Dimensiones claves para fortalecer la atención primaria en el Perú a cuarenta años de Alma Ata

Cuba-Fuentes, María Sofia; Romero-Albino, Zoila; Dominguez, Rafael; Rojas-Mezarina, Leonardo; Villanueva, Rosa M. Tapia

doi:10.15381/anales.v79i4.15642

Cited by 20 publications

(24 citation statements)

References 9 publications

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“…system, overcrowding of hospitals, and poor health expenditure (5% of the gross domestic product) [12]. Our primary care system is deficient in infrastructure and resources and so far has been unable to play a leading role in patient care during this pandemic [13,14]. Our findings should be interpreted within this context.…”

Section: Plos Onementioning

confidence: 74%

Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru

et al. 2020

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Introduction Peru is among the top ten countries with the highest number of coronavirus disease 2019 (COVID-19) cases worldwide. The aim of the study was to describe the clinical features of hospitalized adult patients with COVID-19 and to determine the prognostic factors associated with in-hospital mortality. Methods We conducted a retrospective cohort study among adult patients with COVID-19 admitted to Hospital Cayetano Heredia; a tertiary care hospital in Lima, Peru. The primary outcome was in-hospital mortality. Multivariate Cox proportional hazards regression was used to identify factors independently associated with in-hospital mortality. Results A total of 369 patients (median age 59 years [IQR:49–68]; 241 (65.31%) male) were included. Most patients (68.56%) reported at least one comorbidity; more frequently: obesity (42.55%), diabetes mellitus (21.95%), and hypertension (21.68%). The median duration of symptoms prior to hospital admission was 7 days (IQR: 5–10). Reported in-hospital mortality was 49.59%. By multiple Cox regression, oxygen saturation (SaO2) values of less than 90% on admission correlated with mortality, presenting 1.86 (95%CI: 1.02–3.39), 4.44 (95%CI: 2.46–8.02) and 7.74 (95%CI: 4.54–13.19) times greater risk of death for SaO2 of 89–85%, 84–80% and <80%, respectively, when compared to patients with SaO2 >90%. Additionally, age >60 years was associated with 1.88 times greater mortality. Conclusions Oxygen saturation below 90% on admission is a strong predictor of in-hospital mortality in patients with COVID-19. In settings with limited resources, efforts to reduce mortality in COVID-19 should focus on early identification of hypoxemia and timely access to hospital care.

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Section: Plos Onementioning

confidence: 74%

Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru

et al. 2020

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“…El Modelo de atención integral de salud basado en familia y comunidad (MAIS-BFC), está vigente desde 2011 y fue desarrollado poniendo énfasis en las actividades preventivo-promocionales en el primer nivel de atención, promoviendo la identificación de factores de riesgo en el ámbito comunitario y designando paquetes de intervenciones para cada etapa de vida (21) .…”

Section: Del Modelo De Atención Al Modelo De Cuidadosunclassified

Proceso de transformación hacia las Redes Integradas de Salud en el Perú

Cosavalente-Vidarte¹,

Zevallos

Fasanando

et al. 2019

Rev Peru Med Exp Salud Publica

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a Médico cirujano; b especialista en Administración en Salud; c magíster en Ciencias Políticas; d especialista en Medicina Familiar y Comunitaria, magíster en Gerencia SocialEl Ministerio de Salud del Perú se enfoca en el logro de la cuádruple meta para su sistema sanitario; buscando mejorar la salud de la población, una mejor experiencia del usuario cuando utiliza los servicios sanitarios, mejor uso de los recursos públicos que se vienen inyectando en la última década y una mejor satisfacción laboral de los trabajadores de salud. La promulgación de la Ley 30885 de Redes Integradas de Salud, marca un hito en el esfuerzo del país de lograr resolver las necesidades de atención de los ciudadanos en una red y es la apuesta del sector salud para mejorar el desempeño del sistema sanitario. Para ello se plantean elementos clave para la organización y funcionamiento: Identificación de población y familias, asignación de responsabilidad del cuidado, fortalecimiento de las puertas de entrada al sistema de salud, estratificación de riesgos individuales y familiares, coordinación para facilitar el acceso y utilización de servicios de salud, continuidad y complementariedad del cuidado, y gobernanza en la red. Esta nueva propuesta política implica ajustes en la red de servicios de salud: establecimientos de salud (clínicas de familia) de 12 y 24 horas para el cuidado individual, familiar, manejo de los determinantes de la salud y hospitales para complementar el cuidado. El modelo de cuidado será más complejo y de avance difícil si no está unido a ajustes en el financiamiento, aseguramiento y en la gestión del cambio cultural de los trabajadores, usuarios del sistema y del sistema de gobernanza en salud. ABSTRACTPeru's Ministry of Health focuses on achieving the fourfold goal for its health system: seeking to improve the health of the population, a better user experience when using health services, better use of public resources being invested during the last decade, and better job satisfaction for healthcare workers. The enactment of Law 30885 on Integrated Health Networks marks a milestone in the country's effort to meet the care needs of citizens in a network and is the health sector´s proposal to improve the performance of the healthcare system. To this end, key elements for organization and functioning are proposed: identification of the population and families, assignment of liability for care, strengthening of the entry gates to the health system, stratification of individual and family risks, coordination to facilitate access to and use of health services, continuity and complementarity of care, and network governance. This new proposal involves adjustments to the health service network: 12-and 24-hour health facilities (family clinics) for individual care, family care, management of health determinants, and hospitals to supplement care. The model of care will be more complex and difficult to advance if it is not linked to adjustments in the financing, coverage, and management of the cultural change of workers and users...

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“…It would fall to FISSAL to contribute additional funds for the provision of treatment, given that FISSAL funds should be used for all high-cost illnesses, rare and orphan diseases as well as high-cost procedures. The coverage includes the financing of PNUME (a single national list of essential medications) and non-PNUME medications in accordance with the existing regulations (RM 540-2011/MINSA, RM 1361-2018/MINSA and RM 862-2019/ MINSA) [1][2][3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…This programme covers seven types of cancer (cervical, breast, stomach, colon, prostate, lymphomas and leukaemias). More than 16 million people fighting cancer were covered by SIS, making this being classified as one of the most expensive diseases in its treatment and whose early detection requires the best conditions and resources available [2][3][4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

The current situation regarding the availability and accessibility of anticancer drugs for breast cancer in the Peruvian public health system

Valencia¹,

Rioja²,

Morante-Cruz³

et al. 2021

ecancer

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The availability of effective, accessible, safe and high-quality anticancer drugs for the medical treatment of cancer is fundamental in ensuring optimal healthcare in the public health system in Peru. The main objective is to assess the current situation regarding anticancer drugs (termed ‘high-cost’) for breast cancer, as well as an analysis of the possible factors which negatively impact access to the Peruvian public health systems.There are similarities in the availability of anticancer drugs, since most treatments are covered by the Peruvian Ministry of Health. EsSalud offers an extra monoclonal antibody (pertuzumab) in the metastatic treatment stage. Meanwhile, the National Institute of Neoplastic Diseases (INEN), mainly for metastatic disease, has relied on more tested treatments over the last year. An agreement has been reached with the armed forces, which will enable patients to receive oncology care at the INEN and, thereby, benefit from the use of high-cost drugs.

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Dimensiones claves para fortalecer la atención primaria en el Perú a cuarenta años de Alma Ata

Cited by 20 publications

References 9 publications

Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru

Oxygen saturation as a predictor of mortality in hospitalized adult patients with COVID-19 in a public hospital in Lima, Peru

Proceso de transformación hacia las Redes Integradas de Salud en el Perú

The current situation regarding the availability and accessibility of anticancer drugs for breast cancer in the Peruvian public health system

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