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Boletín Médico del Hospital Infantil de México

2012, Number 3

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Bol Med Hosp Infant Mex 2012; 69 (3)

Hospital structure and its relation to survival in pediatric patients with acute lymphoblastic leukemia

Miranda-Lora AL, Klünder-Klünder M, Ruíz-Cano J, Reyes-López A, Dorantes-Acosta E, Zapata-Tarrés M, Manuell-Lee G, Garduño-Espinosa J, Muñoz-Hernández O

Language: Spanish
References: 26
Page: 205-211
PDF size: 559.74 Kb.


ABSTRACT

Background. Characteristics of medical units that can be considered as ideal standards for pediatric cancer patients have been identified. Implementation of these standards has resulted in improved survival of these patients. As part of the evaluation of the quality of care of pediatric patients with acute lymphoblastic leukemia (ALL) affiliated with the Seguro Popular insurance program, we examined the relationship between hospital structure and patient survival.
Methods. A cross-sectional study was carried out in nine hospitals with different survival rates. We evaluated the structure of the hospitals considering national (accreditation program of the General Administration of Quality and Health Education–DGCES) and international standards.
Results. There was a positive correlation between the score obtained from the accreditation program and hospital survival (r = 0.811, p = 0.001). When considering international reference standards, deficiencies in material and human resources were identified. Factors related to survival were pediatric oncology/hematology fellowship (r = 0.543, p = 0,001), isolation rooms (r = 0.455, p = 0.008), tomography (r = 0.454, p = 0.008), number of patients per physicians and nurses per shift (r = 0.443, p = 0.021), oncology/hematology physicians (r = 0.399, p = 0.021), pediatric infectious disease specialist (r = 0.385, p = 0.027) and pediatric surgeon (r = 0.378, p = 0.030).
Conclusions. The structure of medical units is related to survival of pediatric patients with ALL. It is required that hospitals have human and material resources necessary for the optimal care of these patients.


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