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El impacto de la capacitación de los proveedores informales de atención médica en la India: un ensayo controlado
Jishnu Das1,2, Abhijit Chowdhury3, Reshmaan Hussam4
1Development Research Group, The World Bank, 1818 H Street, NW, Washington, DC 20433, USA.
Science (New York, N.Y.)
|November 16, 2016
Resumen
La capacitación de proveedores informales de atención de la salud en la India rural mejoró significativamente la gestión correcta de casos. Esta formación médica multitópico ofrece una estrategia eficaz para mejorar la calidad de la atención primaria donde las alternativas son escasas.
Área de la Ciencia:
- Salud global
- Investigación en servicios de salud
- Educación médica
Sus antecedentes:
- Los proveedores informales de atención médica brindan más del 70% de la atención primaria en la India rural.
- El acceso limitado a las cualificaciones médicas formales requiere estrategias alternativas para mejorar la calidad de la atención.
- Los proveedores no capacitados pueden presentar riesgos debido a un conocimiento inadecuado de diagnóstico y tratamiento.
Objetivo del estudio:
- Evaluar el impacto de un programa de formación médica estructurado y multitópico en la práctica clínica de los proveedores de atención médica informal.
- Evaluar la eficacia de la formación para mejorar la precisión del diagnóstico y el tratamiento adecuado de enfermedades comunes.
- Determinar la rentabilidad de la formación de proveedores informales como estrategia para mejorar la atención primaria de salud.
Principales métodos:
- Se llevó a cabo un ensayo controlado aleatorio en el que participaron 304 proveedores informales de atención médica en la India rural.
- 152 proveedores recibieron 72 sesiones de formación durante 9 meses; 152 sirvieron como grupo de control.
- Se usaron pacientes estandarizados para evaluar la práctica clínica para tres afecciones distintas, con ceguera para proveedores y entrenadores.
Principales resultados:
- El programa de formación dio lugar a un aumento de 7,9 puntos porcentuales (14,2%) en la gestión correcta de los casos.
- No se observó ningún efecto significativo en la utilización de medicamentos o antibióticos innecesarios.
- El programa demostró un costo de 175 dólares por aprendiz.
Conclusiones:
- La formación médica multitópica es una estrategia eficaz a corto plazo para mejorar la calidad de la atención primaria brindada por los proveedores informales.
- La capacitación específica puede mejorar la toma de decisiones clínicas y los resultados de los pacientes en entornos con recursos limitados.
- Las investigaciones adicionales deben explorar los impactos a largo plazo y la escalabilidad de dichas intervenciones de formación.
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