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 evaluating the quality of care for femoral fractures, and to assess the contribution of the quality of health care as a determinant of partial permanent inability secondary to femoral fractures due to occupational accidents. MATERIALS AND METHODS...
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| Format: | Article |
| Language: | English |
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Instituto Nacional de Salud Pública
2001-01-01
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| Series: | Salud Pública de México |
| Subjects: | |
| Online Access: | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0036-36342001000200005 |
| _version_ | 1818022738660425728 |
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| author | Salinas-Tovar Santiago Reyes-Frausto Sandra Aguilar-Salinas Alberto López-Marmolejo Alberto Hernández-Leyva Blanca E. López-Rojas Pablo |
| author_facet | Salinas-Tovar Santiago Reyes-Frausto Sandra Aguilar-Salinas Alberto López-Marmolejo Alberto Hernández-Leyva Blanca E. López-Rojas Pablo |
| author_sort | Salinas-Tovar Santiago |
| collection | DOAJ |
| description | OBJECTIVE: To construct and validate an indicator for evaluating the quality of care for femoral fractures, and to assess the contribution of the quality of health care as a determinant of partial permanent inability secondary to femoral fractures due to occupational accidents. MATERIALS AND METHODS: The study was conducted from January to December 1995 at Mexican Institute of Social Security. The instrument was designed with experts' contribution along different stages and validated using implicit criteria and factorial analysis. A case-control study was then conducted to evaluate the contribution of the quality of care to inability secondary to femoral fractures. Cases were 108 active workers with permanent inability secondary to femoral fracture; controls were 94 active workers with fracture of femur but no permanent inability. Logistic regression modeling was used to establish the association between quality of care and partial permanent inability, adjusting by relevant variables. RESULTS: The ultimate indicator of quality of care consisted of the following: Timely care, pre-surgical management, surgical management, and fracture complications. A final score over 229 points meant that the worker had received good quality of care. Workers getting 229 or less points had received poor quality of care. Forty-eight (44%) cases and 66 (70%) controls received good quality of medical care. The likelihood of partial permanent inability was almost three times higher among workers given poor quality of care (OR 2.95; 95% CI 1.5 - 5.5). According to the multivariate model, predictors of partial permanent inability were: Having exposed or epiphysiary fractures, being re-submitted to surgery, having less than 90 days of rehabilitation care, and receiving deficient medical care. CONCLUSIONS: The constructed instrument was validated. The level of the quality of care received by workers is a determining factor for the generation of partial permanent inability. In workers having femoral fractures, it is important to consider timely medical care and early rehabilitation, to reduce the high incidence and prevalence of this medical problem in Mexico. The English version of this paper is available too at: <A HREF="http://www.insp.mx/salud/index.html">http://www.insp.mx/salud/index.html</A> |
| first_indexed | 2024-12-10T03:33:12Z |
| format | Article |
| id | doaj.art-ef0bd874be0a49f88367b506f98db10b |
| institution | Directory Open Access Journal |
| issn | 0036-3634 |
| language | English |
| last_indexed | 2024-12-10T03:33:12Z |
| publishDate | 2001-01-01 |
| publisher | Instituto Nacional de Salud Pública |
| record_format | Article |
| series | Salud Pública de México |
| spelling | doaj.art-ef0bd874be0a49f88367b506f98db10b2022-12-22T02:03:47ZengInstituto Nacional de Salud PúblicaSalud Pública de México0036-36342001-01-01432108112Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidentsSalinas-Tovar SantiagoReyes-Frausto SandraAguilar-Salinas AlbertoLópez-Marmolejo AlbertoHernández-Leyva Blanca E.López-Rojas PabloOBJECTIVE: To construct and validate an indicator for evaluating the quality of care for femoral fractures, and to assess the contribution of the quality of health care as a determinant of partial permanent inability secondary to femoral fractures due to occupational accidents. MATERIALS AND METHODS: The study was conducted from January to December 1995 at Mexican Institute of Social Security. The instrument was designed with experts' contribution along different stages and validated using implicit criteria and factorial analysis. A case-control study was then conducted to evaluate the contribution of the quality of care to inability secondary to femoral fractures. Cases were 108 active workers with permanent inability secondary to femoral fracture; controls were 94 active workers with fracture of femur but no permanent inability. Logistic regression modeling was used to establish the association between quality of care and partial permanent inability, adjusting by relevant variables. RESULTS: The ultimate indicator of quality of care consisted of the following: Timely care, pre-surgical management, surgical management, and fracture complications. A final score over 229 points meant that the worker had received good quality of care. Workers getting 229 or less points had received poor quality of care. Forty-eight (44%) cases and 66 (70%) controls received good quality of medical care. The likelihood of partial permanent inability was almost three times higher among workers given poor quality of care (OR 2.95; 95% CI 1.5 - 5.5). According to the multivariate model, predictors of partial permanent inability were: Having exposed or epiphysiary fractures, being re-submitted to surgery, having less than 90 days of rehabilitation care, and receiving deficient medical care. CONCLUSIONS: The constructed instrument was validated. The level of the quality of care received by workers is a determining factor for the generation of partial permanent inability. In workers having femoral fractures, it is important to consider timely medical care and early rehabilitation, to reduce the high incidence and prevalence of this medical problem in Mexico. The English version of this paper is available too at: <A HREF="http://www.insp.mx/salud/index.html">http://www.insp.mx/salud/index.html</A>http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0036-36342001000200005femoral fracturequality of carepermanent disabilityoccupational accidentsMexico |
| spellingShingle | Salinas-Tovar Santiago Reyes-Frausto Sandra Aguilar-Salinas Alberto López-Marmolejo Alberto Hernández-Leyva Blanca E. López-Rojas Pablo Effect of the quality of health care on permanent inability secondary to femoral fractures due to occupational accidents Salud Pública de México femoral fracture quality of care permanent disability occupational accidents Mexico |
| title | 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_short | 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 |
| topic | femoral fracture quality of care permanent disability occupational accidents Mexico |
| url | http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0036-36342001000200005 |
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