Background
Methods
Study variables
Domains | Specialty consultation | Surgery |
---|---|---|
I. Client focus | Waiting time for outpatient consultation in hospital outpatient area ≤ 30 min | Waiting time between referral to surgery and actual surgery is ≤20 completed waiting days History of surgery postponement(s) |
II. Respect | Courtesy: Specialist greeted the patient at the beginning of the consultation Clear communication: Specialist gave the patient an opportunity to talk about health-related concerns Specialist listened to the patient with attention and without interruptions Specialist clearly answered patient questions Specialist resolved patient doubts about health-related self-care | Courtesy: Surgeon greeted patient before surgery Clear communication: Surgeon explained the risks and benefits of surgery Surgeon gave clear information to the patient’s relatives |
III. Competent care | Specialist performed clinical examination | |
IV. Quality of basic amenities | Hospital cleanliness was very good or good | Hospital cleanliness was very good or good |
V. Quality impact | Quality impact on financial risk protection: Patient received all prescribed medicines in the hospital pharmacy free due to their coverage by IMSS health insurance (reference group did not have any prescription to fulfill) | Quality impact on health: Patient did not have complications that required another surgery |
Statistical analysis
Results
Variables | Total n = 6713 Weighted % |
---|---|
Socio-demographic and clinical characteristics | |
Women | 69.6 |
Age groups | |
≤ 35 years | 23.7 |
> 35 & ≤44 years | 16.7 |
> 44 & ≤64 years | 38.0 |
≥ 65 years | 21.6 |
Schooling | |
Incomplete elementary school or without formal education | 12.5 |
Compete elementary school | 22.4 |
Complete secondary school or higher | 65.1 |
Region of residence according to the socio-economic level | |
Stratum 1 (lowest socio-economic level) | 3.8 |
Stratum 2 | 12.2 |
Stratum 3 | 10.6 |
Stratum 4 | 21.1 |
Stratum 5 | 13.3 |
Stratum 6 | 21.4 |
Stratum 7 (highest socio-economic level) | 17.6 |
Level of healthcare in which service was received | |
Secondary | 83.3 |
Tertiary | 16.7 |
Type of specialty consultation | |
Medical-surgical consultation | 56.4 |
Clinical specialties consultation | 43.6 |
Cause of specialty consultation | |
Diseases of the genitourinary system | 11.6 |
Injury, poisoning and other consequences of external causes | 11.0 |
Neoplasms | 8.3 |
Diseases of the musculoskeletal system and connective tissue | 8.2 |
Diseases of the circulatory system | 7.7 |
Endocrine, nutritional and metabolic diseases | 7.1 |
Diseases of the eye and adnexa | 6.4 |
Diseases of the respiratory system and diseases of the ear | 5.3 |
Pregnancy, childbirth and the puerperium | 5.5 |
Mental, behavioural disorders and diseases of the nervous system | 4.6 |
Diseases of the digestive system | 3.8 |
Other diseases | 5.4 |
Factors influencing health status and contact with health services | 7.2 |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified | 7.9 |
Users experience with outpatient consultation | |
I. Client focus | |
Waiting time ≤ 30 min | 59.2 |
II. Respect | |
Specialist greeted patient at the beginning of the consultation | 81.6 |
Specialist gave the patient an opportunity to talk about health-related concerns | 87.9 |
Specialist listened to the patient with attention and without interruptions | 89.4 |
Specialist answered clearly patient’s questions | 90.7 |
Specialist resolved patient’s doubts about health-related self-care | 80.9 |
III. Competent care | |
Specialist performed clinical examination | 75.0 |
IV. Quality of basic amenities | |
Hospital’s cleanliness | |
Good, very good | 78.3 |
Regular, bad or terrible | 21.7 |
V. Quality impact on financial risk protection | |
Patients received all prescribed medicines in the hospital pharmacy | |
Yes | 47.2 |
No | 2.8 |
Did not have any prescription to fill | 50.0 |
Overall satisfaction | |
Satisfied with consultation | 83.0 |
Variables | Total n = 528 |
---|---|
Weighted % | |
Socio-demographic and clinical characteristics | |
Women | 60.3 |
Age groups | |
≤ 35 years | 29.3 |
> 35 & ≤ 44 years | 20.6 |
> 44 & ≤64 years | 32.6 |
≥ 65 years | 17.5 |
Schooling | |
Incomplete elementary school or without formal education | 11.5 |
Compete elementary school | 16.6 |
Complete secondary school or higher | 71.9 |
Region of residence according to the socio-economic level | |
Stratum 1 (lowest socio-economic level) | 1.6 |
Stratum 2 | 12.6 |
Stratum 3 | 5.1 |
Stratum 4 | 24.1 |
Stratum 5 | 15.6 |
Stratum 6 | 20.7 |
Stratum 7 (highest socio-economic level) | 20.3 |
Level of healthcare in which surgery was performed | |
Secondary | 82.6 |
Tertiary | 17.4 |
Cause of surgery | |
Diseases of the digestive system | 24.6 |
Diseases of the genitourinary system | 13.7 |
Diseases of the musculoskeletal system and connective tissue | 12.8 |
Injury, poisoning and other consequences of external causes | 8.9 |
Diseases of the eye and adnexa | 8.2 |
Other types of diseases and cesarean section | 17.4 |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified | 14.4 |
Users experience with surgery | |
I. Client focus | |
Wait time between recommendation for surgery and actual surgery ≤20 days | 71.1 |
History of surgery postponement(s) | 11.1 |
II. Respect | |
Surgeon greeted patient before a surgery | 82.2 |
Surgeon explained the risks and benefits of a surgery | 87.2 |
Surgeon gave clear information to the patient’s relatives | 85.8 |
III. Quality of basic amenities | |
Hospital’s cleanliness very good or good | 76.4 |
IV. Quality impact on health | |
Patient had complications that required another surgery | 13.0 |
Overall satisfaction | |
Satisfied with surgery | 86.6 |
TYPE OF ANALYSIS | Bivariable analysis | Simple double-weighted Poisson regression analysis | Multiple double-weighted Poisson regression analysis | |
---|---|---|---|---|
VARIABLES | Satisfied n = 5738 | Dissatisfied n = 975 | Crude PR (95% CI) | Adjusted PR (95% CI) |
Weighted % | Weighted % | |||
Users experience with outpatient consultation | ||||
I. Client focus | ||||
Wait time* | ||||
≤ 30 min | 87.8 | 12.2 | 1.15 (1.11; 1.90) | 1.11 (1.07; 1.14) |
> 30 min | 76.1 | 23.9 | Ref. | Ref. |
II. Respect | ||||
Specialist greeted patient at the beginning of the consultation* | ||||
Yes | 85.8 | 14.2 | 1.21 (1.15; 1.28) | 1.04 (0.99; 1.09) |
No | 70.7 | 29.3 | Ref | Ref. |
Specialist gave the patient an opportunity to talk about health-related concerns* | ||||
Yes | 85.1 | 14.9 | 1.25 (1.17; 1.34) | 1.11 (1.03; 1.19) |
No | 67.8 | 32.2 | Ref. | Ref. |
Specialist listened to the patient with attention and without interruptions* | ||||
Yes | 85.8 | 14.3 | 1.44 (1.32; 1.56) | 1.16 (1.05; 1.29) |
No | 59.7 | 40.3 | Ref. | Ref. |
Specialist answered clearly patients’ questions* | ||||
Yes | 85.5 | 14.5 | 1.46 (1.34; 1.59) | 1.17 (1.04; 1.31) |
No | 58.6 | 41.4 | Ref. | Ref. |
Specialist resolved patients´ doubts about the health-related self-care* | ||||
Yes | 86.5 | 13.5 | 1.27 (1.20; 1.34) | 1.16 (1.11; 1.22) |
No | 68.3 | 31.7 | Ref. | Ref. |
III. Competent care | ||||
Specialist performed clinical examination* | ||||
Yes | 58.5 | 14.5 | 1.13 (1.09; 1.18) | 1.06 (1.02; 1.11) |
No | 75.6 | 24.4 | Ref. | Ref. |
IV. Quality of basic amenities | ||||
Hospital’s cleanliness* | ||||
Good, very good | 87.1 | 12.9 | 1.28 (1.21; 1.34) | 1.19 (1.14; 1.26) |
Regular, bad or terrible | 68.2 | 31.8 | Ref. | Ref. |
V. Quality impact on financial risk protection | ||||
Patients received all prescribed medicines in the hospital pharmacy* | ||||
Yes | 83.5 | 16.4 | 1.16 (1.03; 1.31) | 1.09 (0.97; 1.21) |
No | 71.8 | 28.2 | Ref. | Ref. |
Did not have any prescription to fulfill | 83.2 | 16.8 | 1.16 (1.03; 1.30) | 1.11 (0.99; 1.23) |
Covariates | ||||
Patients’ socio-demographic and clinical characteristics | ||||
Men | 83.6 | 16.4 | 0.99 (0.96; 1.02) | 1.00 (0.97; 1.03) |
Women | 82.8 | 17.2 | Ref. | Ref. |
Age groups* | ||||
≤ 35 years | 82.9 | 17.1 | Ref. | Ref. |
> 35 & ≤ 44 years | 81.3 | 18.7 | 0.98 (0.93, 1.03) | 1.00 (0.97; 1.04) |
> 44 & ≤64 years | 82,1 | 17.9 | 0.99 (0.95, 1.03) | 1.01 (0.97; 1.05) |
≥ 65 years | 86.2 | 13.8 | 1.04 (0.99, 1.08) | 1.04 (0.99; 1.09) |
Schooling | ||||
Incomplete elementary school or without formal education | 85.3 | 14.7 | 1.04 (0.99; 1.08) | 1.02 (0.98; 1.06) |
Compete elementary school | 84.1 | 15.9 | 1.02 (0.99; 1.06) | 1.01 (0.97; 1.05) |
Complete secondary school or higher | 82.2 | 17.8 | Ref. | Ref. |
Region of residence* | ||||
Stratum 1 | 87.2 | 12.8 | 1.07 (1.01; 1.13) | 1.09 (1.01; 1.17) |
Stratum 2 | 83.3 | 16.7 | 1.02 (0.97; 1.07) | 1.00 (0.95; 1.05) |
Stratum 3 | 82,6 | 17.4 | 1.01 (0.95; 1.07) | 1.03 (0.98; 1.08) |
Stratum 4 | 83.8 | 16.2 | 1.02 (0.97; 1.08) | 1.06 (1.01; 1.12) |
Stratum 5 | 79.1 | 20.9 | 0.97 (0.91; 1.03) | 1.03 (0.96; 1.10) |
Stratum 6 | 81.8 | 18.2 | Ref. | Ref. |
Stratum 7 | 85.9 | 14.1 | 1.05 (0.99; 1.10) | 1.04 (0.99; 1.08) |
Level of healthcare* | ||||
Secondary | 81.8 | 18.2 | Ref. | Ref. |
Tertiary | 89.4 | 10.6 | 1.09 (1.07; 1.12) | 1.08 (1.05; 1.11) |
Type of specialty consultation | ||||
Medical-surgical consultation | 82.1 | 17.9 | 1.03 (0.99; 1.05) | 1.02 (0.99; 1.06) |
Clinical specialties consultation | 84.2 | 15.8 | Ref. | Ref. |
Cause of specialty consultation | ||||
Neoplasms | 83.8 | 16.2 | 1.04 (0.97; 1.13) | 1.05 (0.98; 1.12) |
Endocrine, nutritional and metabolic diseases | 87.3 | 12.7 | 1.09 (1.01; 1.17) | 1.07 (0.99; 1.14) |
Mental, behavioural disorders and diseases of the nervous system | 86.3 | 13.7 | 1.08 (0.99; 1.17) | 1.08 (0.98; 1.19) |
Diseases of the eye and adnexa | 81.2 | 18.8 | 1.01 (0.93; 1.10) | 1.00 (0.93; 1.08) |
Diseases of the respiratory system and diseases of the ear | 83.9 | 16.1 | 1.05 (0.98; 1.14) | 1.04 (0.96; 1.13) |
Diseases of the circulatory system | 83.6 | 16.4 | 1.04 (0.96; 1.13) | 1.01 (0.93; 1.09) |
Diseases of the digestive system | 81.1 | 18.9 | 1.01 (0.92; 1.11) | 1.00 (0.91; 1.10) |
Diseases of the musculoskeletal system and connective tissue | 78.9 | 21.1 | 0.98 (0.91; 1.07) | 1.01 (0.93; 1.10) |
Diseases of the genitourinary system | 84.6 | 15.4 | 1.05 (0.98; 1.13) | 1.07 (1.004; 1.14) |
Pregnancy, childbirth and the puerperium | 85.2 | 14.8 | 1.06 (0.98; 1.15) | 1.04 (0.97; 1.11) |
Injury, poisoning and other consequences of external causes | 80.1 | 19.9 | 0.99 (0.93; 1.07) | 1.02 (0.96; 1.09) |
Other diseases | 85.5 | 14.5 | 1.06 (0.98; 1.16) | 1.07 (0.98; 1.15) |
Factors influencing health status and contact with health services | 83.6 | 16.4 | 1.04 (0.96; 1.12) | 1.02 (0.95; 1.10) |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified | 80.2 | 19.8 | Ref. | Ref. |
TYPE OF ANALYSIS | Bivariable analysis | Simple double-weighted Poisson regression analysis | Multiple double-weighted Poisson regression analysis | |
---|---|---|---|---|
VARIABLES | Satisfied n = 457 | Dissatisfied n = 71 | Crude PR (95% CI) | Adjusted PR (95% CI) |
Weighted % | Weighted % | |||
Users experience with a surgery | ||||
I. Client focus | ||||
Waiting time | ||||
≤ 20 days | 86.6 | 13.4 | 1.05 (0.93; 1.18) | 1.04 (0.93; 1.17) |
≥ 21 days | 84.1 | 15.9 | Ref. | |
Previous surgery postponement(s)* | ||||
Yes | 67.7 | 32.3 | Ref. | Ref. |
No | 88.1 | 11.9 | 1.26 (0.99; 1.60) | 1.24 (1.002; 1.54) |
II. Respect | ||||
Surgeon greeted patient before a surgery* | ||||
Yes | 88.6 | 11.4 | 0.82 (0.69; 0.98) | 1.10 (0.94; 1.30) |
No | 73.1 | 26.9 | Ref. | Ref. |
Surgeon explained the risks and benefits of a surgery | ||||
Yes | 87.2 | 12.8 | 1.10 (0.95; 1.27) | 0.99 (0.85; 1.15) |
No | 76.5 | 23.5 | Ref. | Ref. |
Surgeon gave clear information to the patient’s relatives* | ||||
Yes | 89.9 | 10.1 | 1.39 (1.12; 1.72) | 1.21 (0.99; 1.49) |
No | 65.8 | 34.2 | Ref. | Ref. |
III. Quality of basic amenities | ||||
Hospital’s cleanliness* | ||||
Very good or good, | 89.4 | 10.6 | 1.21 (1.03; 1.41) | 1.13 (0.98; 1.30) |
Regular, bad or terrible | 74.3 | 25.7 | Ref. | Ref. |
IV. Quality impact on health | ||||
Patient had complications that required another surgery* | ||||
Yes | 63.5 | 36.5 | Ref. | Ref. |
No | 89.2 | 10.8 | 1.38 (1.08; 1.76) | 1.30 (1.03; 1.64) |
Covariates | ||||
Patients’ socio-demographic and clinical characteristics | ||||
Men | 85.8 | 14.2 | 1.00 (0.91; 1.11) | 1.00 (0.93; 1.09) |
Women | 85.9 | 14.1 | Ref. | Ref. |
Age groups | ||||
≤ 35 years | 84.3 | 15.7 | Ref. | Ref. |
> 35 & ≤ 44 years | 81.0 | 19.0 | 0.94 (0.78; 1.13) | 0.97 (0.84; 1.13) |
> 44 & ≤64 years | 86.8 | 13.2 | 1.05 (0.94; 1.18) | 1.04 (0.94; 1.14) |
≥ 65 years | 92.3 | 7.7 | 1.11 (0.98; 1.25) | 1.08 (0.93; 1.25) |
Schooling* | ||||
Incomplete elementary school or without formal education | 93.9 | 6.1 | 1.14 (1.05; 1.24) | 1.07 (0.98; 1.17) |
Compete elementary school | 89.8 | 10.2 | 1.09 (0.99; 1.21) | 1.07 (0.98; 1.17) |
Complete secondary school or higher | 82.0 | 18.0 | Ref. | Ref. |
Region of residence | ||||
Stratum 1 | 93.1 | 6.9 | 1.11 (0.90; 1.37) | 1.23 (1.01; 1.51) |
Stratum 2 | 77.9 | 22.1 | Ref. | Ref. |
Stratum 3 | 92.9 | 7.1 | 1.18 (1.03; 1.35) | 1.13 (0.97; 1.32) |
Stratum 4 | 91.4 | 8.6 | 1.16 (1.02; 1.32) | 1.19 (1.03; 1.38) |
Stratum 5 | 83.1 | 16.9 | 0.99 (0.81, 1.22) | 1.10 (0.90; 1.35) |
Stratum 6 | 82.1 | 17.9 | 1.04 (0.87; 1.24) | 1.06 (0.90; 1.26) |
Stratum 7 | 87.8 | 12.2 | 1.08 (0.91, 1.27) | 1.12 (0.96; 1.30) |
Level of healthcare | ||||
Secondary | 85.1 | 14.9 | Ref. | Ref. |
Tertiary | 89.7 | 10.3 | 1.01 (0.90; 1.14) | 1.04 (0.94; 1.15) |
Cause of surgery | ||||
Diseases of the digestive system | 87.8 | 12.2 | 1.15 (0.92; 1.44) | 1.19 (1.005; 1.41) |
Diseases of the genitourinary system | 78.2 | 21.8 | Ref. | Ref. |
Diseases of the musculoskeletal system and connective tissue | 87.4 | 12.6 | 1.18 (0.94; 1.48) | 1.15 (0.95; 1.38) |
Diseases of the eye and adnexa | 90.6 | 9.4 | 1.24 (1.01; 1.52) | 1.17 (0.95; 1.45) |
Injury, poisoning and other consequences of external causes | 75.4 | 24.6 | 1.03 (0.76; 1.39) | 1.03 (0.85; 1.24) |
Other types of diseases and cesarean section | 87,5 | 12.5 | 1.20 (0.97; 1.47) | 1.13 (0.94; 1.34) |
Symptoms, signs and abnormal clinical and laboratory findings, not elsewhere classified | 90.2 | 9.8 | 1.20 (0.97; 1.48) | 1.13 (0.95; 1.35) |