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Cortés-Ramírez R, Ruíz-Velasco CB, González-Ojeda A, Ramírez-Aguado RA, Barrera-López NG, Gómez-Mejía E, Toala-Díaz K, Delgado-Hernández G, López-Bernal NE, Tavares-Ortega JA, Chejfec-Ciociano JM, Cervantes-Guevara G, Cervantes-Cardona G, Cervantes-Pérez E, Ramírez-Ochoa S, Nápoles-Echauri A, Álvarez-Villaseñor AS, Cortés-Flores AO, Fuentes-Orozco C. External urology consultation quality at a third-level public hospital in Mexico. Actas Urol Esp 2024; 48:289-294. [PMID: 38159803 DOI: 10.1016/j.acuroe.2023.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 10/16/2023] [Accepted: 10/17/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Patient satisfaction is the degree of conformity with the healthcare they receive. It is real evidence and one of the most important factors in determining the effectiveness and quality of healthcare systems. OBJECTIVE To identify the quality of care in the Urology outpatient department of a third-level hospital. MATERIALS AND METHODS The NHS (National Health Service) 2018 quality of care questionnaire with 11 sections, 133 items, and duration of approximately 25min was randomly administered to 250 patients attending Urology outpatients at a third-level public hospital in Mexico. RESULTS According to responses, 92% (n=230) knew the reason for the consultation. 64.8% (n=162) had a consultation with the same physician by whom they were initially seen. The longest reported hospital wait time before being seen was more than 2h in 29.6% (n=74). As for consultation time, 212 patients responded and the duration was 11-20min in 52.8% (n=112). Finally, 33.2% (n=83) considered the quality of service to be good. CONCLUSIONS The use of the NHS 2018 survey in the Urology service at a third-level public hospital in Mexico is feasible, since we managed to obtain a significant and continuous improvement in all its indicators which is satisfactory for all.
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Affiliation(s)
- R Cortés-Ramírez
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Servicio de Urología, Guadalajara, Jalisco, Mexico
| | - C B Ruíz-Velasco
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Servicio de Urología, Guadalajara, Jalisco, Mexico
| | - A González-Ojeda
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Unidad de Investigación Biomédica 02, Guadalajara, Jalisco, Mexico
| | - R A Ramírez-Aguado
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Unidad de Investigación Biomédica 02, Guadalajara, Jalisco, Mexico
| | - N G Barrera-López
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Unidad de Investigación Biomédica 02, Guadalajara, Jalisco, Mexico
| | - E Gómez-Mejía
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Unidad de Investigación Biomédica 02, Guadalajara, Jalisco, Mexico
| | - K Toala-Díaz
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Unidad de Investigación Biomédica 02, Guadalajara, Jalisco, Mexico
| | - G Delgado-Hernández
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Unidad de Investigación Biomédica 02, Guadalajara, Jalisco, Mexico
| | - N E López-Bernal
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Unidad de Investigación Biomédica 02, Guadalajara, Jalisco, Mexico
| | - J A Tavares-Ortega
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Unidad de Investigación Biomédica 02, Guadalajara, Jalisco, Mexico
| | - J M Chejfec-Ciociano
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Unidad de Investigación Biomédica 02, Guadalajara, Jalisco, Mexico
| | - G Cervantes-Guevara
- Departamento de Bienestar y Desarrollo Sustentable, Centro Universitario del Norte, Universidad de Guadalajara, Colotlán, Jalisco, Mexico
| | - G Cervantes-Cardona
- Departamento de Disciplinas Filosóficas, Metodológicas e Instrumentales, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - E Cervantes-Pérez
- Departamento de Medicina Interna, Hospital Civil de Guadalajara «Fray Antonio Alcalde», Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - S Ramírez-Ochoa
- Departamento de Medicina Interna, Hospital Civil de Guadalajara «Fray Antonio Alcalde», Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - A Nápoles-Echauri
- Departamento de Disciplinas Filosóficas, Metodológicas e Instrumentales, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - A S Álvarez-Villaseñor
- Coordinación Auxiliar Médica de Investigación en Salud, Instituto Mexicano del Seguro Social, La Paz, BCS, Mexico
| | - A O Cortés-Flores
- Departamento de Cirugía Oncológica, ONKIMIA, Guadalajara, Jalisco, Mexico
| | - C Fuentes-Orozco
- Instituto Mexicano del Seguro Social, Hospital de Especialidades Centro Médico Nacional de Occidente, Unidad de Investigación Biomédica 02, Guadalajara, Jalisco, Mexico.
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Padget M, Peters MA, Brunn M, Kringos D, Kruk ME. Health systems and environmental sustainability: updating frameworks for a new era. BMJ 2024; 385:e076957. [PMID: 38688557 DOI: 10.1136/bmj-2023-076957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/02/2024]
Affiliation(s)
- Michael Padget
- Massachusetts General Hospital Center for the Environment and Health, Boston, MA, USA
| | | | - Matthias Brunn
- Laboratory for Interdisciplinary Evaluation of Public Policies (LIEPP), Sciences Po, Paris, France
| | - Dionne Kringos
- Department of Public and Occupational Health, University of Amsterdam, Amsterdam, Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, Netherlands
| | - Margaret E Kruk
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
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Medina-Ranilla J, Espinoza-Pajuelo L, Mazzoni A, Roberti J, García-Elorrio E, Leslie HH, García PJ. A systematic review of population and patient perspectives and experiences as measured in Latin American and Caribbean surveys. Health Policy Plan 2023; 38:1225-1241. [PMID: 37803966 DOI: 10.1093/heapol/czad083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 07/20/2023] [Accepted: 09/11/2023] [Indexed: 10/08/2023] Open
Abstract
High-quality health systems must provide accessible, people-centred care to both improve health and maintain population trust in health services. Furthermore, accurate measurement of population perspectives is vital to hold health systems accountable and to inform improvement efforts. To describe the current state of such measures in Latin America and the Caribbean (LAC), we conducted a systematic review of facility and population-based assessments that included patient-reported experience and satisfaction measures. Five databases were searched for publications on quantitative surveys assessing healthcare quality in Spanish- or Portuguese-speaking LAC countries, focusing on the domains of processes of care and quality impacts. We included articles published since 2011 with a national sampling frame or inclusion of multiple subnational regions. We tabulated and described these articles, identifying, classifying and summarizing the items used to assess healthcare quality into the domains mentioned earlier. Of the 5584 publications reviewed, 58 articles met our inclusion criteria. Most studies were cross-sectional (95%), assessed all levels of healthcare (57%) and were secondary analyses of existing surveys (86%). The articles yielded 33 unique surveys spanning 12 LAC countries; only eight of them are regularly administered surveys. The most common quality domains assessed were satisfaction (in 33 out of 58 articles, 57%), evidence-based/effective care (34%), waiting times (33%), clear communication (33%) and ease of use (31%). Items and reported ratings varied widely among instruments used, time points and geographical settings. Assessment of patient-reported quality measures through population- and facility-based surveys is present but heterogeneous in LAC countries. Satisfaction was measured frequently, although its use in accountability or informing quality improvement is limited. Measurement of healthcare quality in LAC needs to be more systematic, regular, comprehensive and to be led collaboratively by researchers, governments and policymakers to enable comparison of results across countries and to effectively inform policy implementation.
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Affiliation(s)
- Jesús Medina-Ranilla
- School of Public Health and Administration, Epidemiology, STD and HIV Unit, Cayetano Heredia University (UPCH), Honorio Delgado Av. 430, San Martín de Porres, Lima 150135, Peru
| | - Laura Espinoza-Pajuelo
- School of Public Health and Administration, Epidemiology, STD and HIV Unit, Cayetano Heredia University (UPCH), Honorio Delgado Av. 430, San Martín de Porres, Lima 150135, Peru
| | - Agustina Mazzoni
- Health Care Quality and Patient Safety Department, Institute for Clinical Effectiveness and Health Policy (IECS), Dr. Emilio Ravignani 2024, Buenos Aires C1414CPV, Argentina
| | - Javier Roberti
- Health Care Quality and Patient Safety Department, Institute for Clinical Effectiveness and Health Policy (IECS), Dr. Emilio Ravignani 2024, Buenos Aires C1414CPV, Argentina
| | - Ezequiel García-Elorrio
- Health Care Quality and Patient Safety Department, Institute for Clinical Effectiveness and Health Policy (IECS), Dr. Emilio Ravignani 2024, Buenos Aires C1414CPV, Argentina
| | - Hannah Hogan Leslie
- Division of Prevention Science, Department of Medicine, University of California, San Francisco, 550 16th St., Floor 4, San Francisco, CA 94143, United States
| | - Patricia Jannet García
- School of Public Health and Administration, Epidemiology, STD and HIV Unit, Cayetano Heredia University (UPCH), Honorio Delgado Av. 430, San Martín de Porres, Lima 150135, Peru
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Almeida PFD, Casotti E, Silvério RFL. Care trajectories of COVID-19 patients: from preventive measures to rehabilitation. CAD SAUDE PUBLICA 2023; 39:e00163222. [PMID: 36820728 DOI: 10.1590/0102-311xpt163222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/09/2023] [Indexed: 02/19/2023] Open
Abstract
This study aims to analyze the care trajectories of patients diagnosed with COVID-19 who were hospitalized and are currently undergoing rehabilitation regarding their use of and access to the healthcare network (HN). An evaluative, qualitative study was carried out based on interviews with patients in the city of Niterói, Rio de Janeiro State, Brazil. The care trajectories were reconstructed at three different occasions that express their experiences with the healthcare and support network during the pandemic: prevention, support and diagnosis measures; hospitalization; post-COVID-19 care, rehabilitation and support. The results indicate that the main source of information about COVID-19 was TV newscasts. Preventive hygiene measures were the most widely adopted. The family was the main support network. There was no waiting time for admission to the municipal referral hospital. Hospitalization was very well evaluated in terms of user embracement, multidisciplinary care, virtual visits and daily contact between doctor and family members. A post-discharge "care vacuum" was identified, with no follow-up by primary health care (PHC) and other public services. Low-cost health insurance plans and private specialized post-COVID-19 services were frequently and spontaneously sought until the implementation of the rehabilitation service. In summary, solitary and discontinuous care trajectories of individuals and families shed light on several challenges to the health system, including guaranteed access to coordinated PHC and expanded offer of specialized public services and rehabilitation, aligned with the principles of humanized care, in addition to the maintenance of social support measures.
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Affiliation(s)
| | - Elisete Casotti
- Instituto de Saúde Coletiva, Universidade Federal Fluminense, Niterói, Brasil
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Almeida PFD, Casotti E, Silvério RFL. Care trajectories of COVID-19 patients: from preventive measures to rehabilitation. CAD SAUDE PUBLICA 2023. [DOI: 10.1590/0102-311xen163222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
This study aims to analyze the care trajectories of patients diagnosed with COVID-19 who were hospitalized and are currently undergoing rehabilitation regarding their use of and access to the healthcare network (HN). An evaluative, qualitative study was carried out based on interviews with patients in the city of Niterói, Rio de Janeiro State, Brazil. The care trajectories were reconstructed at three different occasions that express their experiences with the healthcare and support network during the pandemic: prevention, support and diagnosis measures; hospitalization; post-COVID-19 care, rehabilitation and support. The results indicate that the main source of information about COVID-19 was TV newscasts. Preventive hygiene measures were the most widely adopted. The family was the main support network. There was no waiting time for admission to the municipal referral hospital. Hospitalization was very well evaluated in terms of user embracement, multidisciplinary care, virtual visits and daily contact between doctor and family members. A post-discharge “care vacuum” was identified, with no follow-up by primary health care (PHC) and other public services. Low-cost health insurance plans and private specialized post-COVID-19 services were frequently and spontaneously sought until the implementation of the rehabilitation service. In summary, solitary and discontinuous care trajectories of individuals and families shed light on several challenges to the health system, including guaranteed access to coordinated PHC and expanded offer of specialized public services and rehabilitation, aligned with the principles of humanized care, in addition to the maintenance of social support measures.
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Almeida PFD, Silva KS, Bousquat A. Specialized care and health transport from a Health Care Network integration perspective. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-812320222710.07432022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of this study was to analyze the organization and provision of specialized care (SC) and health transport in regional polyclinics in the state of Bahia, Brazil. We conducted a qualitative exploratory single case study of a polyclinic based on semi-structured interviews with key informants in municipal and state health services. We sought to identify elements that characterize network-based models of SC. A number of advances were identified, including: an increase in the provision of SC and the scope and quality of services; effective retention of health professionals; provision of health transport; monitoring of SC; and improvements in the regulation of access to care through the use of computerized systems. The following challenges were observed: tailoring SC planning to regional health needs; the promotion of care coordination by Primary Health Care (PHC); the development of strategies to improve communication between SC and PHC professionals; institutionalization of counter-referral; engagement between the polyclinic and spaces for citizen participation; and fostering matrix support, permanent education, teaching-service integration, and research. Despite the intrinsic challenges of SC and the need to strengthen the central role of PHC, the regional polyclinic arrangement is better suited to the integration of the health care networks.
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Almeida PFD, Silva KS, Bousquat A. Specialized care and health transport from a Health Care Network integration perspective. CIENCIA & SAUDE COLETIVA 2022; 27:4025-4038. [PMID: 36134808 DOI: 10.1590/1413-812320222710.07432022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 06/09/2022] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to analyze the organization and provision of specialized care (SC) and health transport in regional polyclinics in the state of Bahia, Brazil. We conducted a qualitative exploratory single case study of a polyclinic based on semi-structured interviews with key informants in municipal and state health services. We sought to identify elements that characterize network-based models of SC. A number of advances were identified, including: an increase in the provision of SC and the scope and quality of services; effective retention of health professionals; provision of health transport; monitoring of SC; and improvements in the regulation of access to care through the use of computerized systems. The following challenges were observed: tailoring SC planning to regional health needs; the promotion of care coordination by Primary Health Care (PHC); the development of strategies to improve communication between SC and PHC professionals; institutionalization of counter-referral; engagement between the polyclinic and spaces for citizen participation; and fostering matrix support, permanent education, teaching-service integration, and research. Despite the intrinsic challenges of SC and the need to strengthen the central role of PHC, the regional polyclinic arrangement is better suited to the integration of the health care networks.
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Affiliation(s)
- Patty Fidelis de Almeida
- Instituto de Saúde Coletiva, Universidade Federal Fluminense. R. Marquês de Paraná 303, 3º andar, anexo ao Hospital Universitário Antônio Pedro (Huap), Centro. 24220-000 Niterói RJ Brasil.
| | - Kamilla Santos Silva
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia. Vitória da Conquista BA Brasil
| | - Aylene Bousquat
- Faculdade de Saúde Pública, Universidade de São Paulo. São Paulo SP Brasil
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A decade of service development: audit of service users' experience of a rural Psychiatry of Later Life (POLL) service. Ir J Med Sci 2021; 191:347-354. [PMID: 33709308 DOI: 10.1007/s11845-021-02540-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 02/02/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION The HSE "Vision for change", national service plan and other policies emphasise the importance of incorporating the views of service users and carers in the design and delivery of mental health services. AIMS To obtain the views of service users in relation to a rural POLL service. Compare our service to best practice and address issues identified. Repeat the audit cycle based on recommendations. METHODOLOGY New referrals to the POLL service were identified, and a pseudo-anonymised audit tool questionnaire was posted to these patients after initially making a telephone contact and obtaining informed consent. Results were compared to standards set by our team based on local and national policies. We used Microsoft Excel and performed a thematic analysis of qualitative data in the fourth cycle. This audit has been repeated on four occasions: 2012, 2013, 2016 and 2019. RESULTS More than 90% of patients marked as being benefited by the POLL team. Overall, most positive responses pertained to supportive and professional staff, resolution of disease symptoms, psycho-education and attentive follow-up whereas negative responses were in relation to limited access to disabled parking spaces, perceived inadequate discharge planning and non-resolution of disease symptoms in few patients. CONCLUSION Involving POLL patients in audit provided useful insights to improve the quality of service. We resolved the issue of disabled parking access and have developed a service information leaflet and a discharge leaflet. We intend to focus more on psychoeducation and discharge planning based on the results of the current cycle.
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