[Social failure: the concept and a method for its clinical assessment].
BACKGROUND
The social problematic one of the patient often conditions the medical therapeutic attitude, being able to force the hospital admission, to be able to guarantee its attention. In spite of its frequency, we do not have objective procedures that they allow us to quantify and to value its severity.


OBJECTIVE
1 degree: To define the concept of social insufficiency (SI). 2 degrees: To enunciate a formula that allows us to quantify it objectively. 3 degrees: To make a practical validation of the procedure.


METHODS
We did not find in the bibliographical revision, a similar descriptive term neither procedures in order to quantify it. For that reason, we elaborated our own scale of social valuation, applying it within a protocol that also includes clinical aspects, valuations functional physical, mental and cognitive. The SI was considered like the quotient, between the functional capacity of the patient and the degree of social support.


RESULTS
The SI could be defined as the incapacity of the socioeconomic and familiar surroundings of a patient, in order to guarantee the satisfy all the necessities derived from their pathological state, views from an integral perspective. The relationship between functional capacity (determined by means of the scale of the Red Cross of Valuation of Incapacity) and social support (evaluated by means of our scale) in quotient form, could be used to detect and quantify the SI objectively, being in our opinion a simple and practical procedure. We described to its frequency and severity, as well as the clinical and epidemiological characteristics to whom it is associated with greater statistical significance to that the existence in our means.


CONCLUSIONS
The SI is a frequent problem, being necessary to establish their concept and forms of quantification. We propose a formal definition. The relationship between functional capacity and social support, expressed in quotient form, could be used can serve to value the SI objectively.
Carmona Sáez
T
T
Servicio de Medicina Interna, Hospital Provincial, Avila.
Llorente García
F
F
Romero Mayoral
P
P
Román Fernández
C
C
Jiménez Alvarez
A J
AJ
Rodrigo Santos
I
I
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012940:Social Problems / Q000706:statistics & numerical data; D012944:Social Support; D012959:Socioeconomic Factors; D013030:Spain; D018709:Statistics, Nonparametric; D009626:Terminology as Topic