lunes, 6 de julio de 2015

Correlation and concordance between the national test of medicine (ENAM) and the grade point average (GPA): analysis of the peruvian experience in the period 2007 - 2009

Objectives: To evaluate the correlation and concordance between the ‘Peruvian National Exam of Medicine’ (ENAM) and the Mean Grade Point Average (GPA) in recently graduated medical students in the period 2007 to 2009. Materials and Methods: We carried out a secondary data analysis, using the records of the physicians applying to the Rural and Urban Marginal Service in Health of Peru (SERUMS) processes for the years 2008 to 2010. We extracted from these registers, the grades obtained in the ENAM and GPA. We performed a descriptive analysis using medians and 1st and 3rd quartiles (q1/q3); we calculated the correlation between both scores using the Spearman correlation coefficient, additionally, we conducted a lineal regression analysis, and the concordance was measured using the Bland and Altman coefficient. Results: A total of 6 117 physicians were included, the overall median for the GPA was 13.4 (12.7/14.2) and for the ENAM was 11.6 (10.2/13.0).Of the total assessed, 36.8% failed the TEST. We observed an increase in annual median of ENAM scores, with the consequent decrease in the difference between both grades. The correlation between ENAM and PPU is direct and moderate (0.582), independent from the year, type of university management (Public or Private) and location. However, the concordance between both ratings is regular, with a global coefficient of 0.272 (CI 95%: 0.260 to 0.284). Conclusions: Independently of the year, location or type of university management, there is a moderate correlation between the ENAM and the PPU; however, there is only a regular concordance between both grades.
Authors:Huamaní, CharlesGutiérrez, CésarMezones Holguin, Edward
Source: Rev. perú. med. exp. salud publica
URL: http://hdl.handle.net/10757/314461

Labor projection in the countryside and associated factors in newly collegiated physicians in Lima, Peru 2010

 Objectives. To estimate the prevalence and associated factors with the labor porjection in the countryside of physicians from Lima. Materials and methods. We conducted a cross-sectional study of 782 physicians who were surveyed during their affiliation at Peruvian Medical College during March and April 2010. Labor projection in the countryside was defined such as if they responded “inside the country” to the question “Where do you plan to be working in the next five years?” We used a multiple logistic regression model to find the associated factors. Results. The average age of the participants was 25 years, 54% were female and 73% graduated in private universities. Only 7.0% reported plans to work in the countryside and 0,5% in rural areas. No association with gender, place of birth, having physicians in their family, university type, the english efficiency, having resided for more than a one year in the provinces and the year of completion of internship was found. In the multivariate analysis, we found association with having made the internship inside the country (OR: 3.1, 95%CI :1.5-6.3), communicate in Quechua (OR: 2.9, CI 1.4- 6.1), both parents born in the countryside (OR: 2.8, CI :1.4-5.6), while a monthly salary projection of more than $ 1780 dollars (OR: 0.4 CI :0.2-0,8) and living with their nuclear family or partner (OR: 0.3, CI :0.1-0.5) were negatively associated. Conclusions. Labor projection of work in the countryside of recently collegiated physicians from Lima is low. Some of the factors found can help to design strategies to reverse this situation.
Authors: Mayta Tristán, PercyMejia, Christian R.Riega-Lopez, PedroRojas-Mezarina, LeonardoPosso, Margarita
Source:  Rev. perú. med. exp. salud publica
URL: http://hdl.handle.net/10757/314460

sábado, 4 de julio de 2015

Hospital earthquake vulnerability: experiences from the Hospital Regional de Ica within four years from the disaster.

Sr. Editor. Los hospitales son considerados como edificaciones esenciales y su falta de operatividad luego de un desastre supone un gran impacto social y político, ya que estos establecimientos constituyen uno de los pilares fundamentales que sustentan la respuesta ante tal situación (1). Como es de conocimiento público, luego del terremoto del año 2007 sucedido en el Perú, las instalaciones y lí- neas vitales del Hospital Regional de Ica colapsaron, ya que fue construido en la década de 1960, cuando aún no regía la norma de diseño sismorresistente. La atención continuó llevándose a cabo en el mismo lugar, en carpas y contenedores donados y en las más rescatables pero debilitadas estructuras que aún quedaban en pie. Dos años después, en agosto de 2009, los servicios de este establecimiento de salud fueron trasladados a un local del Instituto Peruano del Deporte, continuando en carpas y módulos prefabricados. Sin embargo, esta nueva locación tampoco cumplía con los requisitos necesarios para la labor asistencial.
Autores: Pereyra Elías, ReneéElías-Barrera, Carmen CeciliaMorales-Soto, Nelson
Fuente: Rev. perú. med. exp. salud publica
URL: http://hdl.handle.net/10757/314468

Health economic evaluations: bringing together academia and policy.

En este editorial se describe, inicialmente, un panorama general de los diversos aspectos que han llevado a un incremento en el gasto en salud en los países, con la consiguiente necesidad de priorización en la asignación presupuestaria a nivel sanitario. Igualmente, se presenta a las Evaluaciones Económicas en Salud (EES) como herramientas útiles en los procesos de toma de decisiones, haciendo hincapié en las principales dificultades que existen para lograr el desarrollo y aceptación de dichas evaluaciones. Al mismo tiempo, se da una mirada rápida a los modelos y opciones que proponen algunos paradigmas de la economía de la salud. De la misma forma, se puntualizan ciertas características actuales del sistema de salud peruano, así como acciones y sugerencias para implementar el uso de las EES en el sector. En último lugar, se presenta de modo sucinto el contenido del presente número.
Autor:Mezones Holguin, Edward
Fuente: Rev. perú. med. exp. salud publica
URL: http://hdl.handle.net/10757/314466

Synthesis studies as the basis for economic evaluations in health: the need for their quality appraisal.

Synthesis studies (SS): systematic review and meta-analysis are the basis for developing Health Economic Evaluations (HEE). SS allow us to obtain parameters for estimating probabilities and effectiveness from the combination of the results of primary studies, and, as they include in their methodology the selection, evaluation, systematization and synthesis processes, they are considered the first level of hierarchy in scientific evidence. Nevertheless, they can be prone to bias and methodological failures that can affect the validity of their results. This article initially presents the relevance of the randomization in the hierarchic classification of research designs, then it reviews the main factors affecting the validity of the SS, emphasising the publication bias, the heterogeneity and the inclusion of primary studies with main objective differing from the one of the SS. Moreover, it presents individual studies like a valid alternative for the development of a SS. The conclusion is that one of the key aspects in a SS is the correct evaluation of the study types and the objective evaluation of their quality, being these primary or secondary.
Authors: Bolaños Díaz, RafaelMezones Holguin, EdwardGutiérrez Aguado, AlfonsoMálaga, Germán
Source: Rev. perú. med. exp. salud publica

URL: http://hdl.handle.net/10757/314459