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Background: One of the main determinants of quality in the public health care services is the perceived user satisfaction. Aim: To analyze the relationship between supply (User Orientation of Management) (UO), demand (User Satisfaction with service components) (US) and subjective indicators of effectiveness, such as Perceived Global Quality (PGQ) and Global Satisfaction (GS) among hospital service users. Material and Methods: A survey was applied to users of hospital services, asking about management and quality of hospital services and satisfaction with the service provided. Data was analyzed with exploratory and confirmatory factorial analyses. Structural Equation Models were used to test the hypotheses implied in the theoretical model of effectiveness. Results: The cause-effect relationship between UO and US was confirmed. There was also a direct relationship between PGQ and GS. Conclusions: Efficient nursing and administrative personnel are of highest importance to improve user satisfaction. The hospital management must pay extreme attention to this kind of staff in order to be effective from the point of view of their patients.

Background: One of the main determinants of quality in the public health care services is the perceived user satisfaction. Aim: To analyze the relationship between supply (User Orientation of Management) (UO), demand (User Satisfaction with service components) (US) and subjective indicators of effectiveness, such as Perceived Global Quality (PGQ) and Global Satisfaction (GS) among hospital service users. Material and Methods: A survey was applied to users of hospital services, asking about management and quality of hospital services and satisfaction with the service provided. Data was analyzed with exploratory and confirmatory factorial analyses. Structural Equation Models were used to test the hypotheses implied in the theoretical model of effectiveness. Results: The cause-effect relationship between UO and US was confirmed. There was also a direct relationship between PGQ and GS. Conclusions: Efficient nursing and administrative personnel are of highest importance to improve user satisfaction. The hospital management must pay extreme attention to this kind of staff in order to be effective from the point of view of their patients.

One of the main determinants of quality in the public health care services is the perceived user satisfaction.To analyze the relationship between supply (User Orientation of Management) (UO), demand (User Satisfaction with service components) (US) and subjective indicators of effectiveness, such as Perceived Global Quality (PGQ) and Global Satisfaction (GS) among hospital service users.A survey was applied to users of hospital services, asking about management and quality of hospital services and satisfaction with the service provided. Data was analyzed with exploratory and confirmatory factorial analyses. Structural Equation Models were used to test the hypotheses implied in the theoretical model of effectiveness.The cause-effect relationship between UO and US was confirmed. There was also a direct relationship between PGQ and GS.Efficient nursing and administrative personnel are of highest importance to improve user satisfaction. The hospital management must pay extreme attention to this kind of staff in order to be effective from the point of view of their patients.

Background: Clients and providers of health care can have contrasting perceptions about the quality of service. Provider perceptions are mostly devoted to design and delivery of services while those of clients are focused in the attention received. Aim: To assess perceptions of health care providers and clients about client management and satisfaction with services provided. Material and Methods: Two public hospitals were surveyed. A qualitative analysis was performed first, reviewing reports and patient data bases and through informal meetings with providers and clients. In a second phase, an enquiry with Likert type questions was devised and answered by a total of 377 providers and 400 clients from both hospitals. Results: The median perception of clients about the quality of service was better than that of providers in both hospitals. The communication of hospitals with clients to offer timely information received a poor evaluation both from providers and clients. However the concern of hospitals about health care of the community was considered adequate. The degree of satisfaction with concrete issues such as information panels and physical infrastructure received similar evaluation both by providers and clients. Conclusions: This analysis can be useful for management decision making, identifying strengths and weaknesses of health care provided by these two public hospitals. This type of assessment can be replicated in other public and private health care facilities.

Background: Clients and providers of health care can have contrasting perceptions about the quality of service. Provider perceptions are mostly devoted to design and delivery of services while those of clients are focused in the attention received. Aim: To assess perceptions of health care providers and clients about client management and satisfaction with services provided. Material and Methods: Two public hospitals were surveyed. A qualitative analysis was performed first, reviewing reports and patient data bases and through informal meetings with providers and clients. In a second phase, an enquiry with Likert type questions was devised and answered by a total of 377 providers and 400 clients from both hospitals. Results: The median perception of clients about the quality of service was better than that of providers in both hospitals. The communication of hospitals with clients to offer timely information received a poor evaluation both from providers and clients. However the concern of hospitals about health care of the community was considered adequate. The degree of satisfaction with concrete issues such as information panels and physical infrastructure received similar evaluation both by providers and clients. Conclusions: This analysis can be useful for management decision making, identifying strengths and weaknesses of health care provided by these two public hospitals. This type of assessment can be replicated in other public and private health care facilities.

The level of satisfaction of patients with the services provided by public hospitals is becoming an important issue for health authorities.To analyze an enquiry applied to patients, about the level of satisfaction with the service provided by a public regional hospital in Chile.An enquiry was applied to 150 ambulatory (76% women) and 50 hospitalized patients (56% women). It included 28 questions about management aspects of health care and 20 questions about client satisfaction. Data was analyzed using factorial analysis and multiple regressions.The manners of hospital personnel were the factor with the highest impact on the perception of patients about global quality of services. Attention timing was the most influential aspect on global satisfaction.There results confirm those from abroad and can orient an adequate management of public hospital.

Background: The level of satisfaction of patients with the services provided by public hospitals is becoming an important issue for health authorities. Aim: To analyze an enquiry applied to patients, about the level of satisfaction with the service provided by a public regional hospital in Chile. Material and methods: An enquiry was applied to 150 ambulatory (76% women) and 50 hospitalized patients (56% women). It included 28 questions about management aspects of health care and 20 questions about client satisfaction. Data was analyzed using factorial analysis and multiple regressions. Results: The manners of hospital personnel were the factor with the highest impact on the perception of patients about global quality of services. Attention timing was the most influential aspect on global satisfaction. Conclusions: There results confirm those from abroad and can orient an adequate management of public hospital

Background: The level of satisfaction of patients with the services provided by public hospitals is becoming an important issue for health authorities. Aim: To analyze an enquiry applied to patients, about the level of satisfaction with the service provided by a public regional hospital in Chile. Material and methods: An enquiry was applied to 150 ambulatory (76% women) and 50 hospitalized patients (56% women). It included 28 questions about management aspects of health care and 20 questions about client satisfaction. Data was analyzed using factorial analysis and multiple regressions. Results: The manners of hospital personnel were the factor with the highest impact on the perception of patients about global quality of services. Attention timing was the most influential aspect on global satisfaction. Conclusions: There results confirm those from abroad and can orient an adequate management of public hospital

Hydatid disease is caused by the larval stages of a cestodes belonging to the genus Echinococcus. In humans, hydatid larva and cysts are located90% in the liver and/or lungs. Primary mediastinal location, with absence of documented lung infection, is extremely rare and has not been previously reported in Chile. We report the first case of a primary mediastinal hydatid cyst in Chile and review the literature. A 38 year old woman was admitted because of a painful right supraclavicular mass, dyspnea on exertion and logical dysphagia. Presurgical evaluation evidenced a mediastinal tumor extending to the cervical region that was successfully removed. The diagnosis of mediastinal hydatid cyst was confirmed macroscopically and by biopsy.

La hidatidosis es una parasitosis producida por la larva o quiste del cestodes del género Echinococcus. Una vez que el parásito infecta al hombre se ubica, en más de 90% de los casos, en hígado o pulmón. La localización mediastínica sin afección pleuropulmonar previa es extremadamente infrecuente. En Chile no hay reporte de casos con tal ubicación. Se presenta el primer caso en Chile de un quiste hidatídico (QH) mediastínico: el caso de una mujer de 38 años que consultó por aumento de volumen doloroso supraclavicular derecho, asociado a disnea de esfuerzo y disfagia lógica, cuyo estudio preoperatorio mostró un tumor de mediastino con extensión cervical de aspecto nodal y de naturaleza incierta. Se operó con éxito en nuestro hospital, comprobándose durante la operación y por la biopsia, el diagnóstico de QH mediastínico. Adjuntamos las imágenes más relevantes y las fotografías de la operación y la pieza quirúrgica, como también una revisión de la literatura médica Hydatid disease is caused by the larval stages of a cestodes belonging to the genus Echinococcus. In humans, hydatid larva and cysts are located > 90% in the liver and/or lungs. Primary mediastinal location, with absence of documented lung infection, is extremely rare and has not been previously reported in Chile. We report the first case of a primary mediastinal hydatid cyst in Chile and review the literature. A 38 year old woman was admitted because of a painful right supraclavicular mass, dyspnea on exertion and logical dysphagia. Presurgical evaluation evidenced a mediastinal tumor extending to the cervical region that was successfully removed. The diagnosis of mediastinal hidatyd cyst was confirmed macroscopically and by biopsy

La hidatidosis es una parasitosis producida por la larva o quiste del cestodes del género Echinococcus. Una vez que el parásito infecta al hombre se ubica, en más de 90% de los casos, en hígado o pulmón. La localización mediastínica sin afección pleuropulmonar previa es extremadamente infrecuente. En Chile no hay reporte de casos con tal ubicación. Se presenta el primer caso en Chile de un quiste hidatídico (QH) mediastínico: el caso de una mujer de 38 años que consultó por aumento de volumen doloroso supraclavicular derecho, asociado a disnea de esfuerzo y disfagia lógica, cuyo estudio preoperatorio mostró un tumor de mediastino con extensión cervical de aspecto nodal y de naturaleza incierta. Se operó con éxito en nuestro hospital, comprobándose durante la operación y por la biopsia, el diagnóstico de QH mediastínico. Adjuntamos las imágenes más relevantes y las fotografías de la operación y la pieza quirúrgica, como también una revisión de la literatura médica

The implementation of the marketing strategies in public hospitals provides management advantages and improves the relationship between customers and staff.To analyze the application of marketing strategies in a public hospital, from the perspective of the staff.A structured survey that asked about perceptions in 50 items about communication between personnel and customers/users, customer satisfaction, participation in the development of new policies and incentives for efficiency was applied to a stratified sample of the staff. Factorial and regression analyses were performed to define the impact of marketing strategies on the degree of preoccupation and orientation of the organization towards the satisfaction of customer needs.The survey was applied to 74 males and 122 females. The survey showed that the orientation of the hospital towards the satisfaction of its beneficiaries basically depends on the generation of an organizational culture oriented towards them and the implementation of adequate policies in staff management and quality of service. These basic aspects can be accompanied with practices associated to the new marketing approaches such as a market orientation, customer orientation and relational marketing. All these factors presented positive and significant relations.New marketing strategies should be applied, to achieve an efficient and customer oriented hospital management.

Background: The implementation of the marketing strategies in public hospitals provides management advantages and improves the relationship between customers and staff. Aim: To analyze the application of marketing strategies in a public hospital, from the perspective of the staff. Material and methods: A structured survey that asked about perceptions in 50 items about communication between personnel and customers/users, customer satisfaction, participation in the development of new policies and incentives for efficiency was applied to a stratified sample of the staff. Factorial and regression analyses were performed to define the impact of marketing strategies on the degree of preoccupation and orientation of the organization towards the satisfaction of customer needs. Results: The survey was applied to 74 males and 122 females. The survey showed that the orientation of the hospital towards the satisfaction of its beneficiaries basically depends on the generation of an organizational culture oriented towards them and the implementation of adequate policies in staff management and quality of service. These basic aspects can be accompanied with practices associated to the new marketing approaches such as a market orientation, customer orientation and relational marketing. All these factors presented positive and significant relations. Conclusions: New marketing strategies should be applied, to achieve an efficient and customer oriented hospital management

Background: The implementation of the marketing strategies in public hospitals provides management advantages and improves the relationship between customers and staff. Aim: To analyze the application of marketing strategies in a public hospital, from the perspective of the staff. Material and methods: A structured survey that asked about perceptions in 50 items about communication between personnel and customers/users, customer satisfaction, participation in the development of new policies and incentives for efficiency was applied to a stratified sample of the staff. Factorial and regression analyses were performed to define the impact of marketing strategies on the degree of preoccupation and orientation of the organization towards the satisfaction of customer needs. Results: The survey was applied to 74 males and 122 females. The survey showed that the orientation of the hospital towards the satisfaction of its beneficiaries basically depends on the generation of an organizational culture oriented towards them and the implementation of adequate policies in staff management and quality of service. These basic aspects can be accompanied with practices associated to the new marketing approaches such as a market orientation, customer orientation and relational marketing. All these factors presented positive and significant relations. Conclusions: New marketing strategies should be applied, to achieve an efficient and customer oriented hospital management

Introducción: Se ha descrito que el colesterol dietario produce modestos cambios en los niveles de colesterol sérico. Diversos estudios han mostrado que existe una marcada heterogeneidad en la respuesta individual frente a una dieta baja en colesterol. El polimorfismo de la apo E y sus diferentes isoformas descritas, ha sido reconocido como un factor involucrado en la variación de la respuesta y también como marcador de riesgo cardiovascular en la población. Los estudios que evalúan la respuesta dietaria en relación al gen de la apo E no han sido realizados en la población chilena. Objetivo: Evaluar la respuesta de los lípidos séricos en individuos con genotipo E3/3, frente a una intervención con colesterol dietario en la forma de un huevo sobre su dieta normal. Materiales y Métodos: Se realizó un estudio de diseño prospectivo, randomizado y crossover en 36 hombres provenientes de una institución bancaria de 25 a 55 años de edad. Se determinó colesterol plasmático total, LDL-col, HDL-col, TG, apo B y polimorfismo de apo E. Resultados: Las isoformas de apo E encontradas fueron un 79% de E3/3 y un 16% de E4/3. Los individuos E3/3 modificaron las concentraciones de colesterol total en un 0.1% luego de la adición de un huevo a la dieta por 4 semanas (209,6 ± 5,1 v/s 209,8 ± 5,6 mg/dl respectivamente, IC [- 5,0; 6,8] ). Individuos E4/3 modificaron en un 0,8% la concentración de colesterol total bajo las mismas condiciones experimentales (200,3 ± 9,4 v/s 201,8 ± 6,0 mg/dL, IC [-10,0; 13,0] ). La concentración de Apo B sérico tuvo una variación porcentual de + 5,5% para individuos E3/3 y - 2,1% para individuos E4/3, sin diferencias significativas intra y entre grupos. Conclusión: Individuos con genotipo E3/3 de apo E no modificaron significativamente sus concentraciones de colesterol total luego de la intervención con colesterol dietario, así como también los individuos E4/3 analizados. Nuestros resultados refuerzan la noción que la mayoría de la población es capaz de compensar a un aumento moderado de colesterol. Estos resultados tienen implicancia en las recomendaciones dietarias a la población Introduction: It has been described in the literature that dietary cholesterol produces only slight changes in serum cholesterol in healthy individuals. Nevertheless, several studies have shown a marked heterogeneity in the response to a variation of cholesterol in the diet. One of the factors involved in this response is the Apo E genotype, also singled as a risk factor for cardiovascular disease. There are no studies in Chile that evaluate the response to dietary cholesterol in individuals and its relationship to the Apo E genotype. Objective: To evaluate the response to a cholesterol load in individuals and relate it to their Apo E genotype. Materials and methods: A prospective randomized and cross-over study was carried out in 36 male volunteers either normolipemics or isolated hypercholesterolemic aged 25-55 years old, who were given one egg/day for 4 weeks in addition to their normal diet. Total, LDL, and HDL cholesterol were measured before and after the intervention, as well as Apo B concentration and Apo E genotype. Results: Apo E genotype was 79% E3/3 and 16% E 4/3 in this population. The addition of one egg to their normal diet did not change significantly any of the variables studied. Conclusions: Normocholesterolemic or hypercholesterolemic individuals did not respond to a load of cholesterol given in the form of one egg/day. The implications for population recommendations are discussed

El riesgo de tasa de interés del libro bancario (IRRBB) se ha convertido en un factor de gestión preponderante para los establecimientos de crédito. Su medición en escenarios de estrés puede anticipar coyunturas complejas en materia de liquidez y rentabilidad que, si son previstas a tiempo, incentivan a las entidades a tomar decisiones sobre la estructura de su balance para salvaguardar su capital y margen de intermediación. Este trabajo pretende proponer un modelo estadístico que por medio del Margen Financiero Neto (NIM) pueda aproximar la exposición al IRRBB para los establecimientos de crédito colombianos. Además, se propondrán variables sectoriales y de control macroeconómico que coadyuven a una mejor interpretación de este riesgo en el contexto nacional. Los datos serán recolectados directamente de la Superintendencia Financiera de Colombia, con periodicidad mensual y en un periodo de estudio de 10 años, desde el año 2011 hasta el año 2020. Finalmente, se espera hacer una contribución metodológica al sector financiero colombiano y a la literatura latinoamericana en materia de medición y monitoreo de IRRBB, cuya literatura resulta ser escasa para esta parte de la región. Bank book interest rate risk (IRRBB) has become a preponderant management factor for credit institutions. Its measurement in stress scenarios can anticipate complex situations in terms of liquidity and profitability that, if foreseen on time, encourage entities to make decisions about the structure of their balance sheet to safeguard their capital and intermediation margin.This paper aims to propose a statistical model that through the Net Financial Margin (NIM) that can approximate the exposure to IRRBB for Colombian credit institutions. In addition, sectoral and macroeconomic control variables will be proposed that contribute to a better interpretation of this risk in the national context.The data will be collected directly from the Financial Superintendence of Colombia, monthly and over a 10-year study period, from 2011 to 2020. Finally, we hope to make a methodological contribution to the Colombian financial sector and to Latin American literature on measurement matter and monitoring of IRRBB, whose literature is scarce for this part of the region. Magister en Estadística Aplicada Maestría