Graduate Program in Administration, Universidade Paulista, São Paulo 04026-002, Brazil.
Faculty of Tourism and Rural Development in Pozega, Josip Juraj University in Osijek, Vukovarska 17, 31000 Pozega, Croatia.
Int J Environ Res Public Health. 2024 Jul 8;21(7):887. doi: 10.3390/ijerph21070887.
This study reviewed different country studies and noted that complaints in Brazil are more concentrated in complaints about being attended to and receiving access to services, rather than about clinical quality and safety issues. This paper explores the possible explanations for these differences based on the institutional logics theory and which logics actors privilege, and how they may play out in the healthcare field. To accomplish this undertaking, this study makes use of the healthcare complaint categorization developed by Reader and colleagues, which has been used by various studies. Next, a set of studies about healthcare complaints in different countries was examined to analyze the issues most common in the complaints and compare this information with the Brazilian data. This study identified three explanations why complaints about medical errors seldom occur. One group of studies highlights the hardships of local health systems. Another focuses on patient behavior. Finally, the third kind focuses on the issue of power to determine health orientation. The studies about a lack of resources do not directly explain why fewer complaints about clinical quality occur, thus helping to stress the management issues. Patient behavior studies indicate that patients may be afraid to point out medical errors or may be unaware of the procedures of how to do so, suggesting that family logic is left out of the decisions in the field. The third group of work highlights the prominence of the medical professional logic, both in terms of regulation and medical exercise.
这项研究回顾了不同国家的研究,并指出巴西的投诉更集中在投诉就诊和获得服务方面,而不是临床质量和安全问题。本文基于制度逻辑理论探讨了这些差异的可能解释,以及哪些逻辑参与者享有特权,以及它们在医疗保健领域可能如何发挥作用。为了完成这项任务,本研究使用了 Reader 及其同事开发的医疗保健投诉分类,该分类已被各种研究使用。接下来,检查了一组关于不同国家医疗保健投诉的研究,以分析投诉中最常见的问题,并将这些信息与巴西的数据进行比较。本研究确定了为什么很少发生医疗错误投诉的三个解释。一组研究强调了当地卫生系统的困难。另一组侧重于患者行为。最后,第三种类型侧重于决定健康方向的权力问题。关于资源匮乏的研究并没有直接解释为什么关于临床质量的投诉较少,这有助于强调管理问题。患者行为研究表明,患者可能害怕指出医疗错误,或者可能不知道如何提出投诉的程序,这表明家庭逻辑在该领域的决策中被忽略了。第三组工作强调了医学专业逻辑的突出地位,无论是在监管还是医学实践方面。