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[一级医疗保健中的产前护理:影响用户满意度的提供者特征]

[Prenatal care at the first level of care: characteristics of providers that affect users' satisfaction].

作者信息

Bronfman-Pertzovsky Mario Norberto, López-Moreno Sergio, Magis-Rodríguez Carlos, Moreno-Altamirano Alejandra, Rutstein Shea

机构信息

Centro de Investigación en Sistemas de Salud, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.

出版信息

Salud Publica Mex. 2003 Nov-Dec;45(6):445-54.

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. The English version of this paper is available at:http://www.insp.mx/salud/index.html.

摘要

目的

评估墨西哥初级卫生服务中产前护理使用者的满意度,并根据提供者和服务的特征比较满意度水平。

材料与方法

进行了一项横断面调查,以分析217对护理提供者 - 用户的数据。在墨西哥八个州的95个初级保健单位进行了访谈。通过以下方式收集信息:a)直接观察医疗问诊过程,b)与提供者和使用者进行访谈,c)向提供者发放问卷和进行知识考核。根据提供者的临床能力和就诊期间接受的治疗分析使用者的满意度。计算了主要问题的汇总和离散指标,以及双变量和趋势分析。

结果

产前护理的使用者满意度与就诊期间接受的治疗以及就诊前的等待时间有关,但与提供者的临床能力、年龄或性别无关。就诊期间接受的治疗也与使用者的社会经济水平有关,较贫困的使用者接受的治疗最差。

结论

卫生服务应根据医疗问诊类型评估使用者的满意度,特别是在资源稀缺和存在经济差距的情况下。在这种情况下,医疗服务的提供可能会加剧不平等,对最贫困者的影响更大。本文的英文版本可在以下网址获取:http://www.insp.mx/salud/index.html。

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