Person: Hirmas Adauy, Macarena
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Hirmas Adauy
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Publication Seroprevalence and estimation of the impact of SARS-CoV-2 infection in older adults residing in Long-term Care Facilities in Chile(2022) Rubilar, Paola; Hirmas Adauy, Macarena; Matute, María Isabel; Browne, Jorge; Little, Cedric; Ruz, Gonzalo; Aguilera, Ximena; Avila, Carlos; Vial, Pablo; Gutknecht Mackenzie, TaniaIntroduction Older adults are at a higher risk of severe illness and death from COVID-19. This vulnera bility increases in those who live in long-term care facilities due to overcrowding, greater physical dependence, and contact with health workers. Evidence on the impact of the pan demic on these establishments in low- and middle-income countries has been scant. This study aims to determine the seroprevalence of SARS-CoV-2 in older people residing in long-term care facilities and estimate the impact of infection after the first wave of the pandemic. Methods A cross-sectional design with 2099 residents in three regions of Chile was carried out be tween September and November 2020. Measurement of antibodies was performed with a rapid test. The impact of SARS-CoV-2 infection was estimated with seropositive residents, those who had a history of positive polymerase chain reaction tests, and those who died from COVID-19. Bivariate analysis with the region, sex, age, history of COVID-19, physical dependence, and serological results were performed. In addition, we performed a correla tion analysis between the seroprevalence of the centers by the municipality and the rate of confirmed cases. Results The seroprevalence of SARS-CoV-2 antibodies in the three regions was 14.7% (95% confi dence interval: 13.2 to 16.3%), the infection impact was 46.4%, and the fatality rate was 19.6%. A significant correlation was found between the seroprevalence of older adults re siding in long-term care facilities and the cumulative incidence by municipalities. Conclusions The seroprevalence of older adults residing in long-term care facilities was higher than the general population. The high impact of infection among this population at the end of the first wave of the COVID-19 pandemic is similar to other countries. The centers' environ ment is directly related to COVID-19 infection. Morbidity and mortality monitoring sys tems should be implemented promptly to establish prevention and control measurPublication Exposure of 4- year to 24- year olds to tobacco imagery on prime- time Chilean television(2023) Peruga, Armando; Oscar Urrejola; Delgado, Iris; Matute, María Isabel; Castillo-Laborde, Carla; Molina, Xaviera; Hirmas Adauy, Macarena; Olea, Andrea; González, Claudia; Aguilera, Ximena; Sargent, JamesIntroduction: The extent of the population's exposure to tobacco imagery across all genres of regular TV programming and the contribution of each of these genres is unknown, except for UK broadcast channels. The objective of this study is to estimate the exposure of young people to tobacco imagery on Chilean prime-time television and the programme source contributing to such exposure. Methods: Programmes aired during 3 weeks in 2019 from the 15 highest audience channels in Chile were content-analysed for the occurrence of tobacco categorised as actual use, implied use, tobacco paraphernalia, tobacco brand appearances and whether they violated Chilean smoke-free law for each 1 min interval (92 639). The exposure of young people to tobacco content was estimated using media viewership figures. Results: Young people received 29, 11 and 4 million tobacco impressions of any type, explicit use and smoke-free violation, respectively, at a rate of 21.8, 8.0 and 2.1 thousand impressions per hour of TV viewing. The main sources of exposure to tobacco impressions were feature films and animated productions, which were almost entirely non-Chilean. Finally, young people were exposed to tobacco brand impressions primarily through films, effectively circumventing the advertising ban in Chile. Discussion: Television programming is a source of significant youth exposure to tobacco imagery, including branding impressions. To conform to the WHO FCTC, Chile should prohibit tobacco branding in any TV programme and require strong anti-tobacco advertisements prior to any TV programme portraying tobacco.Publication Gestión de reembolsos de seguros complementarios de salud en Chile: barreras y necesidades que enfrentan profesionales de salud y pacientes(2023) Braun, Michael; Mattoli-Chiavarelli, Maurizio; Haeussler-Risco, Ignacio M.; Hirmas Adauy, Macarena; Sgombich, María; Mauro Lalanne, AlejandroIntroducción: Los seguros complementarios de salud cubren los costos que la institución previsional no absorbe. Este mercado crece año a año en Chile, especialmente los seguros colectivos. Sin embargo, existe escasa evidencia que describa cómo perciben los usuarios la gestión relacionada al reembolso. El objetivo de este estudio es caracterizar la gestión del reembolso del seguro complementario de salud y sus dificultades, desde la perspectiva de pacientes, médicos y odontólogos, y levantar recomendaciones de innovación. Materiales y métodos: Diseño mixto basado en un estudio cuantitativo transversal (412 participantes) y en un estudio cualitativo exploratorio (20 participantes), realizado en 2022. En el componente cuantitativo, se utilizó un cuestionario autoadministrado realizando análisis descriptivos univariados y bivariados utilizando SPSS. El componente cualitativo se basó en entrevistas semiestructuradas desarrollando análisis de contenido. Resultados: Los formularios de reembolso se encuentran disponibles en los establecimientos de salud, o bien, el paciente los lleva impresos. El proceso se percibe complejo por parte delos pacientes, desconocen la información a declarar, mencionan pobre apoyo de aseguradoras, y sitios web de difícil manejo. Los profesionales de salud refieren perder tiempo de consulta relacionado a completar el formulario (especialmente odontólogos), gestiones adicionales que deben realizar, formularios complejos y no estandarizados. Se reconoce la necesidad de contar con un sistema digital integrado y amigable, que facilite la gestión del reembolso. Discusión: En base a las barreras que enfrentan pacientes y profesionales de salud, junto a las recomendaciones identificadas, emerge la necesidad de integración e innovación de los sistemas de reembolsos, centrado en los usuarios, mejorando la experiencia de uso e incorporando nuevas tecnologías. Introduction: Complementary health insurance pays for expenses not covered by public or private insurance. The collective insurance market is growing in Chile. However, little evidence exists on how reimbursement management is perceived by users. This study aims to characterize the management of reimbursement of complementary health insurance from the perspective of patients, physicians, and dentists, and to provide recommendations for innovation. Materials and methods: Mixed design based on a cross-sectional quantitative study (412 participants) and an exploratory qualitative study (20 participants), conducted in 2022. The study used a self-administered questionnaire for quantitative analysis, while semi-structured interviews and content analysis were used for qualitative analysis. Results: The reimbursement forms can be obtained at health facilities or are printed and carried by the patient. Patients perceive the form-filling process as complex due to a lack of information, inadequate insurance support, and websites that are difficult to navigate. Healthcare professionals point to the loss of healthcare time due to filling out the forms (especially dentists), the additional steps involved, and the complex and non-standardized forms. The need for an integrated and user-friendly digital system that facilitates reimbursement management is recognized. Discussion: The healthcare industry needs to develop integrated reimbursement systems with innovative solutions that prioritize the user experience and leverage new technologies to improve outcomes and enhance care quality.Publication Barriers and Facilitators in Access to Diabetes, Hypertension, and Dyslipidemia Medicines: A Scoping Review(2022) Castillo-Laborde, Carla; Hirmas Adauy, Macarena; Matute, María Isabel; Jasmen, Anita; Urrejola, Oscar; Molina, Xaviera; Awad, Camila; Frey, Catalina; Pumarino, Sofia; Descalzi, Fernando; Ruiz, Tomás; Plass, BarbaraObjective: Identify barriers and facilitators in access to medicines for diabetes, hypertension, and dyslipidemia, considering patient, health provider, and health system perspectives. Methods: Scoping review based on Joanna Briggs methodology. The search considered PubMed, Cochrane Library, CINAHL, Academic Search Ultimate, Web of Science, SciELO Citation Index, and grey literature. Two researchers conducted screening and eligibility phases. Data were thematically analyzed. Results: The review included 219 documents. Diabetes was the most studied condition; most of the evidence comes from patients and the United States. Affordability and availability of medicines were the most reported dimension and specific barrier respectively, both cross-cutting concerns. Among high- and middle-income countries, identified barriers were cost of medicines, accompaniment by professionals, long distances to facilities, and cultural aspects; cost of transportation emerges in low-income settings. Facilitators reported were financial accessibility, trained health workers, medicines closer to communities, and patients' education. Conclusion: Barriers and facilitators are determined by socioeconomic and cultural conditions, highlighting the role of health systems in regulatory and policy context (assuring financial coverage and free medicines); providers' role bringing medicines closer; and patients' health education and disease management.