Quality of care and health-related quality of life of climacteric stage women cared for in family medicine clinics in Mexico.
OBJECTIVE
1) To design and validate indicators to measure the quality of the process of care that climacteric stage women receive in family medicine clinics (FMC). 2) To assess the quality of care that climacteric stage women receive in FMC. 3) To determine the association between quality of care and health-related quality of life (HR-QoL) among climacteric stage women.


METHODS
The study had two phases: I. Design and validation of indicators to measure the quality of care process by using the RAND/UCLA Appropriateness Method. II. Evaluation of the quality of care and its association with HR-QoL through a cross-sectional study conducted in two FMC located in Mexico City that included 410 climacteric stage women. The quality of care was measured by estimating the percentage of recommended care received (PRCR) by climacteric stage women in three process components: health promotion, screening, and treatment. The HR-QoL was measured using the Cervantes scale (0-155). The association between quality of care and HR-QoL was estimated through multiple linear regression analysis.


RESULTS
The lowest mean of PRCR was for the health promotion component (24.1%) and the highest for the treatment component (86.6%). The mean of HR-QoL was 50.1 points. The regression analysis showed that in the treatment component, for every 10 additional points of the PRCR, the global HR-QoL improved 2.8 points on the Cervantes scale (coefficient -0.28, P < 0.0001).


CONCLUSIONS
The indicators to measure quality of care for climacteric stage women are applicable and feasible in family medicine settings. There is a positive association between the quality of the treatment component and HR-QoL; this would encourage interventions to improve quality of care for climacteric stage women.
Unidad de Investigación Epidemiológica y Servicios de Salud Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México DF, México. svetlana.doubova@imss.gob.mx
Svetlana
S
Vladislavovna Doubova Dubova
Sergio
S
Flores-Hernández
Leticia
L
Rodriguez-Aguilar
Ricardo
R
Pérez-Cuevas
D002979:Climacteric / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion / Q000379:methods / Q000592:standards; D006304:Health Status; D006801:Humans; D008019:Life Style; D008800:Mexico; D008875:Middle Aged; D009752:Nutritional Status; D017060:Patient Satisfaction; D019984:Quality Indicators, Health Care / Q000592:standards*; D011788:Quality of Life / Q000523:psychology*; D012044:Regression Analysis; D017584:Reproductive History; D012944:Social Support; D016387:Women's Health