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Evaluación de los programas de residencia obstétrica utilizando los resultados de las pacientes

David A Asch¹, Sean Nicholson, Sindhu Srinivas

¹Center for Health Equity Research and Promotion, Philadelphia Veterans Affairs Medical Center, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA 19104-6218, USA. asch@wharton.upenn.edu

|September 24, 2009

Resumen

Los programas de residencia en obstetricia y ginecología se pueden clasificar por las tasas de complicaciones de los pacientes. Esta métrica de calidad de la atención es estable e independiente de las puntuaciones de los exámenes de licencia de médicos.

Área de la Ciencia:

Educación médica y educación médica.
Obstetricia y Ginecología.
La seguridad del paciente.

Sus antecedentes:

El rendimiento del hospital y el médico se evalúa por los resultados del paciente.
Los programas de residencia tradicionalmente usan medidas no clínicas para la comparación.

Objetivo del estudio:

Determinar si los programas de residencia en obstetricia y ginecología pueden evaluarse en función de la calidad de la atención proporcionada por sus alumnos.
Investigando el vínculo entre la capacitación en residencia y los resultados de los pacientes en obstetricia.

Principales métodos:

Análisis retrospectivo de 4.906.169 descargas obstétricas en la Florida y Nueva York (1992-2007). análisis retrospectivo de 4.906.169 descargas obstétricas en la Florida y Nueva York (1992-2007). análisis retrospectivo de 4.906.169 descargas obstétricas en la Florida y Nueva York (1992-2007). análisis retrospectivo de 4.906.169 descargas obstétricas en la Florida y Nueva York (1992-2007).
Examinó a 4.124 obstetras de 107 programas de residencia en los Estados Unidos.
Utilizó nueve medidas de complicaciones maternas para partos vaginales y cesáreas.

Principales resultados:

La variación significativa en las tasas de complicaciones maternas se asoció con los programas de residencia de obstetras.
Los graduados de programas de menor rango tuvieron una tasa de complicaciones un 3,3% más alta en comparación con los programas de mayor rango.
Las clasificaciones de los programas se mantuvieron consistentes a través de diferentes medidas de complicación y no fueron influenciadas por los puntajes de los exámenes de licencia.

Conclusiones:

Los programas de residencia en obstetricia y ginecología se pueden clasificar efectivamente utilizando las tasas de complicaciones maternas de los pacientes de sus graduados.
Estas clasificaciones proporcionan una medida estable y objetiva de la calidad del programa.
Las métricas de calidad de la atención son independientes del rendimiento del examen de licencias de residentes.

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