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S de Mateo

Publications and source records attributed to S de Mateo.

13 recordsLinked to original sources

Legionnaires' disease clusters associated with travel to Spain during the period January 2001 to July 2003.

Epidemiological surveillance and control of travel associated cases of legionnaires' disease are necessary tasks for public health and collaboration between countries is necessary to do this. Within the framework of the European Surveillance Scheme for Travel Associated Legionnaires' Disease (EWGLINET), European Guidelines for Control and Prevention of Travel Associated Legionnaires' Disease have been produced . This has established the reporting and response criteria when cases or clusters appear. In this paper the analysis of the information corresponding to the 46 reported clusters related to Spain is presented. Data corresponds to the period January 2001 to July 2003.

Adult↗

[Socioeconomic differences in the use and accessibility of health care services in Spain].

BACKGROUND: One of the main goals of the public health care systems is to assure an equitable accessibility and utilization of health care services according to the need for care. The present study evaluates the extent to which this objective has been reached in the Spanish National Health System from the socioeconomic perspective. POBLATION AND METHOD: The 1993 National Health Survey was used. Doctor consultation, use of inpatient hospital services, dentist consultation and gynaecologist consultation were the indicators of utilization analysed. Accessibility was measured by time spent travelling to the health centre, time spent waiting at health centre and time spent waiting for an ordinary admission to hospital. Educational level was the socioeconomic variable used. RESULTS: Doctor consultation and use of inpatient hospital services were more frequent in individuals with the lowest level of education, while dentist and gynaecologist consultation were in those with the highest level. No statistically significant differences were observed in doctor consultation and use of inpatient hospital services after adjusting for age, sex, health care coverage and several need indicators by using a multiple logistic regression model. On the contrary, the odds ratios for individuals with first, second and third educational level were 1.31 (CI 95% = 1.14-1.51), 1.74 (1.49-2.03) and 2.06 (1.71-2.47) in dentist consultation and 2.01 (1.71-2.35), 2.40 (2.01-2.87) and 2.54 (2.02-3.21) in gynaecologist consultation. On the other hand, individuals with no education showed the longest average waiting times, especially for an ordinary admission to hospital, which was 83.5 days for subjects with no education and 18.8 for those with third educational level. However, the multiple linear regression analysis only found statistically significant results in time spent travelling to the health center and time spent waiting at the health center. CONCLUSIONS: Although no differences in doctor consultation and use of inpatient hospital services by socioeconomic status were found, the results obtained regarding the use of other health care services and waiting times indicate the persistence of barriers limiting the equitable access and utilization of health care services in Spain.

Dental Health Services↗

[Socioeconomic differences in mortality in 8 Spanish provinces].

BACKGROUND: The scarce fulfillment of the job in the Bulletin on Death (BD) has limited the study of the socioeconomic differences in mortality in Spain. Nonetheless, the authors have studied the socioeconomic differences in mortality by different causes of death, using the Spanish geographical areas in which the information regarding the occupation of the deceased persons in the BD is of good quality. METHODS: Males between 30-64 years of age who died in eight Spanish provinces from 1988-1990 were included in the study. Overall mortality was compared by the relative risk of mortality adjusted for age and by the main causes of death among the professionals and managers, manual workers and farmers. The relative risk was calculated with the use of log-lineal models (Poisson regression) taking the group of professionals and managers as the reference group. RESULTS: The global relative risk of mortality in the group of manual workers was 1.72 and was 1.56 in the farmers. The highest mortality by different causes of death was observed in the manual workers while intermediate mortality was found in the farmers. The exceptions to this general pattern were colon and rectum cancer and leukemias with a higher mortality being found in the group of professionals and managers, although the differences were not statistically significant. Cerebrovascular diseases, suicide and cancer of the nervous system showed the highest relative risk of mortality in the farmers. Both the manual workers and the farmers demonstrated the highest relative risks of mortality in the youngest age groups although this difference attenuated with age. CONCLUSIONS: Except for colon and rectal cancer and leukemias, manual workers and farmers present higher mortality than professionals and managers. Furthermore, these differences may be underestimated since only the active economic population was studied, thereby excluding the individuals pertaining to the population groups with higher mortality rates.

Adult↗

Standardisation or modelling of mortality rates.

STUDY OBJECTIVE: To compare the results obtained when estimating a standardised rate using the conventional technique of stratified analysis and using Poisson regression, and to evaluate the speed of the two techniques in making the calculation. DESIGN: Cross sectional study. SETTING AND PARTICIPANTS: The trend in motor vehicle accident mortality in males from 1985 to 1992 in Spain was compared using stratified analysis and Poisson regression. In the stratified analysis the calculations were made using a specially designed spreadsheet while in the Poisson regression the statistical program used was EGRET. RESULTS: The stratified analysis took two hours and the Poisson regression 15 minutes to complete. In the stratified analysis a single estimate for each year was obtained, whereas the model of Poisson regression that best fitted the data included an interaction term between age and year. CONCLUSION: Poisson regression can be considered a serious alternative to stratified analysis when the objective is to compare mortality rates standardised by one or two variables.

Accidents, Traffic↗

[Perception of the success of primary care health promotion in the province of Toledo].

OBJECTIVE: Identification of factors which can condition the perception by Primary Care professionals of success in health promotion. DESIGN: An observation study of a crossover type. PARTICIPANTS: 106 professionals (doctors, nurses and social workers) from 22 health centres in the province of Toledo, who filled in a questionnaire. MEASUREMENTS AND MAIN RESULTS: A non-conditional, multiple, logistic regression analysis was used. The professional satisfied with his/her work, not a doctor and who worked in a health centre open for less than 3 years, presented, against their opposite values, greater probability (OR 3.01, 2.41 and 1.24 respectively) of having a perception of success in health promotion. CONCLUSIONS: Health promotion undertaken in newly-opened centres, which involves in particular non-medical staff and, above all, is carried out by professionals satisfied with their habitual work, has a 77% probability of being considered successful by these professionals. These factors greatly facilitate its propagation in Primary Care.

Attitude of Health Personnel↗

[Public health surveillance systems: let's not ask for the impossible].

The publication of the Decree creating the National Epidemiological Surveillance Network, 7 years ago now, invites us to reflect on public health surveillance systems in our country and to highlight those aspects that help or obstruct these systems in meeting their basic objective of providing information that can be used to facilitate disease control. Many of the events that have taken place in the health arena in recent years, labeled as health crises by the communications media, have been considered by the population as unacceptable risks that the health system should have avoided; defects in surveillance systems are one of the errors always mentioned in this respect. Some of these defects arise because of limitations of the instruments used to measure and classify health problems, but others are due to an inappropriate understanding of surveillance, which make it difficult to assess the true impact of health problems. A discussion of the two types of defects will not solve surveillance problems, but it may help many people to stop asking our surveillance systems for what they cannot offer.

Humans↗

[An evaluation of the statistical significance and calculation of the confidence interval for the standardized mortality ratio].

The standardized mortality ratio (SMR) is the ratio of the number of deaths observed (D) to the number expected (E), on the basis of the mortality rates of some reference population. Several procedures have been proposed in order to test its significance and to estimate its confidence intervals. In this study, the SMR of two causes of death in 27 health areas of Castilla-La Mancha have been calculated. The significance has been evaluated by exact Poisson test and by four methods approximating the Poisson distribution by the normal: 1) a Z statistic based on the assumption that a Poisson variate with expectation E has a standard deviation equal to square root of E; 2) the Z statistic with a continuity correction; 3) a Z statistic based on the square root transformation of a Poisson variable and 4) an approximation of the exact test by Byar. Also, the confidence intervals have been estimated by exact method and by three approximate procedures: 1) by Byar; 2) by Z statistic uncorrected and 3) by the square root transformation of the Poisson distribution. With the exact methods and Byar procedure the results were very similar; therefore, using the last to testing significance and estimate the confidence intervals of SMR, is suggested.

Confidence Intervals↗

[Trends in infectious diseases mortality in Spain].

OBJECTIVE: The aim of this study was to describe the trend and geographical distribution of mortality by infectious diseases in Spain between 1980 and 1993. METHODS: Deaths caused by infectious diseases ocurred in Spain between 1980-1993 were studied. Data were obtained from the national mortality registry from the Instituto Nacional de Estadística. Deaths included in the International Diseases Classification (ICD-9) in group I were included, and also deaths by infectious diseases included in other groups. The trend in mortality risk was evaluated by means of a log-lineal Poisson model. Standardized mortality rates (SMR) by age for each Spanish province in 1980-83 and 1990-93, were calculated to identify geographical differences in mortality. These SMR were compared using Spearman correlation coefficient. RESULTS: Between 1980 and 1993, the adjusted mortality rate by infectious diseases decreased around 1.4% each year. In 1980 and also in 1993 respiratory tract infections were the first cause of death, 29.6 and 20.3 deaths for 105 inhabitants, respectively. The second cause of death was tuberculosis in 1980, 3.9 x 10⁵ and HIV infection in 1993, 10.7 x 10⁵. This decrease in infectious diseases mortality during the studied period was shown in all age groups, except for the 25 to 44 age group, were mortality rate increased by seven times. The geographical distribution showed that the provinces with the highest mortality rate were the same in 1980-83 and in 1990-93 (Spearman coefficient: 0.49; p < 0.001). CONCLUSIONS: Because deaths by infectious diseases are distributed in different groups in the ICD-9, their impact on mortality is underestimated, although they are the fourth cause of death in Spain. However, between 1980 and 1993 it has been shown a decrease in mortality by these diseases, except for the 25-44 age group where an impressive increase ocurred due to HIV infection. No differences between provinces have been shown.

Communicable Diseases↗