Quality of care for labor and childbirth in a public hospital network in a Brazilian state capital: patient satisfaction

• Published in: Cadernos de saúde pública Vol. 33; no. 12; p. e00175116
• Main Authors: Silva, Ana Lúcia Andrade da, Mendes, Antonio da Cruz Gouveia, Miranda, Gabriella Morais Duarte, Souza, Wayner Vieira de
• Format: Journal Article
• Language: Portuguese
• Published: Brazil 18-12-2017
• Subjects: Adolescent; Adult; Brazil; Child; Cross-Sectional Studies; Delivery, Obstetric - standards; Delivery, Obstetric - statistics & numerical data; Female; Hospitals, Maternity - standards; Hospitals, Public - standards; Hospitals, Public - statistics & numerical data; Humans; Parturition; Patient Satisfaction - statistics & numerical data; Pregnancy; Prenatal Care - standards; Prenatal Care - statistics & numerical data; Quality of Health Care - statistics & numerical data; Socioeconomic Factors; Surveys and Questionnaires; Time-to-Treatment; Young Adult
• ISSN: 1678-4464
• DOI: 10.1590/0102-311X00175116

The study assessed the quality of care for labor and childbirth in the public hospital system in the city of Recife, Pernambuco State, Brazil, according to the mothers' satisfaction, using a cross-sectional exploratory study in all the public hospitals in the network, grouped according to type of hospital management and interviews with 1,000 mothers. Quality of care was measured according to management strata and the following dimensions of quality: reception; respect for individual rights; prenatal and childbirth care; and ambience. The results' significance was analyzed with the Pearson and Friedman chi-square test. There was high prenatal coverage, not linked to childbirth care, and intense migration of deliveries. Waiting time for care by the healthcare team was long, the proportion of vaginal deliveries in the municipal maternity services was 80%, and only 16% of the deliveries included skin-to-skin contact with the newborn; breastfeeding occurred in the birthing room in 11% of the deliveries. Among the various management modalities, the charitable hospital rated highest. The target dimension showed significant differences, with higher satisfaction rates for the following: respect (88.2%), kindness (86.7%), physicians' work (85.2%), and trust in the healthcare staff (84.3%). The highest rates of dissatisfaction were for: temperature on the ward (62.2%), possibility of lodging complaints (48.1%), quantity and quality of hospital clothing and bedding (49.2%), and privacy (43%). Despite positive strides, the findings show the need for reorganization of obstetric care policy, with regionalization, regulation, consolidation of networks of care, and interventions in the healthcare setting, aimed at consolidating the humanization of care.