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Objetivos. La satisfacción del paciente con los servicios sanitarios juega un rol importante en los programas de mejora de la calidad asistencial. Los objetivos de este estudio fueron: identificar las características sociodemográficas del paciente relacionadas con su satisfacción respecto a la atención proporcionada por el médico de familia en los centros de Atención Primaria de Salud (APS) y describir la variabilidad geográfica de este fenómeno en el Servicio Nacional de Salud español. Material y métodos. Los datos se obtuvieron de la Encuesta Europea de Salud de 2009. Se analizaron las razones de prevalencia (brutas y ajustadas) de las características asociadas tanto con una satisfacción excelente como de insatisfacción mediante regresión de Poisson, así como su variabilidad geográfica. Resultados. Aproximadamente uno de cada 3 usuarios de la APS consideró que la atención proporcionada había sido excelente, mientras que el 6,7% se mostró insatisfecho. Existió una amplia variabilidad en la percepción de satisfacción entre los distintos servicios regionales de salud, prevalencias que oscilaron entre el 10,9 y el 55,2%. Por otra parte, esta valoración estuvo estrechamente relacionada con la edad, el nivel de salud autopercibida, la salud mental, los ingresos hospitalarios previos, el estatus de enfermedad crónica y las limitaciones en las actividades diarias. Conclusiones. La satisfacción con la atención proporcionada por el médico de APS es relativamente alta. No obstante, presenta una distribución heterogénea entre las comunidades autónomas y las características sociodemográficas y el nivel de salud del usuario (AU)

Background. Patient satisfaction with health services plays an important role in programs to improve the quality of care from the point of view of users. The objectives of this study were: To identify sociodemographic characteristics associated with patient satisfaction in the care provided by family doctors in Primary Health Care (PHC) centres, and describe the geographical variability of this phenomenon in the Spanish National Health Service. Material and methods. The data come from the European Health Survey (2009). Prevalence ratios (crude and adjusted) of the characteristics associated with both excellent satisfaction and dissatisfaction using Poisson regression, and their geographical variability are discussed. Results. About one in every 3 users of the PHC believes that the care provided was excellent, while 6.7% were dissatisfied. There is a wide variability in the perception of satisfaction among the various regional health services, with prevalence ranging between 10.9% and 55.2%. Moreover, this assessment is closely related to age, level of self-perceived health, mental health, previous hospitalisation, chronic disease status, and limitations in daily activities. Conclusions. Satisfaction with the care provided by the PHC physician is relatively high. However, the distribution between regions and socio-demographic characteristics and health status of the user is heterogeneous (AU)

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BACKGROUND: Patient satisfaction with health services plays an important role in programs to improve the quality of care from the point of view of users. The objectives of this study were: To identify sociodemographic characteristics associated with patient satisfaction in the care provided by family doctors in Primary Health Care (PHC) centres, and describe the geographical variability of this phenomenon in the Spanish National Health Service. MATERIAL AND METHODS: The data come from the European Health Survey (2009). Prevalence ratios (crude and adjusted) of the characteristics associated with both excellent satisfaction and dissatisfaction using Poisson regression, and their geographical variability are discussed. RESULTS: About one in every 3 users of the PHC believes that the care provided was excellent, while 6.7% were dissatisfied. There is a wide variability in the perception of satisfaction among the various regional health services, with prevalence ranging between 10.9% and 55.2%. Moreover, this assessment is closely related to age, level of self-perceived health, mental health, previous hospitalisation, chronic disease status, and limitations in daily activities. CONCLUSIONS: Satisfaction with the care provided by the PHC physician is relatively high. However, the distribution between regions and socio-demographic characteristics and health status of the user is heterogeneous.

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Introducción: La obesidad infantil es un problema de elevada magnitud y con graves repercusiones en el estado de salud, lo que justifica conocer su prevalencia a nivel local para identificar factores condicionantes y emprender acciones preventivas. El objetivo de este trabajo consiste en estimar la prevalencia de sobrepeso y obesidad en población infantil de la Región de Murcia a partir del índice de masa corporal (IMC) aplicando los criterios de referencia del International Obesity Task Force (IOTF), y comparar estos resultados con los obtenidos con otras referencias de uso frecuente en España. Material y método: Se determinó el IMC correspondiente a 178.894 niños de 2 a 14 años de edad. La prevalencia de sobrepeso y obesidad se valoró según los criterios del IOTF, de los estudios de la Organización Mundial de la Salud, de la Fundación Orbegozo (FO), y del Estudio Transversal Español de Crecimiento (ETEC). La concordancia entre los diferentes resultados fue evaluada mediante el índice kappa. Resultados: La prevalencia, mediante los puntos de corte del IOTF, fue para sobrepeso del 20,6% (IC 95%: 20,4-20,8), para obesidad del 11,4% (IC 95%: 11,2-11,5) y para sobrecarga ponderal del 32% (IC 95%: 31,8-32,2), siendo esta última mayor en niñas (33,2%) que en niños (30,9%). La mayor concordancia se da entre el IOTF y FO-2011 (kappa=0,795), y entre este y el ETEC (kappa=0,794). Conclusiones: Se encontraron altas prevalencias de sobrepeso y obesidad en niños de la Región de Murcia. El ETEC y el estudio FO-2011 mostraron las concordancias más altas con los resultados obtenidos según los criterios del IOTF (AU)

Introduction: Childhood obesity is a problem of high magnitude with serious repercussions on health, which justifies estimating its prevalence at local level to identify conditioning factors and to take preventive actions. The main objective of the present work is to estimate the prevalence of overweight and obesity in the children in the general population of the Murcia Region, using the body mass index (BMI) and applying the International Obesity Task Force (IOTF) criteria, and to compare these results with the ones obtained from other frequently used references in Spain. Material and methods: The BMI of 178,894 children aged from 2 to 14 years was determined. The prevalence of overweight and obesity was compared to the IOTF, to the studies of the World Health Organization, as well as those of the Orbergozo Foundation (FO), and the Cross sectional Spanish Growth Study (ETEC) references. The agreement between the different results was evaluated using the kappa index. Results: The evaluation using the IOTF cut-off points gave an overweight prevalence of 20.6% (95% CI: 20.4-20.8), an obesity prevalence of 11.4% (95% CI: 11.2-11.5) and an overweight plus obesity prevalence of 32% (95% CI: 31.8-32.2), with this last one being higher in girls (33.2%) than in boys (30.9%). The highest agreement is between IOTF and FO-2011 (kappa = .795) and between FO-2011 and ETEC (kappa = .794). Conclusion: A high prevalence of overweight and obesity in children in the Region of Murcia was found. The ETEC and the FO-2011 study showed the highest agreement with the results obtained using the IOTF criteria (AU)

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INTRODUCTION: Childhood obesity is a problem of high magnitude with serious repercussions on health, which justifies estimating its prevalence at local level to identify conditioning factors and to take preventive actions. The main objective of the present work is to estimate the prevalence of overweight and obesity in the children in the general population of the Murcia Region, using the body mass index (BMI) and applying the International Obesity Task Force (IOTF) criteria, and to compare these results with the ones obtained from other frequently used references in Spain. MATERIAL AND METHODS: The BMI of 178,894 children aged from 2 to 14 years was determined. The prevalence of overweight and obesity was compared to the IOTF, to the studies of the World Health Organization, as well as those of the Orbergozo Foundation (FO), and the Cross-sectional Spanish Growth Study (ETEC) references. The agreement between the different results was evaluated using the kappa index. RESULTS: The evaluation using the IOTF cut-off points gave an overweight prevalence of 20.6% (95% CI: 20.4-20.8), an obesity prevalence of 11.4% (95% CI: 11.2-11.5) and an overweight plus obesity prevalence of 32% (95% CI: 31.8-32.2), with this last one being higher in girls (33.2%) than in boys (30.9%). The highest agreement is between IOTF and FO-2011 (kappa=.795) and between FO-2011 and ETEC (kappa=.794). CONCLUSION: A high prevalence of overweight and obesity in children in the Region of Murcia was found. The ETEC and the FO-2011 study showed the highest agreement with the results obtained using the IOTF criteria.

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INTRODUCTION: Perinatal mortality has been decreasing in Spain; nevertheless completeness of death certificates was questioned because of the underreporting observed. OBJECTIVE: To quantify perinatal mortality reporting of birth and infant-death certificates and obstetrics and neonatal hospital records of the Autonomous Community of Murcia in 2003. MATERIAL AND METHODS: Newborns with a weight of at least 500 g or 22 weeks gestation, who died before the 8th day, were included. The dates came from birth certificates (stillbirths and infants died before one day of life) and death certificates (more than one day, and obstetrics-neonatal hospital records. Detection rates were calculated for death certificates and hospital registrations. RESULTS: One hundred fifty WHO-cases, of which 72 agreed with both sources. Sixty one percent of coincident cases were stillbirths. The underreporting was 26 % in Obstetrics and 10 % in Neonatology. Only 16 % of deaths were reported in the Official Statistics. CONCLUSIONS: Medical perinatal mortality reporting remains inadequate. Official Statistics and Obstetrics - Neonatology records add independent and complementary information.

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Introducción: La mortalidad perinatal desciende en España, pero varios estudios cuestionan su exhaustividad por la subdeclaración detectada. Objetivo: Cuantificar y comparar la mortalidad perinatal detectada por los boletines estadísticos de parto (BEP) y de defunción (BED) frente a los registros de obstetricia y neonatología de la Región de Murcia en 2003. Material y métodos: Se incluyen los nacidos de al menos 500 g o 22 semanas de gestación que fallecen antes del día 8. Los datos provienen del BED, BEP, paritorio o neonatología. Se calculan las tasas de detección de boletines y registros sanitarios. Resultados: Se obtienen 150 casos-OMS, de los cuales 72 coinciden en ambas fuentes. El 61 % de los casos coincidentes son nacidos muertos. La subcertificación es del 26 % en obstetricia y del 10 % en neonatología. El 16 % de las defunciones sólo constan en los boletines estadísticos. Conclusiones: La certificación médica de la mortalidad perinatal sigue siendo insuficiente. La estadística oficial y los registros obstétrico-pediátricos aportan información independiente y complementaria

Introduction: Perinatal mortality has been decreasing in Spain; nevertheless completeness of death certificates was questioned because of the underreporting observed. Objective: To quantify perinatal mortality reporting of birth and infant-death certificates and obstetrics and neonatal hospital records of the Autonomous Community of Murcia in 2003. Material and methods: Newborns with a weight of at least 500 g or 22 weeks gestation, who died before the 8th day, were included. The dates came from birth certificates (stillbirths and infants died before one day of life) and death certificates (more than one day, and obstetrics-neonatal hospital records. Detection rates were calculated for death certificates and hospital registrations. Results: One hundred fifty WHO-cases, of which 72 agreed with both sources. Sixty one percent of coincident cases were stillbirths. The underreporting was 26 % in Obstetrics and 10 % in Neonatology. Only 16 % of deaths were reported in the Official Statistics. Conclusions: Medical perinatal mortality reporting remains inadequate. Official Statistics and Obstetrics - Neonatology records add independent and complementary information

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