Epidemiology of medical complaints in Mexico: identifying a general profile.

OBJECTIVE

To determine the problems that were the sources of the complaints most frequently received at the National Commission of Medical Arbitration (CONAMED) in Mexico, as well as the diagnoses most frequently related, the institutions involved, and the populations affected.

DESIGN

From all complaints received from 1 January 1998 to 31 December 2000, we chose a random sample of 639 complaints and carried out our study using a cross-sectional design.

SETTING

CONAMED receives complaints from Mexico City and the surrounding areas.

PARTICIPANTS

Patients attending public and private health institutions from the three levels of medical attention who submitted a complaint to the CONAMED in Mexico.

MAIN OUTCOME MEASURES

Assessment of health care quality (good practice or malpractice). Type of malpractice (negligence, lack of skill, or deceit). Main motives of complaint.

RESULTS

We analyzed 639 complaints; 57.6% were submitted by women, average age 41.0 years. Surgical treatment was the main cause of complaint. Most frequent diagnoses were diseases of the digestive system. Evaluation of medical practice revealed 36.5% of malpractice. Lack of skill accounted for 67.4% of those cases.

CONCLUSIONS

Malpractice was identified in a third of the complaints, and lack of skill was the main reason for malpractice. Surgical patients were the most frequently affected. The other two-thirds of the complaints were related to lack of communication between patients and physicians. These results suggest potential points of intervention to decrease the risk and the conflict.