Background Travel from Portugal to other countries has increased in the past 5 years. A pre-travel health consultation is advised to all travellers to raise awareness and reduce travel-related risk. We describe the experience of a pre-travel consultation centre in the public health service. Methods A retrospective observational study about consultations in an international vaccination centre between 2014-2018. Variables included were: sex, age, destination, purpose, referral, and prescriptions. Descriptive analyses were performed for all variables. Results Between 2014 and 2018, there were 1,546 consultations. Regarding individual characteristics, 54% were female, and 80% had between 15 and 64 years of age. There was no referral in 66% of the consultations, followed by 16% from general practitioners in the Primary Care Centres Group. The leading destination was Africa (54%), in a downward trend (74% in 2015 and 32% in 2018) followed by Asia (18%) with an upward trend (12% to 28% in the same period). The primary purpose was tourism (83%), followed by work (9%). In total, 3,287 vaccines were prescribed with typhoid fever vaccine accounting for 26%, hepatitis A vaccine 22%, and yellow fever vaccine 15%. Mefloquine was the primary therapeutic drug prescribed for destinations with risk for malaria (41%). Regarding destinations with low risk for malaria, in 42% of the consultations, personal protective measures were the only recommendation. Conclusions Our data show that pre-travel consultations seem to be valued and actively asked for by travellers, but medical referral is still insufficient. Regarding health promotion and prevention of diseases, tracking trends in the most common destinations allows to optimize the information provided in the consultation, effectively capacitating the traveller to recognize and act on the most common travel-related health risks. In further studies, a post-travel follow-up should be carried out to determine the impact of the consultation. Key messages Pre-travel consultation is an actively sought-after service by the community, but awareness should be promoted in the medical community. Pre-travel consultation can have an important role in the health literacy of travellers.
Background Vaccination is one of the most cost-effective disease prevention strategies. Trips from Portugal to other countries have increased in the past 5 years. Depending on the destination, certain vaccines are advised to travellers in order to reduce travel-related risk. We analyzed the data of an International Vaccination Centre (IVC) in the Public Health Unit of the Primary Care Centres Group (ACES) of Loures-Odivelas. Methods A retrospective observational study comprising data from an IVC database between 2014 and 2018. Variables included were sex, age, destination, purpose, referral, and prescriptions. Descriptive analyses were performed for all variables. Results Between 2014 and 2018, there was a total of 4,873 users. Regarding individual characteristics, 51% were female, 80% had between 15 and 64 years of age, and 51% were referred by general practitioners of the ACES. Africa was the leading destination (66% average for all years) with a downward trend (from 82% in 2014 to 47% in 2018) followed by South America (12%) with an upward trend (from 4% to 16% in the same period). The primary purpose of travelling was tourism (74%) followed by work (15%). A total of 7,323 vaccines were administered, with an annual increase from 1,250 administrations in 2014 to 1,862 in 2018. The yellow fever vaccine accounted for 36,9% of all administrations, followed by typhoid fever vaccine (32,3%) and hepatitis A vaccine (10,2%). Conclusions African countries are still the most common destination for Portuguese travellers, but changing trends might influence the vaccination strategies in the IVC. Information provided in the IVC can be optimized to suit individual profiles better. Key messages As travelling increases, the International Vaccination Centre has an essential role in the prevention of disease. Africa remains the most common destination, requiring pre-travel health counselling and vaccine prophylaxis.
Background Information about the users' experience is an essential element in patient-centered healthcare. We determined the score of the different elements of inpatient experiences of admission episodes in hospitals of the Portuguese health system and examined their contribution to the overall experience score. Methods A national cross-sectional study using randomized telephone interviews was conducted in the general population for the last episode of individuals who had an episode of hospitalization care between November 2016 and October 2017. Descriptive analysis of sociodemographic characteristics, care episode, hospital, elements of experience (16 dimensions), and global opinion was performed. The elements of experience were compared with the global experience through Spearman's correlation, with the contribution of each element to the global opinion calculated through weighted least squares regression. Results We obtained a total of 308 responses, 60.7% were female and the average age was 53.1 years, the average length of stay was 8.06 days; 35.1% were in medical departments; 56.5% were elective; 43.8% hospitals were in the Lisbon Metropolitan Area and 88.3% were from the public health service. All elements of experience and the overall opinion presented median values between 3 and (the maximum) 4. The correlation of each element with the global opinion is positive and statistically significant, having a contribution to the global opinion which varies between 11.5% and 51.6%, independently of demographic, episode of care or hospital characteristics. The domains of emotional support, empathy and respect; and communication, information and personal interaction make the greatest contribution to global opinion. Conclusions Elements of experience do not have the same weight on the global evaluation of inpatient individuals, which seem to privilege relational and interpersonal aspects of care. These findings have implications for patient-centered healthcare. Key messages Most users are satisfied with their hospitalization episodes of the Portuguese health system. The elements that contribute the most to the experience have to do with the healthcare workforce and their interaction with the users.
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