Las quejas y reclamaciones como elemento de participación del paciente en su propia salud y seguridad

Abstract

"Patient-centered care" concept is based on recognizing the active role of patients in making decisions about their health, and clinical decisions should include the patient's perspective. The reflection on the current situation of patients forms of participation in the Spanish health system, leads us to consider that there is a practically unique provider, so the patient can't choose a provider based on their experiences and preferences and has to look for other forms of participation. Complaints and claims usefulness is due to that are a source to identify improvement opportunities and they are also a good way to increase the satisfaction and loyalty of users who complain, when they see that their complaints are taken into account and have been properly managed. Nursing, as guarantor of patient-centered care, must encourage patients and their family participation in health and illness processes as users of the health system. The objectives of this study are to analyze claims and complaints documentation as an improvement opportunity. To identify the most relevant reasons for our users to complaint during the years 2012 to 2015, in a local hospital in Murcia's Autonomous Community. Determine nursing claims. To identify if there is association between claims produced, and professionals to which the claims are addressed. Identify association between age and sex of the claimant with type of complaints and claims and the service where the complaint is addressed. Identify failures in patient safety claims in the studied center. The used methodology has been the study of all claims received in the hospital during the years 2012 to 2015 whit quantitative, retrospective, cross-sectional and descriptive study. Results in this investigation show us that women claim more than men, being the main reasons for claiming the waiting list, assistance delay, planning, organization and coordination, the received treatment, diagnosis and / or treatment disagreement, hostelry and reasons related to incidents in patient safety, these seven reasons are 90% of total claims. Most of claims are not directed to a specific professional estate, but when they do, the main reasons to claim are diagnosis and treatment disagreement and the received treatment in case of physician, and vice versa in nursing case. Claims related to patient safety during the years we have studied have accounted for 2.6% of total claims. The most complained professional state has been the medical establishment. Claimant sociodemographic variables, sex and age, are associated with the activity for which they claim, the reason to complaint, the service that it is claimed and the professional state to which the claim is addressed. With the results of this investigation, we can conclude that claim rate is low. At the same time that claims related to a professional establishment have been decreasing, those claims directed to the global organization of assistance have been increasing. Women claim more than men, but that it's due to female gender role will have to be confirmed with future researches, as well as a greater awareness of women to demand the quality they want in the assistance. Age and sex of person who claims are related to the reasons claiming, the care activity, and the services to which they refer. Nursing, the most numerous professional group in hospital is not the one who receives most claims, it is the medical professional, what make us think that economic situation may be the principal cause, and this raises new studies.