparatively. There were several constraints in the study. In the operational aspect, there were some difficulties with the speed of the updates and selection of the information registered electronically which had been slower than the Health Information System HIS , previously established.

This has depended on the electronic system and the updates of their operational versions.

Crónica de un México que nunca fue (Spanish Edition) Crónica de un México que nunca fue (Spanish Edition)
Crónica de un México que nunca fue (Spanish Edition) Crónica de un México que nunca fue (Spanish Edition)
Crónica de un México que nunca fue (Spanish Edition) Crónica de un México que nunca fue (Spanish Edition)
Crónica de un México que nunca fue (Spanish Edition) Crónica de un México que nunca fue (Spanish Edition)
Crónica de un México que nunca fue (Spanish Edition) Crónica de un México que nunca fue (Spanish Edition)
Crónica de un México que nunca fue (Spanish Edition) Crónica de un México que nunca fue (Spanish Edition)
Crónica de un México que nunca fue (Spanish Edition) Crónica de un México que nunca fue (Spanish Edition)
Crónica de un México que nunca fue (Spanish Edition) Crónica de un México que nunca fue (Spanish Edition)
Crónica de un México que nunca fue (Spanish Edition)

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