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...

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Autores: Santiago Salinas, Alberto Aguilar, Alberto López, Blanca E. Hernández, Sandra Reyes, Pablo López
Formato: artículo
Estado:Versión publicada
Fecha de publicación:2001
País:México
Recursos:Instituto Mexicano del Seguro Social
Repositorio:Redalyc-IMSS
OAI Identifier:oai:redalyc.org:10643207
Acesso em linha:https://www.redalyc.org/articulo.oa?id=10643207
Access Level:acceso abierto
Palavra-chave:Salud
Mexico
quality of care
permanent disability
occupational accidents
Key words: femoral fracture
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oai_identifier_str oai:redalyc.org:10643207
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network_name_str México
spelling Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidents Santiago Salinas Alberto Aguilar Alberto López Blanca E. Hernández Sandra Reyes Pablo López Salud Mexico quality of care permanent disability occupational accidents Key words: femoral fracture 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 Instituto Nacional de Salud Pública 0036-3634 https://www.redalyc.org/articulo.oa?id=10643207
title Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidents
spellingShingle Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidents
Santiago Salinas
Salud
Mexico
quality of care
permanent disability
occupational accidents
Key words: femoral fracture
title_short Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidents
title_full Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidents
title_fullStr Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidents
title_full_unstemmed Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidents
title_sort Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidents
author Santiago Salinas
author_facet Santiago Salinas
Alberto Aguilar
Alberto López
Blanca E. Hernández
Sandra Reyes
Pablo López
author_role author
author2 Alberto Aguilar
Alberto López
Blanca E. Hernández
Sandra Reyes
Pablo López
author2_role author
author
author
author
author
topic Salud
Mexico
quality of care
permanent disability
occupational accidents
Key words: femoral fracture
topic_facet Salud
Mexico
quality of care
permanent disability
occupational accidents
Key words: femoral fracture
description 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
publishDate 2001
format article
status_str publishedVersion
url https://www.redalyc.org/articulo.oa?id=10643207
identifier_str_mv 0036-3634
eu_rights_str_mv openAccess
publisher Instituto Nacional de Salud Pública
institution IMSS
collection Redalyc-IMSS
reponame_str Redalyc-IMSS
instname_str Instituto Mexicano del Seguro Social
_version_ 1878409727543607297
publishDateSort 2001
author_browse Alberto Aguilar
Alberto López
Blanca E. Hernández
Pablo López
Sandra Reyes
Santiago Salinas
publisherStr Instituto Nacional de Salud Pública
score 6,8972664

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