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miércoles, 28 de enero de 2015
The AFP Community Blog: Are treatment recommendations for influenza eviden...
The AFP Community Blog: Are treatment recommendations for influenza eviden...: - Kenny Lin, MD, MPH As the Centers for Disease Control and Prevention (CDC) reported that people who received this season's influenza...
Pediatría Basada en Pruebas: Vacunación de las embarazadas frente a la tosferin...
Pediatría Basada en Pruebas: Vacunación de las embarazadas frente a la tosferin...: La tosferina es muy contagiosa y puede enfermar gravemente a las personas, en especial a lactantes muy pequeños (principalmente en <...
martes, 27 de enero de 2015
QOF business rules v28.0 - Health & Social Care Information Centre
Estas enfermedades o su numero se utiliza tambien en reino unido como medida de pluripatologia( multimorbility). Qof es como nuestro contrato de gestion.
http://www.hscic.gov.uk/qofbrv28
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http://www.hscic.gov.uk/qofbrv28
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Sanidad suspende la comercialización de 29 medicamentos genéricos | España | EL PAÍS
politica.elpais.com/politica/2015/01/27/actualidad/1422366658_776909.html
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Avances en gestión clínica: ¿Cómo incorporar las preferencias de los pacientes en las GPC?
gestionclinicavarela.blogspot.com.es/2015/01/como-incorporar-las-preferencias-de-los.html?utm_source=feedburner&utm_medium=email&utm_campaign=Feed:+AvancesEnGestinClnica+(Avances+en+gesti%C3%B3n+cl%C3%ADnica)&m=1
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sábado, 24 de enero de 2015
viernes, 23 de enero de 2015
Usabilidad importante palabro para tecnologia
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jueves, 22 de enero de 2015
Fwd: Prevalencia de portadores nasales de Staphylococcus aureus y Streptococcus pneumoniae en atención primaria y factores asociados a la colonización
http://www.sciencedirect.com/science/article/pii/S0213005X14003590
--
Francisco Javier Gómez Romero.
--
Residente de Medicina Preventiva y Salud Publica.
Email: gomez_frarom@gva.es
Hospital General Universitario de Elche.
Cami de l'Almassera 11. 03203, Elche (Alicante) - SPAIN
Re: Managing patients with multimorbidity in primary care | The BMJ
Modelos de estratificación de riesgos de la comunidad valenciana
El Miércoles 21 de enero de 2015 23:14, manolo <manuelsanchezmolla@gmail.com> escribió:
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miércoles, 21 de enero de 2015
Eficiencia de las TIC en sanidad | A un Clic de las TIC
www.aunclicdelastic.com/la-telemedicina-debe-incluir-un-rediseno-de-los-procesos-asistenciales
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Impact of Continuity of Care on Mortality and Health Care Costs: A Nationwide Cohort Study in Korea
El fuerte de la medicina de familia, la continuidad asistencial eficaz en la prevencion de eventos.
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Cuidado con los pacientes muy satisfechos y polimedicados...., Health Care Utilization, Expenditures, and Mortality
archinte.jamanetwork.com/Mobile/article.aspx?articleid=1108766
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Curso Aplicación de la Nuevas Tecnologías a la consulta del Médico de Familia II | Grupo de Nuevas Tecnologías de la SoMaMFyC
nuevastecsomamfyc.wordpress.com/2015/01/21/curso-aplicacion-de-la-nuevas-tecnologias-a-la-consulta-del-medico-de-familia-ii
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Enlace desde Twitter
healthitanalytics.com/2015/01/21/chronic-disease-management-lowers-heart-failure-hospital-rates
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(Ann Rheum Dis) Estudio MOVES: condroitín sulfato/glucosamina vs celecoxib en artrosis de rodilla | Sala de lectura
elrincondesisifo.es/2015/01/20/ann-rheum-dis-estudio-moves-condroitin-sulfatoglucosamina-vs-celecoxib-en-artrosis-de-rodilla
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martes, 20 de enero de 2015
Pediatras medico de familia y cuidado de los niños
Pediatras medico de familia y cuidado de los niños.
Fewer Family Physicians Treating Children
Marcia Frellick
October 06, 2014
7 comments
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EDITORS' RECOMMENDATIONS
Millions of US Children Losing Out on Preventive Care
Bill Would Keep Medicaid Raise for Primary Care Through 2016
Pediatric Subspecialty Shortage Little Noticed by Parents
Topic Alert
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Add Healthcare Reform to My Topic Alert
The percentage of family physicians providing care to children decreased from 78% in 2000 to 68% in 2009, according to study results published in the September/October edition of the Annals of Family Medicine.
The decline adds a layer to the debate about physician shortages, the authors say, noting that care for children often gets lost in discussions about the overall physician shortage. Physicians will be further stretched in caring for children as the Affordable Care Act extends insurance to more children and adults.
Laura Makaroff, DO, from the Robert Graham Center: Policy Studies in Family Medicine and Primary Care, Washington, DC, and colleagues found that family physicians spend about 10% of their time on care for children and are the usual source of care for one third of all children. Family physicians are the providers for between 16% and 21% of child care visits.
The authors note, "Children with a usual source of care have better health outcomes, including more preventive health counseling and fewer avoidable hospitalizations, than children who do not. Furthermore, access to patient-centered, comprehensive primary care has been shown to improve delivery of preventive services and decrease unmet medical needs of children."
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Fewer Family Physicians Treating Children
Marcia Frellick
October 06, 2014
7 comments
PrintEmail
EDITORS' RECOMMENDATIONS
Millions of US Children Losing Out on Preventive Care
Bill Would Keep Medicaid Raise for Primary Care Through 2016
Pediatric Subspecialty Shortage Little Noticed by Parents
Topic Alert
Receive an email from Medscape whenever new articles on this topic are available.
Add Healthcare Reform to My Topic Alert
The percentage of family physicians providing care to children decreased from 78% in 2000 to 68% in 2009, according to study results published in the September/October edition of the Annals of Family Medicine.
The decline adds a layer to the debate about physician shortages, the authors say, noting that care for children often gets lost in discussions about the overall physician shortage. Physicians will be further stretched in caring for children as the Affordable Care Act extends insurance to more children and adults.
Laura Makaroff, DO, from the Robert Graham Center: Policy Studies in Family Medicine and Primary Care, Washington, DC, and colleagues found that family physicians spend about 10% of their time on care for children and are the usual source of care for one third of all children. Family physicians are the providers for between 16% and 21% of child care visits.
The authors note, "Children with a usual source of care have better health outcomes, including more preventive health counseling and fewer avoidable hospitalizations, than children who do not. Furthermore, access to patient-centered, comprehensive primary care has been shown to improve delivery of preventive services and decrease unmet medical needs of children."
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En todas partes cuecen habas. También en Usa exist
En todas partes cuecen habas. También en Usa existe la dicotomia medico de familia /pediatra en la atencion a los niños de forma ambulatoria es el medico de familia.
Medscape Family Medicine
Are Family Physicians Caring for the Whole Family?
Laurie Scudder, DNP, NP, Scott A. Shipman, MD, MPHDisclosures
January 15, 2015
6 comments
PrintEmail
Introduction
Is Reimbursement a Factor?
Caring for the Elderly
References
EDITORS' RECOMMENDATIONS
Family Physicians Launch Initiative to Promote Primary Care
Fewer Family Physicians Treating Children
Care From Family Physicians Reported by Pregnant Women
Editor's Note: A recent family physician workforce analysis[1] of data collected by the American Board of Family Medicine confirmed a trend, first documented in the 1990s, of decreasing numbers of family physicians providing care for children. Family physicians overall reported spending about 10% of their time in caring for children. This decline in the proportion of family physicians caring for children was consistent across multiple demographic characteristics, although the percentage varied among physicians of different ages and by practice type and location. Medscape spoke with study coauthor Scott A. Shipman, MD, MPH, an assistant professor of pediatrics and community and family medicine at Dartmouth University and director of primary care initiatives and workforce analysis at the Association of American Medical Colleges, about the results and the implications for family medicine.
Medscape: Could you review this trend of decreasing pediatric care by family medicine physicians? When was this trend first noted? Is there any evidence that this trend is accelerating? Your data are through 2009; is there any evidence this trend is continuing?
Dr Shipman: The robust data collected by the American Board of Family Medicine in the recertification process provides really rich information about the self-reported practice patterns of family physicians. The first data point that studied this trend was the turn of the century, in 2000, and we have seen a steady trend since then demonstrating a decrease in family doctors' participation in caring for children.[2,3]
It is important to emphasize that for this study, the determination of whether an individual family physician provided care to children was binomial: Either they provided none, or they provided some. We didn't look at how much care they say they provide. There are a variety of reasons for that, some methodological and some tied to the fact that this is self-reported information. We felt that this was the most appropriate way to dichotomize the data we had.
You can look at it from a few different perspectives. For instance, there is a national survey, the National Ambulatory Medical Care Survey, which looks at and reports on visits by children and allows us to see the proportion of all children's visits to physicians that are performed by family physicians. That answers a slightly different question than the one we looked at, which was from the family physicians' perspective and asked: Are you still providing any care to children?
Medscape: Your study examined factors that correlated with a likelihood of a family physician delivering services to children. Can you discuss those factors?
Dr Shipman: Our study examined data first reported in 2012[2] to tease out factors associated with whether a family physician provides care to children or not.
It probably is easiest to think of these in two categories: as physician characteristics and area characteristics. The physician characteristics that we found to be predictive of being more likely to provide care to children were younger age, being female, and being a US medical graduate.
I suspect that the reason younger physicians are more likely than older physicians to care for children is, in some part at least, due to the natural aging of a patient population that occurs along with the aging of an individual provider as they go through their years of practice. It is very common for a physician, whether a family physician or anyone else, to have their patient population age as they age: That is, they stop taking on new, younger patients and allow their younger partners to take on those patients as their practice fills, and they have a stable population over time. So that is my suspicion about why the younger physicians are more likely to care for kids.
The issue of women being more likely to care for children is interesting. Again, I can only speculate as to why that is. We do see in the field of pediatrics, and general pediatrics particularly, that nearly three out of four residents today are women. It may be some of the same factors that draw women into pediatrics are also drawing female family physicians into caring for kids, independent of their age and other factors.
In terms of area characteristics that are predictive of family doctors being more or less likely to care for kids, some may be intuitive—but the associations are pretty strong, and we need to think about the implications of these.
Areas where children make up a higher percentage of the overall population had a somewhat higher likelihood of family doctors providing care to kids. If there are more kids around, family doctors are more likely to provide care for them.
Similarly, if there are fewer pediatricians in a healthcare market, family doctors were more likely to provide care for kids. This one was really strong. Compared with geographic areas that had the highest per capita supply of pediatricians, family physicians practicing in areas with no pediatricians were 80% more likely to provide care to kids. So a really strong predictor of whether a family doctor provides care to kids seems to be related to how many pediatricians are in that same geographic region.
Finally, independent of those factors, there are some interesting regional differences. In some areas of the country, such as the South, family physicians were much less likely to provide care to children. Why that is independent of the population, the supply of pediatricians, and all the other factors about individual physicians is unexplained so far. I don't know what the answer to that is, but it was significant.
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Medscape Family Medicine
Are Family Physicians Caring for the Whole Family?
Laurie Scudder, DNP, NP, Scott A. Shipman, MD, MPHDisclosures
January 15, 2015
6 comments
PrintEmail
Introduction
Is Reimbursement a Factor?
Caring for the Elderly
References
EDITORS' RECOMMENDATIONS
Family Physicians Launch Initiative to Promote Primary Care
Fewer Family Physicians Treating Children
Care From Family Physicians Reported by Pregnant Women
Editor's Note: A recent family physician workforce analysis[1] of data collected by the American Board of Family Medicine confirmed a trend, first documented in the 1990s, of decreasing numbers of family physicians providing care for children. Family physicians overall reported spending about 10% of their time in caring for children. This decline in the proportion of family physicians caring for children was consistent across multiple demographic characteristics, although the percentage varied among physicians of different ages and by practice type and location. Medscape spoke with study coauthor Scott A. Shipman, MD, MPH, an assistant professor of pediatrics and community and family medicine at Dartmouth University and director of primary care initiatives and workforce analysis at the Association of American Medical Colleges, about the results and the implications for family medicine.
Medscape: Could you review this trend of decreasing pediatric care by family medicine physicians? When was this trend first noted? Is there any evidence that this trend is accelerating? Your data are through 2009; is there any evidence this trend is continuing?
Dr Shipman: The robust data collected by the American Board of Family Medicine in the recertification process provides really rich information about the self-reported practice patterns of family physicians. The first data point that studied this trend was the turn of the century, in 2000, and we have seen a steady trend since then demonstrating a decrease in family doctors' participation in caring for children.[2,3]
It is important to emphasize that for this study, the determination of whether an individual family physician provided care to children was binomial: Either they provided none, or they provided some. We didn't look at how much care they say they provide. There are a variety of reasons for that, some methodological and some tied to the fact that this is self-reported information. We felt that this was the most appropriate way to dichotomize the data we had.
You can look at it from a few different perspectives. For instance, there is a national survey, the National Ambulatory Medical Care Survey, which looks at and reports on visits by children and allows us to see the proportion of all children's visits to physicians that are performed by family physicians. That answers a slightly different question than the one we looked at, which was from the family physicians' perspective and asked: Are you still providing any care to children?
Medscape: Your study examined factors that correlated with a likelihood of a family physician delivering services to children. Can you discuss those factors?
Dr Shipman: Our study examined data first reported in 2012[2] to tease out factors associated with whether a family physician provides care to children or not.
It probably is easiest to think of these in two categories: as physician characteristics and area characteristics. The physician characteristics that we found to be predictive of being more likely to provide care to children were younger age, being female, and being a US medical graduate.
I suspect that the reason younger physicians are more likely than older physicians to care for children is, in some part at least, due to the natural aging of a patient population that occurs along with the aging of an individual provider as they go through their years of practice. It is very common for a physician, whether a family physician or anyone else, to have their patient population age as they age: That is, they stop taking on new, younger patients and allow their younger partners to take on those patients as their practice fills, and they have a stable population over time. So that is my suspicion about why the younger physicians are more likely to care for kids.
The issue of women being more likely to care for children is interesting. Again, I can only speculate as to why that is. We do see in the field of pediatrics, and general pediatrics particularly, that nearly three out of four residents today are women. It may be some of the same factors that draw women into pediatrics are also drawing female family physicians into caring for kids, independent of their age and other factors.
In terms of area characteristics that are predictive of family doctors being more or less likely to care for kids, some may be intuitive—but the associations are pretty strong, and we need to think about the implications of these.
Areas where children make up a higher percentage of the overall population had a somewhat higher likelihood of family doctors providing care to kids. If there are more kids around, family doctors are more likely to provide care for them.
Similarly, if there are fewer pediatricians in a healthcare market, family doctors were more likely to provide care for kids. This one was really strong. Compared with geographic areas that had the highest per capita supply of pediatricians, family physicians practicing in areas with no pediatricians were 80% more likely to provide care to kids. So a really strong predictor of whether a family doctor provides care to kids seems to be related to how many pediatricians are in that same geographic region.
Finally, independent of those factors, there are some interesting regional differences. In some areas of the country, such as the South, family physicians were much less likely to provide care to children. Why that is independent of the population, the supply of pediatricians, and all the other factors about individual physicians is unexplained so far. I don't know what the answer to that is, but it was significant.
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lunes, 19 de enero de 2015
Hemos leído… » Manejo de la hiperglucemia en DM tipo2. Actualización de 2015
www.hemosleido.es/2015/01/14/manejo-de-la-hiperglucemia-en-dm-tipo2-actualizacion-de-2015?utm_content=buffer367e8&utm_medium=social&utm_source=twitter.com&utm_campaign=buffer
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domingo, 18 de enero de 2015
Actualizacion guia prevencion ictus.
gdtenfcv.blogspot.com.es/2015/01/actualizacionde-la-guia-de-prevencion.html
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Mayores y recursos. Encuesta del estudio.
Interesante es que habla de las dificultades de algunos pacientes para pagar sus farmacos y la brecha tecnologica con los moviles etc.
www.hispacoop.com/home/ConclusionesEstudioMayores.pdf
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Do annual pelvic exams benefit asymptomatic women who receive regular Pap smears? : The Journal of Family Practice
www.jfponline.com/articles/clinical-inquiries/article/do-annual-pelvic-exams-benefit-asymptomatic-women-who-receive-regular-pap-smears/9199ffdfd0bc8123528a0fcdf12b4db4.html
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Patients must drive a digital revolution in NHS | Healthcare Professionals Network | The Guardian
www.theguardian.com/healthcare-network/2015/jan/13/patients-digital-revolution-nhs
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La gripe no necesita más camas sino más Primaria
www.redaccionmedica.com/noticia/el-desprecio-a-la-capacidad-resolutiva-de-primaria-colapsa-las-urgencias-hospitalarias-9436
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viernes, 16 de enero de 2015
AQuAS Blog | Blog de l'Agència de Qualitat i Avaluació Sanitàries de Catalunya
Puede un indicador sintetico resumir la calidad de la atencion prestada, este indicador se fundamenta en la atencion ingresos de epoc insuficiencia cardiaca y diabetes, tres de las patologias incluidas en valcronic.
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martes, 13 de enero de 2015
sábado, 10 de enero de 2015
¿Cuáles son las actividades preventivas ineludibles en atención primaria? | FMC. Formación Médica Continuada en Atención Primaria
www.fmc.es/es/cuales-son-las-actividades-preventivas/articulo/90367240#.VJRiTCcBhvia
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Médico crítico: Hepatitis C: del lado del paciente con visión de población.
Magnifica revisión de un problema sociosanitario actual.
http://medicocritico.blogspot.com.es/2015/01/hepatitis-c-del-lado-del-paciente-con.html
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http://medicocritico.blogspot.com.es/2015/01/hepatitis-c-del-lado-del-paciente-con.html
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miércoles, 7 de enero de 2015
viernes, 2 de enero de 2015
control Anticoagulación desde Atencion primaria.
control Anticoagulación desde Atencion primaria.
¿Es coste efectiva la automonitorizacion por el paciente?
https://www.murciasalud.es/preevid.php?op=mostrar_pregunta&id=20176&idsec=453
El control de INR una competencia de la atención primaria?
http://www.ics.gencat.cat/3clics/main.php?page=ArticlePage&id=303&lang=CAS
dispositivos portatiles
http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90001164&pident_usuario=0&pcontactid=&pident_revista=27&ty=102&accion=L&origen=zonadelectura&web=zl.elsevier.es&lan=es&fichero=27v43n03a90001164pdf001.pdf
seguridad
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045910/pdf/1471-2296-15-104.pdf
atencion primaria frente a centros especializados.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599319/pdf/1472-6963-13-85.pdf
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¿Es coste efectiva la automonitorizacion por el paciente?
https://www.murciasalud.es/preevid.php?op=mostrar_pregunta&id=20176&idsec=453
El control de INR una competencia de la atención primaria?
http://www.ics.gencat.cat/3clics/main.php?page=ArticlePage&id=303&lang=CAS
dispositivos portatiles
http://apps.elsevier.es/watermark/ctl_servlet?_f=10&pident_articulo=90001164&pident_usuario=0&pcontactid=&pident_revista=27&ty=102&accion=L&origen=zonadelectura&web=zl.elsevier.es&lan=es&fichero=27v43n03a90001164pdf001.pdf
seguridad
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4045910/pdf/1471-2296-15-104.pdf
atencion primaria frente a centros especializados.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3599319/pdf/1472-6963-13-85.pdf
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Control de TAO(sintrom) desde primaria.
Nuestro compañeros de Babel nos presentan el modelo que se quiere seguir en todos nuestros centros.
http://www.revistafml.es/upload/ficheros/noticias/200912/05anticoagulacion.pdf
http://www.revistafml.es/upload/ficheros/noticias/200912/05anticoagulacion.pdf
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