RESUMO
OBJECTIVE: To determine the effectiveness and costs of different organizational models in caring for colorectal cancer patients through either clinical management functional units or traditional clinical services. METHOD: Post-operative and long-term (after 30 days and 5 years) mortality was analyzed according to number of patients undergoing surgery because of colorectal cancer. Mortality was adjusted for patient-related confounding factors. With that purpose a thorough review of the literature was conducted; information obtained was used in a meta-analysis of randomized effects. Concerning costs, a literature search was run to describe differences in number of patients per year between hospitals. RESULTS: Surgery costs were found to be smaller, and mean hospital stay shorter, in big-sized hospitals. The meta-analysis showed that the risk of death at 30 days and 5 years was lower in big hospitals versus smaller ones (OR: 1.112; 95% CI 0.986-1.255, and OR: 1.114; 95% CI 1.105-1.183, respectively). CONCLUSIONS: Short- and long-term postoperative mortality is lower in hospitals with a high number of cases per year.
Assuntos
Neoplasias Colorretais/economia , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/cirurgia , Custos e Análise de Custo , Tamanho das Instituições de Saúde , Humanos , Modelos Organizacionais , Análise de SobrevidaRESUMO
OBJECTIVE: To define the incidence of depressive disorders and anxiety disorders in prisoners of three prisons of CCAA in treatment with antiretrovirals, and moreover the associated variables and the intensity of social support within the prison. METHODS: Through a cross-sectional design 281 prisoners were studied. RESULTS: 42% showed mental morbidity and 53.4% lacked social support. To be imprisoned in the Granada prison, to be a woman, poor health state, to describe difficulties for compliance with antiretrovirals drug, a history greater than 13 years for drugs consumption, and usual residence with the couple of family, all were factors associated with mental morbidity. Factors associated with social support non-existence were history of more than one imprisonment, lack of familiarity with the medical equipment, to be more than 35 years old, and to suffer mental morbidity.