“They sent me and my mother from Teodoro Hospital to Los Cerbos Hospital, and my father was referred to a private hospital, but he still spent money on medicine,” said the daughter of hospitalized parents. REPORT | information

Finding medical services in hospitals of the country’s public health network requires meeting with a doctor who has the supplies necessary to treat the case; otherwise, the options are referral to a private facility or traveling to another state facility, while the affected person suffers and Life is at risk as the situation worsens.

The story of Paula’s parents reflects what it means to be sick and need to be hospitalized in Ecuador. Her 73-year-old mother, Rosa Zambrano, collapsed, so in November 2022 she was transferred to the Ecuadorian Social Security Institute, located south of Guayaquil and close to her home. Teodoro Maldonado Cabo Hospital of IESS). But it was in vain. .

When the retiree arrived, she was passed out in a wheelchair and they told her they couldn’t care for her. “There is nothing they can do, let’s not waste time and take her to the IESS hospital in Los Cerbos,” said the daughter of the affected woman.

There were some painful moments during the journey, such as when he passed out again and was only briefly awakened by the scent of perfume.

Rosa’s condition was caused by high potassium levels due to her diabetes. “Normally it’s five, and my mother was nine.”

Eventually he received care, entered the intensive care unit of the IESS hospital in Los Cerbos, and then went to the ward.

Paula said that at night she had to find doctors and nurses if needed. “They seemed to get lost in the corridor. This happened to me when my mother complained of severe pain around 11pm, while everyone attending was already asleep.”

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During the nearly month Rosa was hospitalized, her morning cramps were so severe that they caused her to vomit.this Ampoules reduce potassium costs by $45.influenced I need it every two days. “That hospitalization cost us about $500.“We also purchased special tracks for $15 each.”

The story of Rosa’s husband, Juan, reflects another side of receiving medical care in public networks. He was 83 years old and arrived in Teodoro Maldonado last February suffering from severe chest pains.

“When dealing with the referral to Interhospital, a private hospital complex in Los Cerbos, west of the city, the doctor told me: ‘I will help you,'” he said.

“They took him in an ambulance to be catheterized. He couldn’t breathe. He was hospitalized for three days. This The same doctor in Teodoro handled the paperwork.I don’t know if they suddenly give you something to send, I don’t know, but thank God it’s different and faster. Since my father is older, we were worried that he would develop pneumonia,” said Paola.

Following the referral, Juan’s life was saved through private intervention, ultimately borne by the state through donations from members and employers.

this Hospitalizations increase across health system in 2020 and 2021 907,515 and 1’038,245, in that order.

The trend is, The number of hospitalizations increases year by year. During 2022, a total of 1,130,603, 64.5% of which correspond to people entering the public network, including institutions of the Ministry of Public Health (MSP) and IESS. The remaining 35.5% goes to the private sector.

Number They reflect the health system’s inability to prevent cases from worsening due to a lack of preventive policies.experts agree.

The total number of hospitalized cases registered in the Ministry of Public Health’s (MSP) network of hospitals and centers alone between January and September this year was 383,262, excluding services provided by IESS or private agencies. In these cases, 376,180 people have been discharged from hospitals and 7,082 people have died..

The leading causes of hospitalization for MSP treatment were unexplained pneumonia in men and gallbladder stones in women.

Although total hospital deaths declined in 2022 due to lower COVID-19 mortality rates, Last year’s death toll of 21,518 was the highest since 1995, not including 2020 and 2021 Pandemic.

What else can be seen Increase in net hospital mortality per discharge.this The number of discharged patients increased from 11.2‰ in 1995 to 14.65 in 2022. This only includes people who died after being hospitalized for 48 hours or more, to reduce the impact of death from external causes (murder or accident), which usually died within 48 hours of hospitalization due to the chronic nature of his paintings.

Hospital mortality rates began to rebound in 2014.

this indexEnrique Terán, PhD and professor of pharmacology at the University of San Francisco and Quito (USFQ), said, As the health system improves, it should be gradually reduced as there will be greater success in addressing chronic cases. “More and more patients are being admitted, but the ability to solve their problems is getting weaker and weaker. This is closely related to the situation in public hospitals, where operations are postponed and there are no materials for operations. So he Patients flounder, mortality rates rise“.

What’s serious is this trend make treatment difficultgiven that As the number of people seeking medical care increases, more resources are needed. “The focus of the health system is on treatment and infrastructure, not prevention,” Tran said.

Ángel, 24, works as an assistant at a Sociovivienda store in northwest Guayaquil. Suddenly he felt severe pain, so last July he was transferred to MSP’s Guasmo Sur Hospital. “I went there because I live in the south, but they didn’t want to serve me. “They sent me to the C-Health Center (in southwest Guayaquil) where I had an ultrasound. “

His diagnosis was kidney stones. Now he’s receiving treatment to avoid needing surgery, but he realizes he’ll have to buy most of his medications.

There are not enough medicines and supplies on the public internet, such as the serum Rosa had to buy after her gallbladder surgery last June. Priced at $85 each. “Free just follow. My friend stayed at Teodoro Maldonado Cabo Hospital for almost two months,” said Narciza Mora, who helped her during her recovery.

His 70-year-old brother Daniel Mora was also hospitalized this year. Two years ago he underwent heart surgery, his appendix ruptured, and he was scheduled to be transferred to Guayaquil for severe kidney failure, but last September he was finally treated at the IESS hospital in Santo Domingo, as the hospital is Part of the Farmers’ Social Welfare Institute. Safety.

He arrived at the medical facility in Manabi, where he lives, from La Manga del Cura, El Carmen state. He went to three hospitals before admitting him, but none was willing to admit him. “My brother’s situation was complicated: he was further away than here and they had sent him home to die. But with faith we managed to get him on dialysis and he has remained that way. We had to buy some IESS on Vials that don’t exist,” Narciza said.

Infectious disease expert Washington Aleman said unfortunately, no health measures can promote health to reduce mortality.

“Our health system is committed to welfare, building hospitals and trying to cure patients. We are too late to adopt this model when many diseases are already complex. Unfortunately, over the years people have tried to change this prevention and health promotion the opinion of.”

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The way the health system is managed has political implications: “From a political perspective, prevention and promotion do not leave much profit; it is more profitable to build hospitals, even without doctors or equipment. The best hospitals in a country are those that are not being used of hospitals. This shows that we have a large sick population and no preventive measures,” Aleman explained.

Through prevention, the number of people requiring hospitalization can be reduced. “Unfortunately, we don’t know the ichthyology of the lower respiratory tract infection, the cause; the only thing we have is that they arrived with unidentified pneumonia, which historically, along with diarrheal disease, has been a common cause of hospitalization in the country One of the main reasons.”

The failure is due to the lack of hygiene measures aimed at preventing and promoting health. “These data should put more emphasis on diseases affecting the population in order to contain them,” Aleman said.

For example, one option for dealing with pneumonia is to vaccinate children and vulnerable groups—people with risk factors, such as pregnant women, smokers, people with lung disease, and people who are obese.

The most common bacteria that cause pneumonia are pneumococcus and influenza, Aleman said. “It’s a matter of interpreting the data, not just the cold data, but also trying to find strategies that can stop them.”

Anatomical Differences Leading Reasons for Hospitalization Between Men and Women

Causes of hospital morbidity differ between men and women.

The former are more susceptible to appendicitis, pneumonia, inguinal hernias and fractures. In the latter, cholelithiasis (gallstones) and urinary tract infections appear first and with higher incidence.

Tran explains that this is in response to stark gender differences. “Female gallbladders have less contractile activity than men, so they are more likely to form stones even with the same diet and activity. “It’s an anatomical issue. “

On top of this, experts add, the gallbladder empties more slowly during pregnancy, promoting stone formation.

Last year, 49,223 people were hospitalized with cholelithiasis (gallstones). 58.3% are female.

They are also more likely to develop urinary tract infections. The prevalence is high due to hygiene issues. “For women, especially younger women such as girls and teenagers, cross-contamination with vaginal feces is more common when wiping from front to back,” Tran said.

The second reason is urinary retention due to suppressing the urge to urinate for a long time. “It has to do with limited access to bathrooms. These are often not well maintained; therefore, they persist, which makes them more susceptible to urinary tract infections.”

The incidence of inguinal hernias in men corresponds to the descent of the testicles, which before birth are located in the abdomen, so they must descend to reach the scrotum, Tran said. “During this descent, in some cases, there is a delay in the tissue around the groin, so men, in particular, experience higher rates when they do more physical activity with heavy loads. .”

Tran explains that in women, because their ovaries don’t descend, they don’t have this potential vulnerability.

Men are more likely to have fractures. Research shows this is because they tend to be more reckless and less careful, Tran said. “Even though times are changing, they are more cautious.” (Yo)