El presente plan de negocios presenta el proyecto de aplicativo móvil Dr. Kids cuyo centro de operaciones será en el distrito de Pueblo Libre ubicado en la ciudad de Lima (Perú). Este proyecto consiste en brindar el servicio médico pediátrico domiciliario a través de la solicitud de citas mediante un aplicativo móvil y nace de la insatisfacción percibida en cuanto a los servicios de salud se refiere – tiempo de espera, atención administrativa y trato del personal médico principalmente – y a la disponibilidad de tiempo de los padres o apoderados de los niños y/o adolescentes para acudir a un centro médico ya sea privado o estatal. A través de este servicio se pretende brindar un servicio de calidad; eficiente; seguro e inmediato. Adicionalmente se beneficiará a los pacientes un seguimiento sobre su estado de salud y controles médicos si así lo amerite; es decir un negocio orientado al cliente y a la solución de su problema: En cuanto a la rentabilidad del negocio, podemos afirmar que según los datos obtenidos del plan financiero este negocio es rentable ya que presenta una TIR de 62.60%: y un VAN de: S/. 168,932.64 soles siendo el periodo de recuperación de 3 años 5 meses. / This business plan presents the project of mobile application Dr. Kids whose center of operations will be in the district of Pueblo Libre located in the city of Lima (Peru). This project consists of providing home pediatric medical service through the application of appointments through a mobile application and is born from the perceived dissatisfaction with regard to health services - waiting time, administrative attention and treatment of medical personnel mainly - and the availability of time for parents or guardians of children and / or adolescents to go to a private or state medical center. Through this service we aim to provide a quality service; efficient; safe and immediate. In addition, patients will benefit from a follow-up on their health status and medical check-ups if warranted; that is, a business oriented to the client and to the solution of his problem: As for the profitability of the business, we can say that according to the data obtained from the financial plan this business is profitable since it has an IRR of 62.60%: and a NPV of: S/. 168,932.64 soles being the recovery period of 3 year 5 months. / Trabajo de investigación

The Doctor Interactive Group Medical Appointment (DIGMA) is a group health intervention that combines the services of behavioral health and primary care. The DIGMA was first invented by Edward Noffsinger in 1996, in response to his own difficulties with the overtaxed primary care system at Kaiser Permanente in California (Noffsinger, 1999). Integrating healthcare services in this way has practical implications such as efficient use of resources, treating multiple complaints at once, and beginning to view the mind and body as one (Noffsinger, 1999; Engel, 1977). The DIGMA at the Austin Veterans Outpatient Clinic was designed to address the specific needs of veterans with hypertension. It consists of 4 sessions of 1.5 hours each and addresses such varied topics as exercise, stress-management, nutrition, and medication adherence. These topics are discussed in a group format with the tenets of group psychotherapy (Yalom & Leszcz, 2005) as a backdrop. An exploratory study was warranted to determine whether programs of this sort would be effective on a broad scale. A pretest/posttest design was utilized to determine if the DIGMA was effective at reducing symptoms of hypertension; improving health promoting behavior; increasing self-efficacy to manage hypertension; and increasing internal health locus of control while decreasing chance and powerful others health locus of control. Groups were conducted over a period of seven months with a total of 73 male veterans enrolled in the study. The final n was 58. Findings indicated that both systolic and diastolic blood pressure readings were reduced significantly from pretest to posttest. Health promoting behavior increased significantly; hypertension self efficacy increased significantly; and locus of control did not change significantly from pretest to posttest. The exploratory study concluded that the DIGMA may be efficacious for a variety of aspects of the management of hypertension. It is suggested that further research be conducted but that integrating services in this way can lead to improved patient outcomes and can also be cost-effective. / text

Secretaria do Planejamento e GestÃoSecretaria do Planejamento e GestÃo / This study aims to evaluate the effects of smoking on the medical appointments demand, it was used the data of Household Sample Survey - PNAD 2008 by the Brazilian Institute of Geography and Statistics - IBGE. In this work, subjects were separated into different categories: smokers (which were separated in two subcategories: intensive and non-intensive), former smokers and never smokers. It was investigated the relationship between tobacco consumption and the number of medical appointments in one year. It was used the number of medical consultations as dependent variable and variable of socioeconomic kind, health related outcomes associated with smoking and other independents. It was noted by analysis and Zero-Inflated Negative Binomial count model that was not found significant difference between smokers and never smokers on the number of medical appointments. In relation to former smokers, it was observed that these require more medical visits than those who never smoked. In addition, it was analyzed the influence of other factors in the number of queries. / Este estudo tem como objetivo avaliar os efeitos do tabagismo na demanda por consultas mÃdicas. Foram utilizados os dados da Pesquisa Nacional por Amostra de DomicÃlios â PNAD de 2008 realizada pelo Instituto Brasileiro de Geografia e EstatÃstica â IBGE. No presente trabalho, os indivÃduos foram separados em categorias: fumantes (estes, em duas subcategorias: intensivos e nÃo intensivos), ex-fumantes e nunca fumantes, buscando-se investigar a relaÃÃo entre consumo de tabaco e a quantidade de consultas mÃdicas realizadas no perÃodo de um ano. Foi utilizado o nÃmero de consultas mÃdicas realizadas como variÃvel dependente e variÃveis de natureza socioeconÃmicas, variÃveis relacionadas à saÃde e outras associadas ao tabagismo como independentes. Foi possÃvel verificar pela anÃlise descritiva e pelo modelo de contagem Binomial Negativo Inflacionado de Zeros que nÃo houve diferenÃa significativa entre fumantes e nunca fumantes quanto ao nÃmero de consultas mÃdicas demandadas e que, em relaÃÃo aos ex-fumantes, observou-se que estes demandam mais consultas mÃdicas do que aqueles que nunca fumaram. AlÃm disso, foi analisada a influÃncia de outros fatores no nÃmero de consultas.

To examine evidence-based interventions for nurses to use when supporting cancer survivors self-manage their symptoms. Part I: A systematic review to determine the effect of shared medical appointments (SMAs) on patients with a physical chronic illness (excluding diabetes mellitus), their healthcare providers and the healthcare system. Nine randomized controlled trials were included; one focused on breast cancer survivors. This trial was feasible and showed no difference in outcomes compared to usual care. Part II: A descriptive study to adapt and evaluate the acceptability of an evidence-informed symptom practice guide (SPG) for use by nurses for the assessment, triage, and management of patients experiencing dyspnea due to cancer treatment-related cardiotoxicity. Guided by the CAN-IMPLEMENT© methodology, evidence from seven guidelines on heart failure was added to the original SPG. Eleven participants indicated the adapted SPG was comprehensive and easy to follow, and would be helpful for handling symptom calls from patients.

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En el Perú, el tiempo de espera para la consulta en las instituciones de salud está limitado por el número de recursos médicos y sus franjas horarias disponibles. Investigaciones recientes han demostrado que los sistemas en línea basados en la programación de citas médicas ayudan a los centros médicos a reducir el tiempo de espera de los pacientes para recibir atención médica. La presente investigación tiene como objetivo analizar y comparar sistemas de reserva de citas médicas, tomando en cuenta sus ventajas, características y funcionalidades que ayuden en la optimización de tiempo de espera para la atención médica y mejoren la calidad de la atención a los usuarios. Asimismo, se analizará las plataformas Cloud y herramientas multiplataforma que ayudarán en el desarrollo de la solución tecnológica. / In Peru, waiting time for medical appointments at healthcare facilities is limited by the number of medical resources and their available time slots. Recent studies have shown that online systems based on medical appointment scheduling help medical centers to reduce patients' waiting time for medical healthcare. The present research aims to analyze and compare medical appointment scheduling systems, considering their advantages, features and functionalities that help in the optimization of waiting time for medical care and improve the quality of care to users. Likewise, Cloud platforms and cross-platform development tools that will help in the development of the technological solution will be analyzed. / Trabajo de investigación

Approximately 8.3% of the U. S. population has type 2 diabetes. Preventing the onset and improving the management type 2 diabetes are crucial for health care professionals. The purpose of this project was to develop and evaluate a type 2 diabetes prevention and management education program in a primary care setting using group medical appointments (GMAs). The chronic care model provided the framework for the study. The education program consisted of information from the Centers for Disease Control on the management of type 2 diabetes to be delivered by clinic staff using a GMA approach, a timeline for implementing the education program, and evaluation strategies for assessing patient health outcomes. Staff participants included 9 females and 1 male. One week after the presentation, staff responded to open-ended questions addressing the plan for prevention and management of type 2 diabetes. Findings indicated that staff unanimously approved the content of the program, thought the program could realistically be implemented, thought the proposed evaluation methods were appropriate, and thought the program would have a positive influence on patient health outcomes. Prevention and management education programs using a GMA approach may be used to reduce incidence and improve management of type 2 diabetes.