[Maternal mortality at the Mexican Institute of Social Security (IMSS). Initial results from a reduction intervention strategy].

Objective: To analyze the preliminary results of a medical manager intervention to improve the quality of medical care during pregnancy, delivery and puerperium, on the maternal mortality rates in population covered by the Mexican Institute of Social Security (IMSS).

Material And Methods: We selected the 14 administrative delegations of IMSS that showed the highest rates and absolute numbers of maternal deaths in the years 1999 to 2001. Within this group, the manager medical staff developed activities for medical training of family physicians and gynecologists, to improve medical resources, to achieve a better coordination among medical services, to adequate reference of obstetrical complications to higher-level hospitals, and for monitoring of maternal mortality committees operation.

[Fractures in postmenopausal women in the IMSS: frequency and costs of hospital care].

Objective: To analyze the frequency and costs of hospitalary care due to fractures in postmenopausal period occurred in Instituto Mexicano del Seguro Social (IMSS).

Material And Method: Study about hospitalary discharges in IMSS, among 2000-2001, with diagnosis of hip, distal forearm and vertebral fractures, with an analysis by sex and age groups. To estimate hospitalary costs, we utilized the data of Grupos Relacionados de Diagnóstico (GRD) used in IMSS.

[Training experience in climacteric and menopause among physicians of the IMSS].

Objective: To analyze the level of knowledge concerning climateric and menopause among family physicians and gynecologists and obstetricians of the Instituto Mexicano del Seguro Social (IMSS), after a training process in institutional technical guidelines and in educational content for population. We also analyze possible changes in frequency of medical attention for climateric and menopause in the first level of medical care.

Material And Methods: Prospective and descriptive study on 1) results of the knowledge evaluation by means of 23 questions with multiple answers, and 2) analysis of rates of medical care for menopausal and perimenopausal disturbances (N95 code, X Revision, IDC) from 1995 to 2000.