[Evaluation of the medical care quality. Expectations of the patients and the workers of the medical units].
Quality evaluation as a first step to improve health care is an essential step in the medical process. In the Mexican Social Security Institute (IMSS), this concern was first put into action in 1956, when a review of the medical records was undertaken at the La Raza hospital. The IMSS Medical Supervision Commission was formed in 1957, and in 1959 a medical auditorship was established. Until 1983 quality of care evaluation was centered on the information contained in the medical records. However, based on an extensive bibliographical review, the need to account for other aspects of medical care was then acknowledged, and attention was brought to issues such as the sufficiency and quality of the physical resources, availability and technical proficiency of human resources, supply of materials, organization of services, fulfillment of procedures according to current quality of care normativity, and optimization of results, all within a frame of humanitarian treatment of the patient. Quality of care can be viewed from three different angles: the patient's, the institution's, and the worker's standpoints. It has been customary to evaluate quality of care from the side of institutional expectations, unattending the other two viewpoints. In this study, a survey was made of 735 external patients, 853 hospitalized patients, and 1,353 workers, from 33 second and third level hospitals in both the federal District and the states, asking levels of satisfaction with the services provided. In the first group the highest percentage of dissatisfaction was related to medical information and doctor-patient relationship. In the hospitalization area the main problems were associated to food and attention by the social worker, but there were also problems in medical information, doctor-patient relationship, and patient orientation. Workers manifested dissatisfaction with wages and working-area conditions, and asked for more institutional support and better motivations.
Aguirre-Gas
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D001291:Attitude of Health Personnel; D003258:Consumer Behavior; D006760:Hospitalization; D006801:Humans; D007588:Job Satisfaction; D008800:Mexico; D011786:Quality Control; D011787:Quality of Health Care; D011795:Surveys and Questionnaires
Evaluación de la calidad de la atención médica. Expectativas de los pacientes y de los trabajadores de las unidades médicas.