medigraphic.com
Instituto Nacional de Salud Pública

2003, Number 6

<< Back Next >>

salud publica mex 2003; 45 (6)

Prenatal care in the primary level of healthcare: provider characteristics which influence users’ satisfaction

Bronfman-Pertzovsky MN, López-Moreno S, Magis-Rodríguez C, Alejandra Moreno-Altamirano, Shea Rutstein

Language: Spanish
References: 33
Page: 445-454
PDF size: 101.80 Kb.


ABSTRACT

Objective. To assess the satisfaction level attained by prenatal care users in primary health services in Mexico, and to compare the level of satisfaction according to characteristics of the provider and the service. Material and Methods. A cross-sectional survey was conducted to analyze data from 217 care provider user pairs. Interviews were carried out in 95 primary care units in eight Mexican states. The information was collected through a) direct observation of the medical encounter, b) interviews with providers and users, and c) a questionnaire and knowledge examination to providers. Users' satisfaction was analyzed according to providers' clinical ability and the treatment received during the visit. Summary and dispersion measures of the main issues were calculated, as well as bivariate and trends analysis. Results. User satisfaction in prenatal care is associated with the treatment received during the visit and to the waiting time before being attended, but not with the provider's clinical ability, nor with his or her age or gender.The treatment received during the visit was also associated with the user's socioeconomic level,where the poorer users received the worst treatment. Conclusions. Health services should assess users' satisfaction according with the type of medical encounter, particularly where resources are scarce and where economic disparities are present. In such cases, the provision of healthcare services may intensify inequality,with greater impact on the poorest.


REFERENCES

  1. Ramírez STJ, Nájera AP, Nigenda LG. Percepción de la calidad de la atención de los servicios de salud en México: perspectiva de los usuarios. Salud Publica Mex 1998;40:3-12.

  2. Rahmqvist M. Patient satisfaction in relation to age, health status and Dther background factors:A model for comparisons of care units. Int I Quality Health Care 2001:13(5):385-390.

  3. Drain M. Quality improvement in primary care and the importance of satients perceptions. j Ambulatory Care Manag 2001;24(2):30-46.

  4. Cherin DA, Huba GJ, Steinberg J, Reis P, Melchior LA. Marconi K et al. satisfaction with services in innovative managed care programs for groups of traditionally underserved individuals with HIV/AIDS: Empirical models. Home Health Care Sery Q 2001;19(1):103-125.

  5. Donabedian A. La calidad de la atención médica, México, DF: Ed La Prensa Médica Mexicana, 1984.

  6. Vidal PLM, Reyes ZMC. Diseño de un sistema de monitoria para el desarrollo de programas de garantía de calidad. Salud Publica Mex 1993;35(3):326-331.

  7. Donabedian A. Continuidad y cambio en la búsqueda de la calidad. Conferencia magistral. Salud Publica Mex 1993;35(3):238-247.

  8. Evans DB,Tan-Torres ET, Lauer J, Frenk J, Murray CJL. Measuring quality: From system to the provider. Int J Quality Health Care 2001; 13 (6):439-446.

  9. Ware JE, Davies AA, Stewart AL.The measurement and meaning of patient satisfaction. Health Med Care Sery Rev 1978;1:2-15.

  10. McKinley RK.Terjinder MS, Hasting AM, French DP, Baker R. Reliability and validity of a new measure of patient satisfaction with out of hours primary medical care in the United Kingdom: Development of a patient questionnaire. BMJ I997;314(7075):193-207.

  11. Draper M, Cohen P, Buchan H. Seeking consumer views:What use results of hospital patient satisfaction surveys? Inc J Quality Health Care 2001;13(6):463-468.

  12. Duff DL, Camping DL,Ahmed LB. Evaluating satisfaction with maternity care in women from minority ethnic communities: Development and validation of a Sylheti questionnaire. Int J Quality Health Care 2001;13(3):215-230.

  13. Barón EO, Dushenat M, Friedman N. Evaluation of the consumer model: Relationship between patients expectations, perceptions and satisfaction with care. Int J Quality Health Care 2001:13(4):317-323.

  14. Dellana SA, Glascoff DW.The impact of health insurance plan type on satisfaction with health care. Health Care Manag Rev 2001;26(2): 33-46.

  15. Sánchez PHJ, Ochoa DLH, García GMM, Martín MM. Bienestar social y servicios de salud en la Región Fraylesca de Chiapas: el uso de servicios de atención prenatal. Salud Publica Mex 1997;39:530-538.

  16. Sánchez PHJ, Ochoa DLH, Navarro IGA, Martin MM. La atención del parto en Chiapas, México: ¿dónde y quién los atiende? Salud Publica Mex 1998;40:494-502.

  17. Donabedian A. Quality, cost, and cost containment. Nurs Outlook 1984;32:142-145.

  18. Gómez DO, Garrido LF,Tirado GLL, Ramírez D, Macias C. Abastecimiento de medicamentos en unidades de primer nivel de atención de la Secretaría de Salud de México. Salud Publica Mex 2001;43:224-232.

  19. Mant J. Process versus outcome indicators in the assessment of quality of health care. Int J Quality Health Care 2001; 13(6):475-480.

  20. Ruelas BE, Zurita GB. Nuevos horizontes de la calidad de la atención a la salud. Salud Publica Mex I 993;35(3):235-237.

  21. Ruelas BE, Reyes ZH, Zurita GB,Vidal PLM, Karschmer S. Círculos de calidad como estrategia de un programa de la atención médica en el Instituto Nacional de Perinatología. Salud Publica Mex 1990;32:207-220.

  22. Ruelas BE,Vidal PLM. Unidad de garantía de calidad. Estrategia para asegurar niveles óptimos en la calidad de la atención médica. Salud Publica Mex 1990:32:225-231.

  23. Bobadilla JL. Quality of perinatal medical care in Mexico City. Cuernavaca, Morelos, México: Instituto Nacional de Salud Pública; Perspectivas en Salud Pública No. 3 .

  24. Garza EME, Rodríguez CMS,Villarreal RE, Salinas MAM, Núñez RGM. Patrón de uso de los servicios de atención prenatal, parto y puerperio en una institución de seguridad social mexicana. Rev Esp Salud Publica 2003;77:267-274.

  25. Secretaría de Salud. Programa Nacional de Salud 2001-2006. La democratización de la salud en México. México, DF: SSA, Gobierno de la República, 2000:25-77.

  26. Secretaría de Salud. México Salud 2001. México, DF: SSA, 2002.

  27. Fundación Mexicana para la Salud. Diagnóstico basal de calidad: hospitales y centros de salud urbanos y rurales de la Secretaría de Salud. México, DF: FUNSALUD, 1999.

  28. Zurita B, Nigenda G, Ramírez T. Encuesta de satisfacción con los servicios de salud 1994. En: Frenk J, ed. Observatorio de la salud. México, DF: Fundación Mexicana para la Salud, 1997.

  29. Bollini S. No real progress towards equity: Health of migrants and ethnic minorities on the eve of the year 2000. Soc Sci Med 1995;(41)6:819-828.

  30. Kennedy B, Kawachi I, Prothrow D. Income distribution and mortality. En: Kawachi I, Ed.The society and population health Reader. Income, inequality and health.The New Press, 1999.

  31. Starfield B. Improving equity in health:A research agenda. lnt) Health Services 2001;31(3):545-566.

  32. Sen A. Health in development. Keynote address in the Fifty-second World Health Assembly; 1999 May 18; Ginebra, Suiza:1-8.

  33. Rodgers, GB. Income inequality as determinant of mortality:An international cross-section analysis. lnt) Epidemiol 2002;31:533-538.




2020     |     www.medigraphic.com