Acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiar

Background: Cholelithiasis (CL) represents a major health burden in Chile, with rates of cholecystectomy (CCT) of ~40.000 per year. The explicit health care guaranties (GES) program includes prioritized CCT for CL carriers between 35 and 49 years of age. Aim: To assess the access and opportunity of...

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Autores principales: Bay,Constanza, Ocares,Marcia, Toledo,Fernando, Barticevic,Nicolás, Mora,Isabel, Villouta,Francisca, Cruz,Francisco, Puschel,Klaus, Miquel,Juan Fco
Lenguaje:Spanish / Castilian
Publicado: Sociedad Médica de Santiago 2016
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Acceso en línea:http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016000300006
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spelling oai:scielo:S0034-988720160003000062016-06-13Acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiarBay,ConstanzaOcares,MarciaToledo,FernandoBarticevic,NicolásMora,IsabelVillouta,FranciscaCruz,FranciscoPuschel,KlausMiquel,Juan Fco Access, and Evaluation Cholelithiasis Cholecystectomy Health Care Quality Background: Cholelithiasis (CL) represents a major health burden in Chile, with rates of cholecystectomy (CCT) of ~40.000 per year. The explicit health care guaranties (GES) program includes prioritized CCT for CL carriers between 35 and 49 years of age. Aim: To assess the access and opportunity of CCT in a screening program of CL in Family Medicine Centers, according to the age of the patients. Material and Methods: A systematic ultrasound screening program of CL was developed in Family Medicine Centers ANCORA-UC between March 2009 and March 2013 during which 1.450 individuals were assessed, (80% women) and 281 were identified as having CL (19.4%). After a minimum follow up interval of six months, patients with CL were contacted and surveyed by phone. They were categorized as being beneficiaries of the GES program (those aged between 35 to 49 years) or not (those aged < 35 o &gt; 49 years). Results: Two hundred thirteen patients were contacted (76%), 81 beneficiaries of the program and 132 non-beneficiaries. The attending physician indicated CCT to 191 patients (89.6%). During a mean follow-up time of 641 days/person, 100 patients had CCT, 11% of which were emergency interventions due to complications. A greater proportion of program beneficiaries than non-beneficiaries had an elective CCT (74 and 21% respectively). The waiting interval for elective CCT was longer in non-beneficiaries compared with beneficiaries (340 ± 247 and 229 ± 201 days respectively). Only 46% of the elective CCT in GES patients were done within deadlines determined by the program (&#8804; 150 days). Conclusions: The age of patients at the moment of CL diagnosis conditions the access and opportunity to CCT. Beneficiaries of the explicit health care guaranties program have higher rates of cholecystectomy with less waiting time.info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.144 n.3 20162016-03-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016000300006es10.4067/S0034-98872016000300006
institution Scielo Chile
collection Scielo Chile
language Spanish / Castilian
topic Access, and Evaluation
Cholelithiasis
Cholecystectomy
Health Care Quality
spellingShingle Access, and Evaluation
Cholelithiasis
Cholecystectomy
Health Care Quality
Bay,Constanza
Ocares,Marcia
Toledo,Fernando
Barticevic,Nicolás
Mora,Isabel
Villouta,Francisca
Cruz,Francisco
Puschel,Klaus
Miquel,Juan Fco
Acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiar
description Background: Cholelithiasis (CL) represents a major health burden in Chile, with rates of cholecystectomy (CCT) of ~40.000 per year. The explicit health care guaranties (GES) program includes prioritized CCT for CL carriers between 35 and 49 years of age. Aim: To assess the access and opportunity of CCT in a screening program of CL in Family Medicine Centers, according to the age of the patients. Material and Methods: A systematic ultrasound screening program of CL was developed in Family Medicine Centers ANCORA-UC between March 2009 and March 2013 during which 1.450 individuals were assessed, (80% women) and 281 were identified as having CL (19.4%). After a minimum follow up interval of six months, patients with CL were contacted and surveyed by phone. They were categorized as being beneficiaries of the GES program (those aged between 35 to 49 years) or not (those aged < 35 o &gt; 49 years). Results: Two hundred thirteen patients were contacted (76%), 81 beneficiaries of the program and 132 non-beneficiaries. The attending physician indicated CCT to 191 patients (89.6%). During a mean follow-up time of 641 days/person, 100 patients had CCT, 11% of which were emergency interventions due to complications. A greater proportion of program beneficiaries than non-beneficiaries had an elective CCT (74 and 21% respectively). The waiting interval for elective CCT was longer in non-beneficiaries compared with beneficiaries (340 ± 247 and 229 ± 201 days respectively). Only 46% of the elective CCT in GES patients were done within deadlines determined by the program (&#8804; 150 days). Conclusions: The age of patients at the moment of CL diagnosis conditions the access and opportunity to CCT. Beneficiaries of the explicit health care guaranties program have higher rates of cholecystectomy with less waiting time.
author Bay,Constanza
Ocares,Marcia
Toledo,Fernando
Barticevic,Nicolás
Mora,Isabel
Villouta,Francisca
Cruz,Francisco
Puschel,Klaus
Miquel,Juan Fco
author_facet Bay,Constanza
Ocares,Marcia
Toledo,Fernando
Barticevic,Nicolás
Mora,Isabel
Villouta,Francisca
Cruz,Francisco
Puschel,Klaus
Miquel,Juan Fco
author_sort Bay,Constanza
title Acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiar
title_short Acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiar
title_full Acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiar
title_fullStr Acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiar
title_full_unstemmed Acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiar
title_sort acceso a colecistectomía en un programa de tamizaje ecográfico de colelitiasis en centros de medicina familiar
publisher Sociedad Médica de Santiago
publishDate 2016
url http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872016000300006
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