[Organizational climate in management teams and its relationship with health care outcomes]. / Clima organizacional de equipos directivos y su relación con los resultados en la atención a la salud.

OBJECTIVE: To identify the relationship between organizational climate of management teams and the performance of health services. MATERIALS AND METHODS: A transversal and analytical study was designed. The Organizational Climate Scale (OCS) was utilized and performance was assessed by the achievement indicators through correlation analysis and multiple regression. Thirty four medical benefits services headquarters (JSPM) were measured of the Mexican Social Security Institute. RESULTS: Of 862 participating, 238 (27.6%) evaluated the climate of their organizations with a high level; the maximal score was 56%. Average performance value was 0.79 ± 0.07 (minimal: 0.65; maximal: 0.92). A positive correlation was demonstrated between organizational climate level and performance (r=0.4; p=0.008). CONCLUSIONS: The organizational climate of the health services managers (JSPM) is directly related with performance in health care.

Clima organizacional de equipos directivos y su relación con los resultados en la atención a la salud / Organizational climate in management teams and its relationship with health care outcomes

Objetivo. Identificar la relación entre el clima organizacional de los equipos directivos y el desempeño de los servicios de salud. Material y métodos. Estudio transversal y analítico. Se utilizó la Escala de Clima Organizacional (EDCO). El desempeño se valoró por el logro de indicadores a través de correlación y regresión múltiple. Se evaluaron 34 jefaturas de servicios de prestaciones médicas del Instituto Mexicano del Seguro Social. Resultados. De 862 participantes, 238 (27.6%) evaluaron el clima de sus organizaciones con nivel alto. El promedio de desempeño fue 0.79±0.07 (mínimo: 0.65; máximo: 0.92). Se muestra una correlación positiva entre clima organizacional y desempeño (r=0.4; p=0.008). Conclusiones. El clima organizacional de las jefaturas de servicios de prestaciones médicas se relaciona con el desempeño en la atención a la salud.

Objective. To identify the relationship between organizational climate of management teams and the performance of health services. Materials and methods. A transversal and analytical study was designed. The Organizational Climate Scale (OCS) was utilized and performance was assessed by the achievement indicators through correlation analysis and multiple regression. Thirty four medical benefits services headquarters (JSPM) were measured of the Mexican Social Security Institute. Results. Of 862 participating, 238 (27.6%) evaluated the climate of their organizations with a high level; the maximal score was 56%. Average performance value was 0.79 ± 0.07 (minimal: 0.65; maximal: 0.92). A positive correlation was demonstrated between organizational climate level and performance (r=0.4; p=0.008). Conclusions. The organizational climate of the health services managers (JSPM) is directly related with performance in health care.

[Factors associated with complaints against physicians working at Mexican Institute of Social Security hospitals]. / Factores asociados a la gestión de quejas contra médicos que laboran en hospitales del Instituto Mexicano del Seguro Social.

OBJECTIVE: To identify the factors associated with complaints of patients against physicians who work at general hospitals of the Mexican Institute of Social Security (MISS). MATERIAL AND METHODS: All the medical complaint files in a three-year period at the nine general hospitals of Mexico State MISS East District were examined. For each complaint filed, two control files were selected from the same hospital and clinical area. Associations were assessed using odds ratios and logistic regression. RESULTS: A total of 130 complaint cases and 260 controls were included. Seven out of 14 risk factors were selected: complications during hospitalization (OR 2.8, 95% CI 1.3-5.8), diagnostic error (OR 3.18, 95% CI 1.7-5.6), use of diagnostic tests (OR 3.7, 95% CI 1.2-11.3), insufficient information given by physicians (OR 2.64, 95% CI 1.22-5.7), voluntary hospital discharge (OR 7.2, 95% CI 2.22-23.6), lack of clinical monitoring during hospitalization (OR 19.12, 95% CI 2.25-162.6), and multiple vaginal revisions during labor (OR 5.17, 95% CI 1.5 17.07). Complaints were filed more often when there was a poor patient-physician relationship, deficient monitoring during labor, therapeutic error, and delay in surgery. Statistical significance was not attained. CONCLUSIONS: Complaints against Mexico State MISS hospital physicians were associated with diagnostic technical factors, as well as with the patients' perception of receiving deficient information and care during hospitalization. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

Factores asociados a la gestión de quejas contra médicos que laboran en hospitales del Instituto Mexicano del Seguro Social / Factors associated with complaints against physicians working at Mexican Institute of Social Security hospitals

OBJETIVO: Identificar los factores asociados a la gestión de quejas contra los médicos que trabajan en hospitales generales del Instituto Mexicano del Seguro Social. MATERIAL Y MÉTODOS: Se revisaron las quejas presentadas y los expedientes clínicos correspondientes, en los nueve hospitales de la Delegación Estado de México Oriente, del Instituto Mexicano del Seguro Social. Por cada expediente clínico con queja se seleccionaron como controles dos expedientes sin queja, de la misma unidad y servicio. Se buscaron asociaciones por medio de razón de momios y regresión logística. RESULTADOS: Se incluyeron 130 expedientes motivo de queja y 260 expedientes control. Se identificaron siete factores asociados a queja de 14 investigados: complicaciones durante la atención RM 2.8 (IC 95 por ciento 1.3-5.8), error diagnóstico RM 3.18 (IC 95 por ciento 1.7-5.6), utilización de estudios de gabinete RM 3.7 (IC 95 por ciento 1.2-11.3), información deficiente por parte del médico RM 2.64 (IC 95 por ciento 1.2-5.7), alta voluntaria RM 7.2 (IC 95 por ciento 2.2-23.6), falta de vigilancia durante la hospitalización RM 19.12 (IC 95 por ciento 2.2-162.6) y revisiones vaginales múltiples durante el trabajo de parto RM 5.17 (IC 95 por ciento 1.5-17.07). Hubo tendencia a la presentación de quejas cuando se reportaron: mala relación médico-paciente, deficiente atención del trabajo de parto, error terapéutico y diferimiento de cirugía, sin significancia estadística. CONCLUSIONES: Las quejas contra médicos de hospitales del Instituto Mexicano del Seguro Social en el Estado de México se asocian con aspectos técnicos en el diagnóstico y con la percepción del derechohabiente de recibir información y vigilancia deficientes durante la hospitalización.