To compare health services utilization between the immigrant and indigenous populations in Spain.
We used information provided by the following four health surveys carried out around 2005: Catalonia 2005; city of Madrid 2005, Canary Islands 2004 and the Autonomous Community of Valencia 2005. The health services studied were general practice, specialist services, emergency services, hospitalization, and two preventive services: pap smear test and mammography.
In general, most health services were less frequently used by the immigrant population than by the Spanish population. The health services showing the least differences between the two populations were general practice and hospitalization, while the greatest differences were found in the use of specialist and preventive services. The most heterogeneous results were found in general practice and hospitalization, since some immigrant groups showed a relatively high frequency of use in some geographical areas and a relatively low frequency in other areas.
The results of the present study reproduce those found in other studies carried out in countries with similar social and economic characteristics to Spain. Like previous results, the present results are difficult to explain. Future research should aim to use other study designs and to test hypotheses not put forward by the scientific community to date.
Pediatric ankle injuries are a common complaint in the emergency setting. The objective of this study was to prospectively validate the Ottawa ankle rules (OAR) in children in Mexico. This could reduce costs and waiting times in the emergency room.
The authors applied the OAR to all patients aged 0 to 18 years old with an acute ankle injury. The main outcome measure was radiograph and/or clinical outcome determined through telephone contact. The presence of fracture was considered an adverse outcome.
One hundred and eleven patients, aged 3-18 years, were enrolled. The prevalence of fractures was 15 %. The sensitivity and negative predictive value of the OAR were 100 %. Use of the OAR would have reduced the radiography rate by 5.4 %.
The sensitivity and applicability of the OAR in children in Latin-America are confirmed, although reduction in the use of radiography is lower than in other countries.