Costos y calidad de la prueba de detección oportuna del cáncer cervicouterino en una clínica pública y en una organización no gubernamental

Abstract

To compare the costs and quality of cervical cancer screening between a non-governmental organization (NGO) and a Ministry of Health clinic. A quantitative and qualitative cross-sectional study was conducted between April and July 1999, in two healthcare clinics in Cuernavaca, Morelos, Mexico. Cervical cancer screening production processes were compared along four components: a) Pap smear collection; b) its transportation to the cytology center; c) analysis and interpretation; and d) notification of results. The framework developed by Bruce was used for assessing the quality of care. The framework includes users' perceptions on information received and waiting times, as well as providers' perceptions of space and equipment availability. The unitary cost of the production process in the public clinic ($144 pesos or US$15.5) was 26% higher than in the NGO ($114 pesos or US$12.3). Women attending NGO services reported a higher satisfaction with the quality of care than those who attended the public clinic. The waiting time prior to screening and the time each woman has to wait to receive test results were the main sources of insatisfaction. Analysis of costs and quality of care results suggest that NGOs should be considered as an alternative in the provision of cervical cancer screening. The English version of this paper is available at: http://www.insp.mx/salud/index.html