Category: Surgical Therapy: Parkinson's Disease
Objective: To show the experience of implementing a functional neurosurgery program with Deep Brain Stimulation (DBS) for patients with Parkinson’s Disease (PD), in low-income regions outside of Metropolitan Santiago. Describe the approach of steps and obstacles to overcome for its implementation with favorable results.
Background: Chile’s public health system is not equitable, centralizing most of the high-complexity healthcare services, hospitals and health personnel in the Metropolitan Santiago region, which has a current population of more than 8 million inhabitants. The Coquimbo region in northern Chile has about 900K inhabitants. Functional surgery with DBS for PD is not covered by the public health system and must be fully paid for by the patients, with a variable burden equivalent to 60K – 70K USD.
This work presents the challenge and the policies implemented to carry out the DBS project for PD patients in regions with scarce resources.
Method: Through an exhaustive step-by-step monitoring of the DBS program and its implementation, education and dissemination have been carried out among medical colleagues for their co-participation and/or integration into work teams. Likewise, through presentations to the Health System, Regional Government (GoRe), the policies and protocols have been established to execute the projects and maintain their continuity in the future.
Results: The project was financed with funds granted by the GoRe with the Coquimbo Health Service, and the administration by the Levantemos Chile Foundation.
The program made it possible to complete the first segment with 8 patients, the second is currently ending to total 9 additional patients and the next stage for 2022 contemplates another 9 patients currently in the pre-selection process.
The project described in this report has also been replicated in the Arica and the Antofagasta region. In all cases, the results have been favorable, coinciding with major publications available elsewhere.
Conclusion: Although it is necessary to check the progress step by step overcoming various logistical, political and economic obstacles, it is possible to implement free programs for patients with PD who can benefit from DBS therapy techniques and their follow-up. Emphasis is placed on the need for an effective search for resources for financing and logistics, following an action protocol designed and adapted to each region.
To cite this abstract in AMA style:M. Contreras Pinto, J. Hortal, G. Fernandez. Swimming against the current: Successful implementation of functional neurosurgery programs in underserved regions of Chile [abstract]. Mov Disord. 2022; 37 (suppl 2). https://www.mdsabstracts.org/abstract/swimming-against-the-current-successful-implementation-of-functional-neurosurgery-programs-in-underserved-regions-of-chile/. Accessed September 25, 2023.
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MDS Abstracts - https://www.mdsabstracts.org/abstract/swimming-against-the-current-successful-implementation-of-functional-neurosurgery-programs-in-underserved-regions-of-chile/