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Objectives: To describe the results of a voluntary reporting system for adverse events in a Patient Safety Program of an occupational injuries mutual insurance company., Method: In 2008 a system of notification and registration of adverse events (actual or potential) was introduced in 2008 by the Union de Mutuas, an occupational injuries insurance company with 36 health centres, and provides coverage for 259,922 workers. The reporting questionnaire covers all areas of health care provided by the mutual company. Access to the questionnaire was conducted through the intranet, was voluntary and anonymous. The notifications registered between 1 January 2009 and 31 December 2010 are analysed., Results: A total of 16 questionnaires were completed, with a total of 205 incidents. The profile of the reporter was first-level health care (57.7%), and seniority in their job for 5-10 years. Of all the notifications, a health care cause of the incident was seen in 43.5% of cases, of which 85.9% of the incidents were preventable. Of all reported events, 71.7% were related to an ambulatory care medical centre, and only 2.4% was related to a surgical procedure., Conclusions: Most of the notifications were preventable incidents, and recorded by first-level medical care. The reporting questionnaire was shown to be a valid tool in our work environment for the detection of adverse events in the care process., (Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.)

Objectives: This study evaluated the relative position of Vall d'Uixó within the province of Castellón, the Valencian Community and Spain., Design: The study covers the period from 1981 to 1993. A multivariate analysis of the main components was performed. This compared the interrelationship of these indicators in the different zones analysed., Patients and Other Participants: Our study focused on an area of 27,387 population, geographically within the province of Castellón in the south-west of La Plana county., Results: The analysis showed that Vall d'Uixó had a low level of development and little economic activity. It had a relatively young population., Conclusions: The health problems were linked to the social and economic situation. Apart from the re-creation of industrial jobs, it would be desirable to improve programmes to monitor TB and cardiovascular diseases.

A descriptive study was made of the health indicators in 5 rural municipalities of the province of Castellón (Spain), with a total of 1428 inhabitants. This population is characterized by its aging, 36.9% of all individuals being older than 65 years. A retrospective evaluation was made of the annual mortality rates between 1940 and 1990, and of morbidity and medications consumption for the period between June 1991 and May 1992. An increase in general mortality was observed during the study period, though the rates also diminished in relation to age groups, sex and cause of death. In addition, 59.45% of the study population made use of health-care services in the course of one year, an average of 2.59 drugs being prescribed per inhabitant in that same period. Morbidity in decreasing order of importance was attributed to acute respiratory disease, osteomuscular disorders, hypertension, depression and gastric pathology. Medications for the common cold and coughing were the most frequently used drugs, along with pain-killers, cardioactive agents, psycholeptics and non-sterioidal anti-inflammatory drugs (NSAIDs). Aging causes the mortality variations recorded, despite the socio-sanitary improvements observed in the zone during the study period. Aging may also be related to the important use of healthcare services and of drugs noted in the study. The highest morbidity rates and drug consumption levels corresponded to chronic diseases that deteriorate patient quality of life without actually increasing mortality.

Background: Nosocomial infections presently imply a 10-day average prolongation of hospital stay per infection, with an important increase in mortality and costs. A comparison is made between the prevalence of nosocomial infections, microorganisms isolated and antimicrobial agents used in the Arnau de Vilanova Hospital (Valencia, Spain), and those corresponding to other hospitals of similar characteristics in the triple-province Valencia Community., Methods: Cross-sectional epidemiological study, reflecting the prevalence of hospital infections globally and in each of services., Results: The global prevalence of hospital infections was 6.08%. Services with greatest prevalence are Intensive Care, Internal Medicine and Surgery. Respiratory tract and postoperative wound infections were the most frequent presentations., Conclusions: Global prevalence was slightly less than in the Valencian Community for 1992 (8.28%), with a predominance of gram-negative over gram-positive germs, in contrast with the results reported globally for the Valencia an hospitals.

Background: Of among the different measures systems of hospital production, we adopted the Diagnosis Related Groups (DRG) approach for the management of the cases series of the "Arnau de Vilanova" Hospital (Valencia, Spain). The use of hospital services makes it possible to establish the number of patients attended and in which services, while pathology distribution reflects the types of patients who makes us of the hospital., Methods: A transverse study was made, reviewing the clinical histories of the hospitalized patients and applying an autoexcluding medical or surgical DRG designation. Patient inspection and comments with the healthcare staff afforded greater specifications. We included all patients hospitalized between May 11 and 24, 1992, i.e., 263 in total, corresponding to 2.53% of the annual hospitalizations in 1992., Results: The most frequently employed services were Internal Medicine and General and Digestive Surgery. Hospital activity was defined by 90 DRGs, the GDRGs most associated to hospital (nosocomial) infection being HIV-positive individuals, those operated on for inguinal hernia, and oncological patients with laryngeal cancer., Conclusions: Hospital activity was found to be concentrated in high volume DRGs--one of them being the Medical Type "non-groupable diseases due to clinical incompleteness of the management parameters, as a result of which this information remained undetermined.

Background: The incidence of arterial hypertension and other cardiovascular diseases has undergone an increase in Spain during recent years, particularly in rural areas, as a consequence of progressive population aging. A study is made of drug prescriptions associated with non-complicated arterial hypertension in a rural setting., Methods: Field work was initiated in four rural municipalities of Castellon province on the Spanish Mediterranean coast, with highly aged populations. Out of a total population of 1064, 60% made use of the area health care services in the course of year. Of these, 11% had at one time or other suffered one or more episodes of non-complicated arterial hypertension., Results: The drugs most commonly prescribed were calcium antagonists, angiotensin converting enzyme inhibitors, and diuretics, although differences in order of importance were seen depending on patients age. The cost of the active components prescribed were below the average of those commercialized within each therapeutic group., Conclusions: To conclude, interactions were detected with other drugs used by the patients while on hypotensives. The most relevant in this sense were nonsteroidal anti-inflammatory agents; consumption of these drug was very high, in part also due to the high incidence of osteomuscular complaints among the geriatric population of the zone.

A retrospective descriptive study is carried out from the whole of malignant cutaneous melanomas diagnosed at the Dermatology Service of the General University Hospital of Valencia (HGUV), during the period 1977-1987, in which the 80% of the whole of the cases in the province of Valencia are diagnosed, specifically 247 patients are studied. The ones located on the leg stand out 21%, followed by posterior thorax 14% and face 12%. Likewise, differences statistically significant p less than 0.001 are observed among the distinct histological types of cutaneous malignant melanoma (CMM) with regard to the depth of the tumours invasion (measured in Clark levels and millimetres of depth), mitosis/area, mitosis index and prognosis index. Being the lentigo of malignant melanoma (LMM) the histological type diagnosed in earlier phases, hence it is the most capable variant of curative treatment, just the opposite that happens to the nodular malignant melanoma (NMM), that is normally diagnosed in more advanced phases of the illness.