This study aims to determine the waiting time and the forms of access to specialized health services in public hospitals in Ecuador. A representative sample of 32 hospitals under the Ministry of Public Health was considered, with 26 selected by accessibility convenience. Data will be collected using a structured questionnaire. Patients will be asked about the number of days they waited for their medical appointments and the method used to schedule their appointments. The study distinguishes between standardized access, based on Ecuador’s formal referral and counter-referral system, and non-standardized access methods, such as personal connections or hospital staff involvement. The data of this protocol are registered and publicly accessible at: https://dx.doi.org/10.17504/protocols.io.261ge5z7wg47/v1. We expect to identify a correlation between waiting times and the type of access to specialized medical services, with non-standardized access potentially leading to shorter waiting times. This research may highlight disparities in the system and suggest areas for improvement in equity and efficiency within the healthcare referral process. To do so, a structured survey will be used. Since a construct is not needed to determine the waiting time or the forms of access, it was not necessary to validate the instrument. However, we did validate the understanding of the questions and the response options in several places in the country. According to the results of the validation of the instrument, pollsters will be instructed to inform users about the meaning of the question on ethnic identification, which was difficult to understand in the country’s coastal areas.

Objective: to establish a relationship between the form of access and the waiting time for care of users who needed specialized medical consultation in areas that required a referral from a general practitioner in the public hospitals of the cities of Manta and Portoviejo during the period. from January to March 2023. Methodology: Cross-sectional study, where users of public hospitals were asked about how they obtained their medical appointment and how long they waited to be seen from the scheduling of their medical appointment to the moment they were seen. A structured questionnaire with social, demographic and economic questions was used to determine the factors that influenced waiting time. The t test and ANOVA with Welch correction with a significance level of 0.05 were used to establish relationships between the average waiting time and the social and demographic variables. Results and discussion: On average, patients wait 49 days for their specialized medical consultation, and in some cases, the wait extended up to 180 days. Those who accessed through the formal process had to wait up to 19 days longer compared to those who accessed with the help of a family member or friend who worked at the hospital. Originality/value: The results suggest the existence of informal access to obtain specialized medical appointments in the three public hospitals of Manabí, which could be one of the causes of the delay in appointments scheduled through the referral and counter-referral system.

Objetivo El objetivo de este estudio es medir el aumento de la pobreza debido a los gastos directos en salud y analizar la equidad del financiamiento del sistema de salud ecuatoriano, con base en datos de encuestas nacionales representativas del país.Método Fue realizado con datos de la “Encuesta de condiciones de vida 2013-2014” (ECV) y utilizó líneas de pobreza, con enfoques relativo y absoluto para medir el aumento de la pobreza y, mediante Análisis de Incidencia en el financiamiento, fueron medidas las desigualdades en la distribución del financiamiento.Resultados La pobreza aumentó 2,2% debido al gasto de las familias en salud, especialmente en gastos de medicamentos y consultas médicas, que representaron 36,7% y 14,6% del gasto total en pagos directos. Además, las fuentes más importantes de financiamiento resultaron ser regresivas, hecho que afecta principalmente a la clase media. Cuando fueron consolidadas, las fuentes de financiamiento analizadas resultaron ser proporcionales. Este, aunque no es el peor escenario, no es el esperado para un sistema de salud que debe garantizar protección financiera a sus usuarios.Discusión Aunque existen metas de financiamiento de difícil alcance, al menos las leyes del país establecen la búsqueda de ese fin. Sin embargo, pérdidas de recursos financieros dificultan el logro de los objetivos trazados.

La toxoplasmosis, causada por el parásito Toxoplasma gondii, plantea preocupaciones significativas, especialmente en adolescentes en estado de gestación debido a sus posibles complicaciones durante el embarazo. El objetivo de la investigación se centró en analizar los factores de riesgo de Toxoplasma gondii en adolescentes en estado de gestación que asisten al laboratorio clínico integral FERFA. Se desarrolla la metodología adoptando un enfoque transversal retrospectivo, evaluando usuarios de dicho laboratorio, además, se lleva a cabo una actualización de la revisión bibliográfica, utilizando publicaciones científicas encontradas en distintas fuentes académicas sobre la infección parasitaria toxoplasma. Los resultados obtenidos en este análisis sugieren una asociación significativa entre el lugar de residencia y el consumo de agua con la presencia de anticuerpos IgG contra Toxoplasma. Aunque no se encontraron asociaciones significativas entre el nivel de instrucción y la presencia de anticuerpos IgG en el modelo de regresión logística, el análisis de asociación entre variables categóricas sugiere que los individuos con educación primaria tienen una mayor probabilidad de tener anticuerpos IgG en comparación con aquellos con educación secundaria. En conclusión, se enfatiza la relevancia de considerar factores como el lugar de residencia y el consumo de agua con la presencia de anticuerpos IgG contra Toxoplasma. En respuesta, se propone una iniciativa educativa para concienciar sobre la toxoplasmosis, enfocada en campañas multimedia, eventos comunitarios y alianzas estratégicas. Se recomienda una investigación más profunda de estos factores asociados y estrategias preventivas adaptadas.

MQRInvestigar Revista de Investigación Científica

Background/Objectives: Frailty syndrome favors the deterioration of health; therefore, identifying associated factors is essential for establishing preventive measures. Oral candidiasis is a factor that may be related to the onset of frailty. Our objective was to evaluate the association between frailty and oral candidiasis in institutionalized participants. Methods: We conducted a cross-sectional study involving 589 institutionalized individuals aged 65 years or older. A diagnosis of candidiasis was established clinically and with a microbiological study (potassium hydroxide (KOH) test and culture for candidiasis). Assessments of salivary flow and the use of dental prostheses were also performed. Frailty was classified according to Fried’s phenotype criteria. Results: Frailty and prefrailty were found in 28.9% and 66.7% of the participants, respectively. Oral candidiasis was diagnosed in 39.05% of cases and was more frequent among individuals with dental prostheses (49.13%) and hyposalivation (47.54%). Conclusions: Our findings suggest that frailty in institutionalized older adults is associated with the presence of subprosthetic stomatitis associated with candidiasis and hyposalivation, indicating the need for integrated oral health strategies in geriatric care.