Unidad de Investigación Epidemiológica y en Servicios de Salud, Instituto Mexicano del Seguro Social, Monterrey, México.
Int Arch Occup Environ Health. 2010 Oct;83(7):813-21. doi: 10.1007/s00420-010-0550-2. Epub 2010 Jun 11.
Worksites have been considered a propitious environment for promoting health. In 2005, an integrated preventive care (IPC) system was implemented in Mexico consisting of health promotion and disease prevention interrelated activities, delivered on a single visit and on location. This project contributes relevant information on IPC coverage and its degree of effectiveness on providing health promotion services to workers at high-risk worksites.
There were included 68 worksites particularly affected by high fatal and nonfatal injury rates; the target population comprised 45,724 workers. Coverage referred to the completion of IPC actions within the last year, and effectiveness was defined as the extent to which an observed IPC coverage came close to an ideal IPC coverage. Means and 95% confidence intervals (CI) were calculated for given estimates.
Overall IPC mean coverage effectiveness was 61.2% (95% CI 60.8-61.6), a value below satisfactory range limits. Results broken down by sex and age showed higher mean coverage effectiveness for adult working men than adult working women (p < 0.0001). Promotion of reproductive health was the IPC process with the lowest mean coverage effectiveness (51.8%; 95% CI 50.8-52.7), followed by the disease detection process (59.0%; 95% CI 58.4-59.6) and the disease prevention and control process (61.0%; 95% CI 60.5-61.5). Maintaining the health of the workforce poses a significant challenge for health services. Therefore, analysis of coverage effectiveness represents a useful tool for evaluating and reorganizing preventive medicine care at worksites.
工作场所被认为是促进健康的有利环境。2005 年,墨西哥实施了综合预防保健(IPC)系统,该系统由相互关联的健康促进和疾病预防活动组成,在一次就诊和现场进行。该项目提供了有关 IPC 覆盖范围及其在向高风险工作场所工人提供健康促进服务方面的有效性程度的相关信息。
纳入了 68 个特别受到高致命和非致命伤害率影响的工作场所;目标人群包括 45724 名工人。覆盖范围是指在过去一年中完成 IPC 行动的情况,有效性定义为观察到的 IPC 覆盖范围接近理想 IPC 覆盖范围的程度。给出了给定估计的平均值和 95%置信区间(CI)。
总体而言,IPC 平均覆盖有效性为 61.2%(95%CI 60.8-61.6),低于满意范围的限制。按性别和年龄细分的结果表明,成年男性工人的平均覆盖有效性高于成年女性工人(p<0.0001)。生殖健康促进是 IPC 过程中平均覆盖有效性最低的(51.8%;95%CI 50.8-52.7),其次是疾病检测过程(59.0%;95%CI 58.4-59.6)和疾病预防和控制过程(61.0%;95%CI 60.5-61.5)。维护劳动力健康对卫生服务构成重大挑战。因此,覆盖有效性分析是评估和重组工作场所预防医学保健的有用工具。