{"id":83049,"date":"2018-03-10T00:07:07","date_gmt":"2018-03-10T00:07:07","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/la-historia-clinica-como-fuente-de-informacion-en-los-estudios-de-calidad-asistencial\/"},"modified":"2018-03-10T00:07:07","modified_gmt":"2018-03-10T00:07:07","slug":"la-historia-clinica-como-fuente-de-informacion-en-los-estudios-de-calidad-asistencial","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/ciencias-medicas\/la-historia-clinica-como-fuente-de-informacion-en-los-estudios-de-calidad-asistencial\/","title":{"rendered":"La historia clinica como fuente de informaci\u00f3n en los estudios de calidad asistencial"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Antonio Reyes Dominguez <\/strong><\/h2>\n<p>La pr\u00e1ctica cl\u00ednica tiene un elevado grado de variabilidad y las decisiones cl\u00ednicas se toman de acuerdo a criterios que no siempre suponen el uso m\u00e1s adecuado de los recursos. En este contexto, los estudios de calidad asitencial sond e promordial imporancia para racionalizar la asistencia de los hospitales. Parece enprincipio que la informaci\u00f3n contenida enlas historias cl\u00ednicas (hc) es la de mayor valor apara poder realizar tales estudios.  objetivo:  examinar la disponibilidad de informaci\u00f3n en las hc e informes de alta hospitalaria imah para evaluar la adecuaci\u00f3n de cuidados en pacientes con angina cr\u00f3nica.  dise\u00f1o:  revisi\u00f3n retrospectiva de hc e imah.  lugar:  servicios de medicina interna y cardiolog\u00eda delos tres hospitales universitarios de sevilla.  sujetos:  muestran randomizada simple de 722 pacientes.  extraccion de la muestra:  los datos fueron extra\u00eddos por seis m\u00e9dicos de familia previamente entrenados con criterios expl\u00edcitos.  selecci\u00f3n de variables:  a partir de una revisi\u00f3n de la literatura y los criterios de un panel de expertos (metodolog\u00eda rand-ucla) se seleccionaron los datos considerados necesarios para evaluar la asistencia en cardiopat\u00eda isqu\u00e9mica.  an\u00e1lisis:  porcentaje de hc e imah consuficiente informaci\u00f3n para evaluar la pr\u00e1ctica cl\u00ednica. Se consider\u00f3 una hc o imah suficiente cuando dispon\u00eda de al menos del 80% de los datos referidos como necesarios. Modelo multivariante de factores asociados a la suficiencia de la informaci\u00f3n.  resutlados:  el 78,5% de las hc disponen de suficientes datos para evaluar la totalidad de la asistencia prestada a pacientes con cardiopat\u00eda isqu\u00e9mica. Se detect\u00f3 un d\u00e9ficit d einformaci\u00f3n enlos pacientes mayores de 80 a\u00f1os (or; 0,42), pacientes con presentaci\u00f3n cl\u00ednica como equivalente isqu\u00e9mico (or: 0,45) y en uno de los tres hospitales evaluados (or: 0,43). El 28% de los imah eransuficientes, existiendo menos informaci\u00f3n<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>La historia clinica como fuente de informaci\u00f3n en los estudios de calidad asistencial<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 La historia clinica como fuente de informaci\u00f3n en los estudios de calidad asistencial <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Antonio Reyes Dominguez <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Sevilla<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 21\/01\/2000<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li> Lacalle Remigio Juan  Ramon<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: julio De la morena fern\u00e1ndez <\/li>\n<li>Juan Polo padillo (vocal)<\/li>\n<li>agustin Gomez de la camara (vocal)<\/li>\n<li>Emilio Pujol de la llave (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Antonio Reyes Dominguez La pr\u00e1ctica cl\u00ednica tiene un elevado grado de variabilidad y las decisiones cl\u00ednicas se [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center 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