Un estudio de reclamos hospitalarios: el rol de la relación médico-paciente

Abstract

A study of hospital complaints and the role of the doctor-patient communication Background: Medical practice in Chile has changed dramatically over the last few years. Patients have raised their expectations and there is a growing number of complaints, and malpractice lawsuits. The doctor-patient relationship plays a fundamental role in patient satisfaction and has also been identifi ed as an issue in most medical lawsuits. Aim: To analyze the importance of doctor-patient communication in the complaints received in a university hospital in Chile. Material and Methods: Review of all complaints received at the offi ce for quality of care at a university hospital. Complaints classifi ed in delay, manners and information categories were selected for further analysis. Results: Of a total of 8931 complaints registered between 2001 and 2008, 635 (19%) involved a doctor. Fifty one per cent of the latter, were related to the doctor-patient relationship. Of these, 146 cases (45%) were further classifi ed as "Dysfunctional delivery of Information", 74 cases (23%) as "Not understanding the patient/family's perspective", 54 cases (17%) as "Discrediting the patient or family's views" and 49 cases (15%) as "Lack of communication". Conclusions: The percentage of complaints related to communication with the doctor is high, though lower than cited in other studies. The most common complaint is the dysfunctional delivery of information.

Effects of and Prospects for the Hierarchical Medical Policy in Beijing, China

“…However, although the hierarchical medical policy has improved workloads, healthcare workers continue to report severe job stress. Challenge stress is still high among healthcare workers in all types of hospitals, and especially in tertiary hospitals because the number of patients and their expectations for quality of care are rising [ 30 , 31 ]. Moreover, frequent incidents of medical violence and the large variety of work tasks increase challenge stress [ 32 ].…”

Reclamos por atención en salud. Experiencia en un centro privado

“…Finalmente, dado que, en el contexto social actual, el respeto por el otro se sitúa como uno de los principales valores a defender y procurar, existe un gran espacio para reducir las tasas de reclamos debido a lo que hemos llamado falla en el trato y comunicación con el médico y que en otras publicaciones son englobadas como menoscabo en el "trato digno" 6,[12][13][14] . Debemos reforzar la formación integral de los médicos, con el fin de que las situaciones de conflicto por asuntos relativos a las relaciones humanas, que se dan en el binomio paciente-médico, se minimicen y eventualmente, desaparezcan 15 .…”

“…La tasa de reclamos por atenciones efectuadas, su naturaleza y la forma de resolverlos habitualmente queda en los registros internos de los centros. En Chile, de experiencia de prestadores privados, sólo conocemos la publicada por Moore et al 6 en el Hospital Clínico de la Pontificia Universidad Católica de Chile, el año 2011. El objetivo del presente trabajo es analizar las causas y manejo de los reclamos en un centro privado de salud, también universitario, que presentaron pacientes o sus familiares, de acuerdo al derecho de las personas, consagrado por la referida Ley 20.584.…”

Event-based versus process-based informed consent to address scientific evidence and uncertainties in ionising medical imaging

“…Research has shown that effective patient-physician communication can improve health outcomes [42–45]. On the other hand, a lack of physician-patient communication also generates more recurrent medical litigations [46–49]. The event-based model is considered ineffective [37, 41, 50, 51], additionally contributing to inappropriateness, as only written information is provided and this does not necessarily imply that patients are truly informed about the risks and benefits of the examination and potential alternatives [52, 53].…”