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    Item type:Publication,
    Perinatal Anxiety and Mother–Infant Health in Chile
    (Springer Nature Switzerland, 2024) ;
    Ana Flavia Bennett
    ;
    María Ignacia García
      2
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    Item type:Publication,
    Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security
    (Elsevier BV, 2025-03)
    Hamish R Graham
    ;
    Carina King
    ;
    Ahmed Ehsanur Rahman
    ;
    Freddy Eric Kitutu
    ;
    Leith Greenslade
    Scopus© Citations 53  1
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    Item type:Publication,
    Patient centered outcomes in stroke: utility-weighted modified Rankin Scale results in a community-based study
    (Frontiers Media SA, 2025-03-21)
    Carlos Delfino
    ;
    Gabriel Cavada
    ;
    ; ;
    Background and aims</jats:title><jats:p>The transformation of modified Rankin Scale (mRS) scores based on the corresponding utilities of health-related quality of life questionnaires can facilitate the capture of Patient-Centered Outcomes (PCO) in stroke. We aimed to derive utility-weighted modified Rankin Scale (UW-mRS) values by mapping mRS functional status to EQ-5D-3L scores in a population-based cohort of stroke patients.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>The UW-mRS was obtained by analyzing the EQ5-D-3 L and mRS scores at 180 days after any stroke in the ÑANDU study, a large prospective community-based study in Chile. The mRS prediction was estimated using a linear regression adjusted by the EQ-5D-3L value. Generalized linear and binary logistic regression models were constructed to determine influencing factors of the UW-mRS, using STATA software (version 18.0).</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We included 773 patients presenting with any stroke during 2015–2016: 48% were female, with a mean age of 71 years (SD 13.8), and 85% had an acute ischemic stroke (AIS). 82% of patients had a low socioeconomic status, 50% had less than 12 years of formal education, and only 32% lived in urban areas. UW-mRS values for mRS categories 0–6 at 180 days were 0.913, 0.694, 0.425, 0.249, −0.102, −0.347 and 0, respectively. Multivariable analysis identified age &amp;gt; 70 years (Coefficient <jats:italic>β</jats:italic> [β] -0.038 [Standard error SE 0.018], <jats:italic>p</jats:italic> = 0.032), prior mRS score 3–5 (<jats:italic>β</jats:italic> −0.556 [SE 0.197], <jats:italic>p</jats:italic> &amp;lt; 0.001), ischemic stroke (β −0.066 [SE 0.025], <jats:italic>p</jats:italic> = 0.010), and National Institutes of Health Stroke Scale (NIHSS) at admission&amp;gt;5 (<jats:italic>β</jats:italic> −0.015 [SE 0.002], <jats:italic>p</jats:italic> &amp;lt; 0.001) as significant predictors of worse UW-mRS scores (R<jats:sup>2</jats:sup> = 70%) in the overall group. Sex-disaggregated analysis showed that age &amp;gt; 70 years was a significant predictor in males (β −0.069 [SE 0.024], <jats:italic>p</jats:italic> = 0.006), while presenting an AIS had a greater impact on female’s worse UW-mRS score (β −0.087 [SE 0.033], <jats:italic>p</jats:italic> = 0.010).</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>These results present UW-mRS values derived from a population-based stroke study. Key determinants of health-related quality of life in post-stroke patients included age, prior disability, and stroke severity. Sex-disaggregated analysis revealed age being significant for males and AIS for females. Incorporating PCO as UW-mRS in stroke research can provide a more nuanced understanding of the impact of stroke on survivors, offering valuable insights for clinical decision-making and rehabilitation strategies across diverse healthcare contexts.<
    Scopus© Citations 1  6
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    Retrospective study on disparities in time-to-treatment by health insurance system in Chilean breast cancer patients
    (Medwave Estudios Limitada, 2025-04-10) ;
    Teresa Ip
    ;
    Lea Maureira
    ;
    Cesar Sanchez
    ;
    Claudia Osorio
    Introduction Breast cancer is the most common malignancy in the Americas, and the second leading cause of cancer death. Disparities in the time to treatment can significantly impact patient outcomes and typically affect lower socioeconomic individuals and/or ethnic minorities. Our study sought to evaluate disparities in time to treatment at three health institutions in Chile according to their type of health insurance (public or private). Methods Our study analyzed a database of breast cancer patients diagnosed between 2017 and 2018. Analyses included descriptive statistics and a linear regression model that incorporated clinical and demographic variables. Additionally, using a proportional risks model, we analyzed the association between clinical variables and mortality. Results Public health insurance (National Health Fund, FONASA) was associated with longer time-to-treatment and extended treatment times versus private health insurance (Social Security Institutions, ISAPRE; p &lt; 0.0001). As expected, a more advanced stage at diagnosis was associated with lower survival. Our proportional risks model found that age was a predictor of breast cancer mortality in stage II patients. Also, total treatment time significantly increased the risk of breast cancer mortality in stage I patients. Conversely, total treatment time did not affect mortality on stages II or III. Conclusions We found significant disparities in the time to treatment of Chilean breast cancer patients using FONASA versus private ISAPRE. FONASA patients experience delays in the initiation of treatment and longer total treatment times compared to their private insurance counterparts. Finally, longer time-to-treatment was associated with more advanced stages and increased mortality.
      3
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    Cancer plans should consider local needs
    (Elsevier BV, 2025-02)
    Bettina Müller
    ;
    Raul Murillo
      1Scopus© Citations 2
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    Excess burden of antibiotic-resistant bloodstream infections: evidence from a multicentre retrospective cohort study in Chile, 2018–2022
    (2024)
    Kasim Allel
    ;
    Anne Peters
    ;
    Hassan Haghparast-Bidgoli
    ;
    Maria Spencer-Sandino
    ;
    Jose Conejeros
    Scopus© Citations 2  4
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    Item type:Publication,
    Health access to immigrants: identifying gaps for social protection in health
    OBJECTIVE: To compare the access to and effective use of health services available among international migrants and Chileans. METHODS: Secondary analysis of the National Socioeconomic Characterization Survey (CASEN - Caracterización Socioeconómica Nacional ), version 2017. Indicators of access to the health system (having health insurance) and effective use of health services (perceived need, appointment or coverage, barriers and need satisfaction) were described in immigrants and local population, self-reported. Gaps by immigrant status were estimated using logistic regressions, with complex samples. RESULTS: Immigrants were 7.5 times more likely to have no health insurance than local residents. Immigrants presented less perceived need than local residents, together with a greater lack of appointments (OR: 1.7 95%CI: 1.2-2.5), coverage (OR: 2.7 95%CI: 2.0-3.7) and unsatisfied need. The difference between immigrants and locals was not statistically significant in barriers to health care access (α = 0.005). CONCLUSIONS: Disadvantages persist regarding the access to and use of health services by immigrants as opposed to Chileans compared with information from previous years. It is necessary to reduce the gaps between immigrants and people born in Chile, especially in terms of health system access. This is the first barrier to effective use of services. The generation of concrete strategies and health policies that consider an approach of social participation of the immigrant community is suggested to bring the health system closer to this population.
    Scopus© Citations 38  1
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    Item type:Publication,
    Seroprevalence of Natural and Acquired Immunity against the SARS-CoV-2 Virus in a Population Cohort from Two Chilean Cities, 2020–2022
    (2023)
    Loreto Núñez-Franz
    ;
    Muriel Ramírez-Santana
    ;
    ;
    Macarena Said
    ;
    <jats:p>Background: Chile has achieved the highest coverage for vaccines against the SARS-CoV-2 virus worldwide. Objective: To assess the progression of immunity (natural and acquired by vaccine) in a cohort from two Chilean cities. Methods: Individuals (n = 386) who participated in three phases of population-based serial prevalence studies were included (2020–2021 and 2022). Presence of SARS-CoV-2 antibodies was measured in serum. Data including time of vaccination and type of vaccine received were analysed with descriptive statistics. Results: Seroprevalence was 3.6% in the first round and increased to 96.9% in the second and 98.7% in the third. In the third round, 75% of individuals who had received the basal full scheme were seropositive at 180 days or more since their last dose; 98% of individuals who received one booster dose were seropositive at 180 days or more, and 100% participants who received two boosters were seropositive, regardless of time since their last dose. Participants receiving mRNA vaccines had higher seroprevalence rates over time. Conclusions: The high vaccination coverage in Chile enabled the population to maintain high levels of antibodies. Vaccination boosters are essential to maintain immunity over time, which also depends on the type of vaccine administered.</jats:p>
      1Scopus© Citations 12
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    Effectiveness of an inactivated SARS-CoV-2 vaccine in children and adolescents: a large-scale observational study
    (2023)
    Alejandro Jara
    ;
    Eduardo A. Undurraga
    ;
    Juan Carlos Flores
    ;
    José R. Zubizarreta
    ;
    Cecilia González
      7Scopus© Citations 15