Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidents
Objective. To construct and validate an indicator for evaluatingthe quality of care for femoral fractures, and to assessthe contribution of the quality of health care as adeterminant of partial permanent inability secondary tofemoral fractures due to occupational accidents. Materialsand methods. The...
| Autores: | , , , , , |
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| Tipo de recurso: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2001 |
| País: | México |
| Institución: | Instituto Mexicano del Seguro Social |
| Repositorio: | Redalyc-IMSS |
| OAI Identifier: | oai:redalyc.org:10643207 |
| Acceso en línea: | https://www.redalyc.org/articulo.oa?id=10643207 |
| Access Level: | acceso abierto |
| Palabra clave: | Salud Mexico quality of care permanent disability occupational accidents Key words: femoral fracture |
| Sumario: | Objective. To construct and validate an indicator for evaluatingthe quality of care for femoral fractures, and to assessthe contribution of the quality of health care as adeterminant of partial permanent inability secondary tofemoral fractures due to occupational accidents. Materialsand methods. The study was conducted from Januaryto December 1995 at Mexican Institute of Social Security.The instrument was designed with experts contributionalong different stages and validated using implicit criteriaand factorial analysis. A case-control study was then conductedto evaluate the contribution of the quality of careto inability secondary to femoral fractures. Cases were 108active workers with permanent inability secondary to femoralfracture; controls were 94 active workers with fractureof femur but no permanent inability. Logistic regressionmodeling was used to establish the association betweenquality of care and partial permanent inability, adjustingby relevant variables. Results. The ultimate indicator ofquality of care consisted of the following: Timely care, presurgicalmanagement, surgical management, and fracturecomplications. A final score over 229 points meant that theworker had received good quality of care. Workers getting229 or less points had received poor quality of care. Forty-eight (44%) cases and 66 (70%) controls received good qualityof medical care. The likelihood of partial permanent inabilitywas almost three times higher among workers givenpoor quality of care (OR 2.95; 95% CI 1.5 - 5.5). Accordingto the multivariate model, predictors of partial permanentinability were: Having exposed or epiphysiary fractures,being re-submitted to surgery, having less than 90 days ofrehabilitation care, and receiving deficient medical care. Conclusions.The constructed instrument was validated. Thelevel of the quality of care received by workers is a determiningfactor for the generation of partial permanent inability.In workers having femoral fractures, it is important toconsider timely medical care and early rehabilitation, to reducethe high incidence and prevalence of this medical problemin Mexico. The English version of this paper is availabletoo at: http://www.insp.mx/salud/index.html |
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