Comparison of users of the closed Hospital do Desterro with former users of Hospital de São José in the access to the Outpatient Department of Internal Medicine consultation – Part II: differences in the realized access

摘要

Context: Following the Hospital do Desterro (HD) closure, the main attention of this study is focused on Outpatient Department of Internal Medicine (MI) and its integration in the Hospital de São José (HSJ).Purpose: The general purpose of this paper is, in this second part, to compare the realized access at HSJ Outpatient Department of Internal Medicine from users of HD Outpatient Department of Internal Medicine (in the three months prior to the transfer of the department) with those who were already users of HSJ Outpatient Department before the integration of both departments. Population and methods: This is an epidemiological, cross-sectional and analytical study, where selection was made through random sampling proportionally stratified from the two study groups, according to gender and age of the population, previously analyzed, with a final size equal to 256 elements for each group. Data collection was performed for the two groups by administering a questionnaire by telephone, preceded by the sending of a registered letter explaining the outlines of the study. Data analysis was performed by comparing the two groups using de chi-square test for homogeneity and independence, ANOVA one-way and ordinal regression. Main findings: Significant differences in realized access were found between group I (HD) and group II (HSJ) particularly with regard to the number of appointments in 2008 at HSJ to which the user has not shown, the perception about the quality of care by the administrative, the waiting time before consultation, the level of perceived quality about the information received from the physician about one’s own health, the involvement in the therapeutic decision, the fulfillment of the expectations, the overall perceived quality, the overall satisfaction, the loyalty and the likelihood to recommend the HSJ service to family members, friends or colleagues.Conclusion: The closure of HD and the subsequent transfer of Outpatient Department of Internal Medicine to HSJ had a negative effect on important components of performed access such as the use of services, the perceived quality of the service, the satisfaction, the loyalty and the recommendation to family members, friends or colleagues.