Correspondencia: Morelos 133 Ote. 5° piso. Col. Centro. Monterrey. NL México. CP 64000
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Rodríguez, R. Llop, M.E. Barceló, E. Cucurull, J.A. Vallés, E. Diogène, N. García, E. Fernández, N. Sabaté, E. Simó, J. Casadevall" "autores" => array:11 [ 0 => array:2 [ "nombre" => "D." "apellidos" => "Rodríguez" ] 1 => array:2 [ "nombre" => "R." "apellidos" => "Llop" ] 2 => array:2 [ "nombre" => "M.E." "apellidos" => "Barceló" ] 3 => array:2 [ "nombre" => "E." "apellidos" => "Cucurull" ] 4 => array:2 [ "nombre" => "J.A." "apellidos" => "Vallés" ] 5 => array:2 [ "nombre" => "E." "apellidos" => "Diogène" ] 6 => array:2 [ "nombre" => "N." "apellidos" => "García" ] 7 => array:2 [ "nombre" => "E." "apellidos" => "Fernández" ] 8 => array:2 [ "nombre" => "N." "apellidos" => "Sabaté" ] 9 => array:2 [ "nombre" => "E." "apellidos" => "Simó" ] 10 => array:2 [ "nombre" => "J." 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"documento" => "article" "crossmark" => 0 "licencia" => "http://www.elsevier.com/open-access/userlicense/1.0/" "subdocumento" => "edi" "cita" => "Aten Primaria. 2003;31:609-10" "abierto" => array:3 [ "ES" => true "ES2" => true "LATM" => true ] "gratuito" => true "lecturas" => array:2 [ "total" => 1630 "formatos" => array:3 [ "EPUB" => 33 "HTML" => 519 "PDF" => 1078 ] ] "es" => array:7 [ "idiomaDefecto" => true "titulo" => "La acupuntura en la artrosis de rodilla" "tienePdf" => "es" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "609" "paginaFinal" => "610" ] ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Romera" "autores" => array:1 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Romera" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0212656703763161?idApp=UINPBA00004N" "url" => "/02126567/0000003100000010/v1_201307091640/S0212656703763161/v1_201307091640/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Impacto de la atención ambulatoria del primer nivel de atención en la hospitalización de población asegurada con diabetes mellitus tipo 2" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "611" "paginaFinal" => "617" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "A.M. Salinas-Martínez, D. Sandoval-Espinosa, G.M. Núñez-Rocha, M.E. Garza-Elizondo, E. Villarreal-Ríos" "autores" => array:5 [ 0 => array:4 [ "nombre" => "A.M." "apellidos" => "Salinas-Martínez" "email" => array:1 [ 0 => "imssnorteinv@infosel.net.mx" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Sandoval-Espinosa" ] 2 => array:2 [ "nombre" => "G.M." "apellidos" => "Núñez-Rocha" ] 3 => array:2 [ "nombre" => "M.E." "apellidos" => "Garza-Elizondo" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Villarreal-Ríos" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Unidad de Investigación Epidemiológica y en Servicios de Salud. Instituto Mexicano del Seguro Social. Monterrey. NL México" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "*" "correspondencia" => "Correspondencia: Morelos 133 Ote. 5° piso. Col. Centro. Monterrey. NL México. CP 64000" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Impact of primary care on hospitalization of type 2 diabetics with equal conditions of health insurance" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaAceptado" => "2002-05-22" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec194858" "palabras" => array:3 [ 0 => "Atención primaria" 1 => "Primer nivel de atención" 2 => "Diabetes" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec194859" "palabras" => array:3 [ 0 => "Primary care" 1 => "Ambulatory care" 2 => "Diabetes" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar el impacto de atención ambulatoria del primer nivel de atención en la hospitalización del diabético tipo 2 en una población con condiciones iguales de aseguramiento.</p> <span class="elsevierStyleSectionTitle">Diseño</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio de casos y controles. Los casos son pacientes diabéticos hospitalizados por enfermedad relacionada con el padecimiento, y los controles son pacientes diabéticos sin antecedente de hospitalización en el último año.</p> <span class="elsevierStyleSectionTitle">Emplazamiento</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Centros de atención primaria urbanos.</p> <span class="elsevierStyleSectionTitle">Participantes</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Los casos fueron seleccionados consecutivamente en 4 de 5 hospitales generales urbanos (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>123). Los controles fueron elegidos al azar en la unidad de atención primaria de donde provenía el caso (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>135). Se excluyó a las mujeres con diabetes gestacional y a todos los que no contaban con expediente localizable (aproximadamente un 15%).</p> <span class="elsevierStyleSectionTitle">Mediciones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Se construyó un índice de atención primaria según las recomendaciones de la Asociación de Médicos Norteamericanos, la Comisión Conjunta de Acreditación de Organizaciones de Salud, el Comité Nacional de Aseguramiento para la Calidad, la Asociación Norteamericana de Diabetes y la Norma Oficial Mexicana. Se consideró que un cumplimiento menor al 60% correspondía a una atención subóptima.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Los factores de riesgo para la hospitalización fueron los siguientes: menos de 2 vistas al médico de familia en el último año (OR ajustada, 16,2; IC del 95%, 1,5–174,2), valor de glucosa (OR ajustada, 1,006; IC del 95%, 1,002–1,010) y nivel de conocimientos sobre la enfermedad (OR ajustada, 0,98; IC del 95%, 0,96–0,99), además de la práctica de ejercicio y el tiempo de diagnóstico. La atención primaria subóptima se registró en el 65,3% de los casos y el 49,1% de los controles (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,03) e incrementó 2,5 veces el riesgo de hospitalización (IC del 95%, 1,2–5,0; seudo R<span class="elsevierStyleSup">2</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0,279; p < 0,001).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">La evidencia disponible indica que la atención primaria puede ser un factor potencial para reducir la tasa de hospitalización por diabetes mellitus tipo 2. Los programas de manejo efectivos contribuirían a evitar hospitalizaciones innecesarias.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Objective</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">To determine the impact of primary care on hospitalization of type 2 diabetics with equal conditions of health insurance.</p> <span class="elsevierStyleSectionTitle">Design</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">A case-control study. Case<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>diabetic hospitalized by a disease related condition. Control<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>diabetic without hospitalization during the last 12 months.</p> <span class="elsevierStyleSectionTitle">Setting</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Urban primary care centers.</p> <span class="elsevierStyleSectionTitle">Participants</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Cases were consecutively selected from four out of five urban hospitals (n=123). Controls were chosen at random from primary care units matched by primary care source (n=135).Women with gestational diabetes were excluded as well as individuals with missing medical charts (approximately 15%).</p> <span class="elsevierStyleSectionTitle">Measurements</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">A primary care index was constructed with process and outcome indicators recommended by the American Medical Association, the Joint Commission on Accreditation of Healthcare Organizations, the National Committee for Quality Assurance, the American Diabetes Association and the Official Mexican Standards. Compliance to less than 60% of recommendations was considered unsatisfactory primary care.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">The following were hospitalization risk factors: less than 2 visits to family physician during the last year (OR adjusted, 16,2; 95% CI, 1,5–174,2), glucose level (OR adjusted, 1,006; 95% CI, 1,002–1,010) and cognitive level (OR adjusted, 0,98; 95% CI, 0,96–0,99), in addition to exercising and year of diagnosis. Sixty-five percent of cases observed unsatisfactory primary care compared with 49,1% of controls (P=0,03). Unsatisfactory primary care increased 2,5 times the risk of hospitalization (95% CI, 1,2–5,0) (pseudo R<span class="elsevierStyleSup">2</span>=0,279; P<0,001).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">Primary care is a potential factor for reducing hospitalization of type 2 diabetics. Effective primary care programs would contribute to a better disease control and less unnecessary hospitalizations.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:16 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Utilización de servicios hospitalarios por pacientes diabéticos: estudio en población abierta" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. 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año/Mes | Html | Total | |
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2024 Noviembre | 1 | 1 | 2 |
2024 Octubre | 16 | 8 | 24 |
2024 Septiembre | 13 | 5 | 18 |
2024 Agosto | 12 | 10 | 22 |
2024 Julio | 11 | 16 | 27 |
2024 Junio | 12 | 17 | 29 |
2024 Mayo | 15 | 14 | 29 |
2024 Abril | 15 | 24 | 39 |
2024 Marzo | 32 | 27 | 59 |
2024 Febrero | 19 | 21 | 40 |
2024 Enero | 21 | 31 | 52 |
2023 Diciembre | 30 | 23 | 53 |
2023 Noviembre | 28 | 64 | 92 |
2023 Octubre | 39 | 54 | 93 |
2023 Septiembre | 30 | 25 | 55 |
2023 Agosto | 24 | 29 | 53 |
2023 Julio | 30 | 66 | 96 |
2023 Junio | 39 | 29 | 68 |
2023 Mayo | 32 | 12 | 44 |
2023 Abril | 23 | 5 | 28 |
2023 Marzo | 18 | 3 | 21 |
2023 Febrero | 18 | 13 | 31 |
2023 Enero | 4 | 4 | 8 |
2022 Diciembre | 13 | 6 | 19 |
2022 Noviembre | 23 | 16 | 39 |
2022 Octubre | 23 | 20 | 43 |
2022 Septiembre | 18 | 43 | 61 |
2022 Agosto | 17 | 23 | 40 |
2022 Julio | 11 | 22 | 33 |
2022 Junio | 28 | 23 | 51 |
2022 Mayo | 17 | 15 | 32 |
2022 Abril | 21 | 21 | 42 |
2022 Marzo | 13 | 13 | 26 |
2022 Febrero | 6 | 7 | 13 |
2022 Enero | 5 | 6 | 11 |
2021 Diciembre | 9 | 7 | 16 |
2021 Noviembre | 16 | 20 | 36 |
2021 Octubre | 10 | 8 | 18 |
2021 Septiembre | 2 | 4 | 6 |
2021 Agosto | 6 | 4 | 10 |
2021 Julio | 13 | 6 | 19 |
2021 Junio | 8 | 9 | 17 |
2021 Mayo | 5 | 9 | 14 |
2021 Abril | 8 | 12 | 20 |
2021 Marzo | 18 | 15 | 33 |
2021 Febrero | 15 | 8 | 23 |
2021 Enero | 15 | 8 | 23 |
2020 Diciembre | 15 | 12 | 27 |
2020 Noviembre | 13 | 11 | 24 |
2020 Octubre | 13 | 23 | 36 |
2020 Septiembre | 18 | 8 | 26 |
2020 Agosto | 2 | 6 | 8 |
2020 Julio | 5 | 3 | 8 |
2020 Junio | 2 | 2 | 4 |
2020 Mayo | 1 | 9 | 10 |
2020 Abril | 3 | 3 | 6 |
2020 Marzo | 3 | 18 | 21 |
2020 Febrero | 7 | 13 | 20 |
2020 Enero | 13 | 29 | 42 |
2019 Diciembre | 29 | 42 | 71 |
2019 Noviembre | 2 | 7 | 9 |
2019 Octubre | 3 | 10 | 13 |
2019 Septiembre | 7 | 5 | 12 |
2019 Agosto | 2 | 6 | 8 |
2019 Julio | 6 | 10 | 16 |
2019 Junio | 29 | 35 | 64 |
2019 Mayo | 71 | 90 | 161 |
2019 Abril | 3 | 11 | 14 |
2019 Marzo | 3 | 4 | 7 |
2019 Febrero | 1 | 6 | 7 |
2019 Enero | 0 | 2 | 2 |
2018 Diciembre | 1 | 7 | 8 |
2018 Noviembre | 2 | 10 | 12 |
2018 Octubre | 9 | 10 | 19 |
2018 Septiembre | 2 | 5 | 7 |
2018 Agosto | 0 | 1 | 1 |
2018 Julio | 0 | 3 | 3 |
2018 Junio | 1 | 2 | 3 |
2018 Mayo | 0 | 7 | 7 |
2018 Abril | 2 | 0 | 2 |
2018 Marzo | 0 | 2 | 2 |
2018 Febrero | 2 | 0 | 2 |
2018 Enero | 0 | 2 | 2 |
2017 Noviembre | 1 | 2 | 3 |
2017 Octubre | 1 | 0 | 1 |
2017 Septiembre | 3 | 1 | 4 |
2017 Agosto | 4 | 2 | 6 |
2017 Julio | 1 | 1 | 2 |
2017 Junio | 5 | 1 | 6 |
2017 Mayo | 6 | 2 | 8 |
2017 Abril | 11 | 0 | 11 |
2017 Marzo | 11 | 1 | 12 |
2017 Febrero | 5 | 2 | 7 |
2017 Enero | 1 | 1 | 2 |
2016 Diciembre | 7 | 1 | 8 |
2016 Noviembre | 5 | 0 | 5 |
2016 Octubre | 14 | 3 | 17 |
2016 Septiembre | 7 | 0 | 7 |
2016 Agosto | 8 | 0 | 8 |
2016 Julio | 2 | 0 | 2 |