Objective: To identify and assess factors associated with the quality of health care in hospital outpatient services within the state of Hidalgo, Mexico, based on a user survey.
Methods: We performed a cross-sectional, comparative, analytical study of 15 public hospitals within the state of Hidalgo, Mexico. The sample, which was made up of 9 936 interviewees (power: 85%; significance level: 95%) was randomly selected among users of outpatient services between July 1999 and December 2000. We looked at the quality of care using a Likert-type scale. The statistical analysis consisted of inconditional logistic regression.
Results: The quality of care was perceived as being good by 71,37% of users surveyed and as bad by 28,63%. Poor quality was primarily perceived in institutions belonging to the social security system (39,41% vs. 19,42% in other institutions). Of those surveyed, 84,94% said they were satisfied with the care they received, and 49,2% said they expected to get better care. In all, 16% claimed they would return to the same hospital only because they had no other choice, and 2% said they would never return. A higher educational level and a better income showed a direct association with the perception of poor quality and discontent with the lenghty waiting period (odds ratio [OR]: 2,3; 95% CI: 2,02 to 2,82) and with the physician's discourteous attitude (OR: 4,22; 95% CI: 3,6-4,8).
Conclusions: They main factors that determine poor quality in health care, according to users, are lengthy waiting times before being ushered in, incomplete physical examination and diagnosis, difficulty of getting an appointment, and poor treatment on the part of services staff.