Monday, January 30, 2023

IPSUSS was commissioned by the Health Commission to analyze the underutilization of surgical wards in the country.

The Institute of Public Health Policies of the University of San Sebastián (IPSUSS) was invited to make a presentation to the representatives of the Commission of Health regarding the use of surgical wards of the public health system that Minsal relies on.

Illustration reporting and elaborating the main findings, conclusions and proposals made by the study titled “How are surgical wards used in Chile? X-rays of the state health sector” prepared by Raul Aguilar and Carolina Velasco, IPSUSS researchers made possible. ,

“We can do more with what we have,” Carolina Velasco, director of studies at IPSUSS, emphasized during her presentation. According to the analysis, the expenditure on hospital services has increased by about 50% between 2009 and 2019; However, this increase has not been reflected in the number of hospital discharges.

“Costs have gone up, and we want to understand why through this study,” Velasco said.

To construct the study, all major surgery wards in the country were analyzed using data and information from 2019, however, only the period before the pandemic, i.e. from 2017 to 2019, was considered, so that event can be generated. COVID-19 will not affect the results and conclusions.

Pavilions are not authorized and use of authorized people for few hours raises concern among MPs
“On average, 14% of our wards are not being utilised. This means we are failing to perform 150,000 surgeries annually. There are mainly two reasons: lack of personnel and the equipment needed to perform major surgeries”, explained the researcher.

Continuing the above, Velasco states that “We only have an average of 86% of operating rooms to be utilized and 100% have not been built.”

The situation becomes even more worrying in the opinion of IPSUSS researchers. As he explained, out of that 86% that is required to do the job, i.e. with adequate human resources along with necessary machinery, the actual utilization is 61%. Therefore, 40% of the time major surgeries are not performed, which has an impact of 367,000 surgeries not being performed per year.

In his speech, Deputy Daniel Lelauy also expressed his concern, saying that “I think the analysis being done is very serious, I think the surgical wards are underutilized.” Deputy María Luisa Cordero agrees, stating that “surgical wards are underutilized in Chile.”

Next, and delving into the results of the analysis, Velasco indicated that “if we take 100% of the total number of wards for major surgery, authorized and not authorized, we are only using 50% of their hours.” Huh.” A relevant problem for the IPSUSS researcher as the standard of use in other countries is consistent with 83%.

“Total, We’re not doing more than 500,000 surgeries a year. This is because we under-utilize our pavilions or because we have not been able to enable them, despite the fact that we have already made initial investments and built them,” Velasco told the health commission.

A situation that sets off alarm bells and raises concerns across the board, considering the current system’s extensive waiting list, which averages close to 300,000 surgeries each year. These can be fully covered if 100% of the wards are enabled for major surgery and the utilization rate increases to at least 80% from the present 61%.

In Chile, the surgery suspension rate corresponds to 8%, ie approximately 1 out of every 10 surgeries is suspended. with this, Studies show that more than 90% of reasons for suspending surgery can be avoided with proper management by the hospital.

The analysis indicates, “Knowing the reasons for suspension of surgery allows, on the one hand, to address them and thus increase the number of interventions and, on the other hand, to predict suspensions and thus improve programming.” allows for.”

With respect to the evidence provided by IPSUSS, “This study provides us with fundamental information, but it also worries us” for the Commission President, Representative Tomas Lagomarsinos.,

Meanwhile, deputy Marta Bravo proposed that what was exposed by researcher Carolina Velasco “does not remain only in a presentation. We, as the Commission of Health, will also raise the concern with the Ministry and thus we will finally inform the public.” can provide solutions for.

On the contrary, as Carolina Velasco elaborated at the end of her presentation, there are several proposals that make it possible to correct the underutilization of surgical rooms.

One of them aims to provide a more long-term view of the work that hospitals and health services do. For which it is necessary that first of all the hospital administration should be depoliticized so that there is continuity in work and planning and above all attention is paid to the needs of the patient. This is because both hospital directors and health service directors are replaced every four years with each change of government, which in Velasco’s opinion “plays against the long-term plan and guidelines each new administration has to follow.” with the wants, not the needs, of the patient”.

Along with the above, The researcher explained that “a public body independent of the Ministry of Health and the government in power has been proposed to take charge of the administration of the hospitals.”

Similarly, in proposals focused at the hospital level, He pointed to the importance of setting goals linked to the fulfillment of relevant indicators, such as the use of flags and other performance indicators., However, he indicated, “this should go hand in hand with strengthening local management, so that these health facilities can have their own management of their human, financial, technical, administrative and medical resources through greater powers.” Only in this way can citizens be held accountable.”

The study states that “It is imperative to create a framework that encourages good performance, patient focus and accountability for the use of public health resources. For this, across the board, it is proposed to restructure the structure, corporate Administration and the Qualities of State Health Providers”.

After its presentation, Carolina Velasco positively evaluated this example because, in her opinion, These places “allow parliaments to contribute, in this case to the health commission of the chamber. We recognize that our role is to be a kind of bridge between the academic and parliamentary worlds.”

A role that is part of the objectives of IPSUSS: To contribute to improving public health policies through the development of proposals based on evidence and best practices.

“We believe it is fundamental that those of us who are involved in the development of public policies, based on evidence, based on research, can be heard by parliamentarians as well as have their questions and proposals heard. It is our duty to cooperate with the evidence and with the technically sound and by the way, realistic and adjusted”, Carolina Velasco indicated at the end of her analysis.

IPSUSS President Enrique Paris thanked the dissemination space provided by the Health Commission and appreciated the work prepared by the researchers Pointing out that “he has personally visited some hospitals to present the results. It is important that we find solutions, especially for the patients. This is essential for us.”

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