Uncertainties and vulnerabilities of management of congenital hypothyroidism: a case study abstract

Abstract

Objective: Explore management of diagnosis and follow-up of boys and girls with a high risk of congenital hypothyroidism (CH) born in the Davila Clinic between 2006 and 2010. Material and method: A case study logy was used, using the Davila Clinic as the unit of analysis, as part of the Northern Metropolitan Health Service. A framework for analysis was developed based on review of scientific literature and the national recommendations on the topic. Quantitative and qualitative sources were used to evaluate compliance with public health objectives, diagnosis, follow-up, and information management, in the congenital hypothyroidism program at the Davila Clinic. Results: In four years, 28 cases of

CH have been confirmed by laboratory, of which 77% were Fonasa beneficiaries. The clinic presents strengths in diagnosis and recording cases, but no institution carries out active follow up of the con- firmed cases. Fragmentation of useful information for follow-up and management of suspected cases was observed, as well as a lack of analysis of the problem. Discussion: A high level of uncertainty was found, with respect t follow-up and outcomes for children with CH born in the Davila  Clinic and who are also Fonasa beneficiaries. In this phase of the program, this group is not being correctly monitored according to national standards.