Fatores que influenciam a satisfação do paciente ambulatorial em uma população de baixa renda: um estudo de base populacional

[Determinants of satisfaction with the care provided by Basic Health Units (BHU)]

The scope of this paper is to analyze the determinants of satisfaction with the care provided by Basic Health Units (BHU). The data were extracted from the external evaluation microdata of the National Program for Improvement of Access and Quality of Primary Care (PIAQ) for the year 2013. The results revealed that individuals in better financial standing tend to be less satisfied with the care provided by the UBS. In addition to this, evaluating variables such as waiting times for consultation, respect for the patient and the guarantee of privacy, it becomes clear that the improvement in the perception of care provided by the UBS can be achieved with better administration of resources, namely without increasing financial overheads. Lastly, it becomes apparent that individuals value the care provided more than the infrastructure of the UBS when asked to evaluate care.

Demand for health services or professionals among Brazilian adolescents according to the National School Health Survey 2015

INTRODUCTION

Knowing the profile of individuals who demand health services or professionals could help in the improvement and reorganization of services. However, this subject is still underexplored among adolescents. This study aimed to describe and identify characteristics related to the demand for health services or professionals by Brazilian students.

METHODS

Using data from the 2015 National School Health Survey, the prevalence and respective 95% confidence intervals (95%CI) of the demand for health services or professionals among students were estimated, and Poisson regression adjusted by age and region of residence was used to identify the associated factors.

RESULTS

More than half of the students demanded for health services or professionals in the last year, with a higher demand among females. The characteristics associated with the outcome were sociodemographic (female, white, private school), family (maternal schooling of 12 years or more, having meals with parents/guardians and parents' knowledge of the adolescent's activities in their free time), risk behaviors (alcohol consumption and sexual intercourse without a condom) and health-related issues (physical violence, wheezing, toothache, hygiene habits, and attitude to one's own weight).

CONCLUSION

Organizing health services in a way that takes the particularities of this population into account may provide a space to deal with subjects related to the risks to which it is exposed.

A satisfação do usuário na avaliação de serviços de saúde: ensaio sobre a imposição de problemática

RESUMO Pesquisas de satisfação de usuários encontram-se colocadas atualmente como uma das principais estratégias para a participação, proteção e defesa dos direitos do usuário dos serviços públicos, a despeito da existência de um conjunto de evidências reportadas na literatura internacional há mais de quatro décadas, que questionam a validade de tais abordagens. O presente ensaio tem por objetivo contribuir para a compreensão de alguns aspectos negligenciados sobre o significado dos inquéritos de satisfação do usuário e seus resultados, particularmente sobre o paradoxo da elevada satisfação encontrada como resultado dessas pesquisas. Esse fenômeno será analisado por meio de uma analogia com as sondagens de opinião, discutindo a hipótese de que a elevada satisfação, descrita na literatura, pode representar um artefato de pesquisa decorrente de uma imposição de problemática, no sentido discutido por Bourdieu (1973) e Champagne (1998). As respostas obtidas não correspondem necessariamente a representações sociais ou percepções relativas aos serviços, mas às reações dos usuários à situação de pesquisa, caracterizando-se como uma resposta forçada frente às condições de realização dos inquéritos.

Evaluation of the satisfaction of users of a service specialized in diabetes mellitus

OBJECTIVE

to evaluate the satisfaction of users of a service that specializes in diabetes mellitus.

METHOD

evaluative research, with mixed approach, developed at the Integrated Center for Diabetes and Hypertension of Barbalha-CE, in the period from 2011 to 2014, with 97 users. Data concerning the characterization and satisfaction of users in relation to the dimensions of infrastructure, accessibility and the user-health team relationship were collected.

RESULTS

77.3% were older adults, 88.7% women and 84.8%, retired. 63.9% of the users were satisfied with the service; however, dissatisfaction with the dimensions of infrastructure (offices, equipment and medicines) and accessibility (laboratory tests and medical consultations) was reported.

FINAL CONSIDERATIONS

most users revealed be satisfied with the service received considering the dimensions analyzed. However, studies that assess the satisfaction of users need to contemplate the participants' reports and not rely on the use of previously structured forms only.

Hearing Health Care: perception of the users of a public service

Purpose

Evaluate hearing health service under the users' perspective according to the aspects: access, care, communication, and professional competence, and its correlation with clinical, sociodemographic and assistance characteristics.

Methods

This is an observational analytic cross-sectional study with a probability sample stratified by gender and age. The Hearing Health Care Assessment questionnaire and the Brazilian Economic Classification Criterion questionnaire were used. In total, 214 users were interviewed, which were assisted from May 2009 to May 2013.

Results

It was observed that most of the evaluated users are female, elderly, literate, presenting moderate degree of hearing impairment, who had access to transportation out-of-pocket, was submitted to ENT evaluation for diagnosis and sought the service to purchase a hearing aid, besides belonging to class C. Regarding user satisfaction, most were satisfied with access, hearing evaluation, personalized service, benefit for the family, communication and information, and professional competence. In the analysis of correlation between the scores, it was found that when users are satisfied with access, as well as with communication and information, the total score increases with moderate correlation coefficient.

Conclusion

The users showed greater satisfaction with the professional competence domain and lower satisfaction with the benefit for the family. In addition, assessment proved that access and communication are considered important quality indicators for the hearing health service according to users.

Assessing women's satisfaction with family planning services in Mozambique

Background

The contraceptive prevalence rate in Mozambique was estimated as 11.3% in the last Demographic and Health Survey. The impact of family planning (FP) on women's health and on the reduction of maternal mortality is well known.

Methods

Acknowledging the importance of user satisfaction in the utilisation of health services, exit interviews were used to assess women's satisfaction with FP services in Mozambique. The survey, conducted in 174 health facilities, was representative at the national level, covered all provinces, and both urban and rural areas.

Results

Overall, 86% of respondents were satisfied with FP services, but issues such as insufficient supplies of oral contraceptives and the low quality of healthcare provider/client interactions were given as reasons for women's dissatisfaction.

Conclusion

Defined actions at the level of health service provision are needed to tackle the identified issues and ensure improved satisfaction with, and better utilisation of, FP services in Mozambique.

Percepção da população brasileira sobre a assistência prestada pelo médico. Brasil, 2013

Resumo O objetivo foi analisar a percepção dos usuários sobre a consulta médica, utilizando as informações da Pesquisa Nacional de Saúde, 2013. Entre os que se consultaram com médico nos últimos 12 meses, foram analisados 12 aspectos relacionados aos serviços de saúde e à consulta médica, segundo o local de atendimento (público/privado). Por meio de regressão logística multivariada, foram estabelecidos os fatores associados à insatisfação com o atendimento recebido. Para a redução de dimensionalidade dos aspectos avaliados, utilizou-se análise de componentes principais. A PNS revelou que 74,2% se consultou com médico. Entre as diferenças por local de atendimento, destacaram-se a forma de obtenção da consulta, o tipo de médico, o tempo de espera, e o motivo da consulta. Os escores medianos se concentraram em 80 (bom), com exceção do tempo de espera entre os usuários do SUS. Proporções de avaliação muito boa foram, porém, maiores entre os usuários do setor privado. O atendimento por médicos generalistas foi significativamente associado à insatisfação. Apesar da avaliação positiva em ambos os setores, público e privado, a configuração das Unidades da Federação no plano formado pelos dois eixos principais seguiu um padrão de marcantes desigualdades regionais.

Quality of emergency rooms and urgent care services: user satisfaction

Objective

To evaluate the quality of emergency rooms and urgent care services according to the satisfaction of their users.

Methods

A cross-sectional descriptive study with a quantitative approach. The sample comprised 136 users and was drawn at random. Data collection took place between October and November 2012 using a structured questionnaire.

Results

Participants were mostly male (64.7%) aged less than 30 years (55.8%), and the predominant level of education was high school (54.4%). Among the items evaluated, those that were statistically associated with levels of satisfaction with care were waiting time, confidence in the service, model of care, and the reason for seeking care related to acute complaints, cleanliness, and comfortable environment.

Conclusion

Accessibility, hospitality, and infrastructure were considered more relevant factors for patient satisfaction than the cure itself.