Abstract
Objetivo
Describir las opiniones, vivencias y percepciones en torno a las listas de espera de cirugía electiva de cataratas y de artroplastia de cadera y rodilla entre los ciudadanos de Cataluña
Diseño
Cuatro grupos focales para cada procedimiento
Emplazamiento
Entre los meses de febrero y marzo de 2000, en Cataluña
Participantes
Cada grupo focal incluyó a especialistas (oftalmólogos, traumatólogos, rehabilitadores, reumatólogos, médicos de familia), profesionales relacionados (enfermería, asistentes sociales, médicos de familia, fisioterapeutas, ópticos/optometristas), pacientes y familiares y población general. Los participantes se seleccionaron a partir de los investigadores y los comités científicos clínicos del estudio, de acuerdo con unos criterios de selección preestablecidos
Mediciones principales
El análisis de la información se hizo aplicando la técnica del análisis de contenido (transcripción del contenido de las sesiones, clasificación de la información según las líneas temáticas)
Resultados
Se identificaron 10 líneas temáticas. Entre las principales causas de las listas de espera se mencionaron la falta de recursos, su mala gestión y el conflicto de intereses de los especialistas. Todos coincidieron en que la responsabilidad de la solución es de la Administración, aunque algunos reclaman más participación ciudadana. Para solucionar el problema se propuso la prevención y educación sanitaria, más recursos y una mejor gestión. Se puso de manifiesto una comunicación médico-paciente deficitaria. Los grupos estuvieron en desacuerdo con el actual sistema implícito de priorización, pero ninguno quiso asumir esta responsabilidad
Conclusiones
Los ciudadanos apuntan a que un abordaje multifactorial de las listas de espera podría mitigar el problema y contribuir a su mejor aceptación social
Palabras clave: Participación comunitaria, Opinión pública, Listas de espera, Toma de decisiones, Prioridad quirúrgica, Artoplastia, Cirugía de catarata, Grupo focal
Abstract
Objectives
The aim of this study is to describe the views, perceptions and personal experience around elective cataract and hip and knee replacement waiting lists in Catalonia in order to improve their management
Design
Qualitative methodology: four focus groups for each procedure.Place.Conducted between February-March 2000 at the Catalan Health Services headquarters
Participants
Each focus group included consultants (ophtalmologists, orthopedic surgeons, rheumatologists, rehabilitators, GPs), other related health professionals (nurses, social workers, physiotherapists, opticians/optometrist, GPs), patients and relatives and general population. Participants were selected through researchers and the clinical scientific committees. All of them followed a pre-established inclusion criteria
Main measures
The analysis of the information was performed using the content analysis technique (contents of sessions were transcripted and information classified according to themes)
Results
Ten themes were identified. Waiting lists were argued to be a consequence of lack of resources, bad management and conflict of interest among consultants. Overall, the health care authority responsibility for the solution was acknowledged, although some participants claim more citizen participation. Among proposed solutions, prevention and education, more resources and improved management were found. Furthermore, a better physician-patient communication was considered essential. All the groups disagreed with the implicit current prioritisation system, however none wanted to assume the responsibility
Conclusions
Citizen's perceptions and personal experiences point to a multifactorial approach to waiting lists management, which would ameliorate the problem and lead to a better social acceptance
Key words: Consumer participation, Publicopinion, Waiting lists, Decision making, Surgical priority, Joint replacement surgery, Cataract extraction, Focus group
El estudio ha sido financiado por el Institut Català de la Salut y parcialmente por el Fondo de Investigaciones Sanitarias (01/0921) y por la Fundación para la Investigación de la Visión
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