International Journal for Quality in Health Care Advance Access originally published online on March 14, 2006
International Journal for Quality in Health Care 2006 18(3):220-223; doi:10.1093/intqhc/mzl004
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Epidemiology of medical complaints in Mexico: identifying a general profile
1 National Institute of Public Health, Tuberculosis Unit, Cuernavaca, Morelos, 2 National Institute of Medical Sciences and Nutrition, Salvador Zubiran, Subdirection of Hospital Epidemiology and Quality of Medical Care, 3 Mexican Institute of Social Security, IMSS and 4 National Institute of Cancerology, General Direction, D.F., Mexico City, Mexico
Objective. To determine the problems that were the sources of the complaints most frequently received at the National Commission of Medical Arbitration (CONAMED) in Mexico, as well as the diagnoses most frequently related, the institutions involved, and the populations affected.
Design. From all complaints received from 1 January 1998 to 31 December 2000, we chose a random sample of 639 complaints and carried out our study using a cross-sectional design.
Setting. CONAMED receives complaints from Mexico City and the surrounding areas.
Participants. Patients attending public and private health institutions from the three levels of medical attention who submitted a complaint to the CONAMED in Mexico.
Main outcome measures. Assessment of health care quality (good practice or malpractice). Type of malpractice (negligence, lack of skill, or deceit). Main motives of complaint.
Results. We analyzed 639 complaints; 57.6% were submitted by women, average age 41.0 years. Surgical treatment was the main cause of complaint. Most frequent diagnoses were diseases of the digestive system. Evaluation of medical practice revealed 36.5% of malpractice. Lack of skill accounted for 67.4% of those cases.
Conclusions. Malpractice was identified in a third of the complaints, and lack of skill was the main reason for malpractice. Surgical patients were the most frequently affected. The other two-thirds of the complaints were related to lack of communication between patients and physicians. These results suggest potential points of intervention to decrease the risk and the conflict.
Keywords: malpractice, negligence, patient complaint
Address reprint requests to Maria-Eugenia Jimenez-Corona, Instituto Nacional de Salud Publica, Av. Universidad No. 655, Col. Sta. Maria Ahuacatitlan, C.P. 62508, Cuernavaca, Morelos, Mexico. E-mail: ejimenez{at}correo.insp.mx
Accepted for publication February 16, 2006.
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