[Evaluation of quality at the first health care level]

A study of the quality of the health care process was carried out in three types of general practices: outpatients clinics, rural clinics and health centers. Data were collected from 6,163 protocols collected from the patients during the medical visit, and positive and negative parameters were elaborated from them. The highest quality was found in the health centers; there was a marked difference between them favoring the second one, in which the results were: 75.6% of medical acts, a mean time of 9 minutes 23 seconds for medical act; 65.5% of physical examinations; 15.6% of systematic medical examinations and 4.3% of questionably needed drug therapies. The satisfaction of the user was also evaluated by means of 421 questionnaires administered to the general population. Satisfaction was greatest in the health centers for the accessibility and service character, in the outpatients clinics for the perception of one's own health status, and there were no differences between the three types of centers for helpfulness and professional skill.