Violencia laboral externa tipo amenaza contra médicos en servicios hospitalarios de Lima Metropolitana, Perú 2014

Abstract

Objetivos. Estimar la frecuencia y los factores asociados a la violencia laboral externa tipo amenaza (VLETA) contra médicos en servicios de salud hospitalarios de Lima Metropolitana, Perú. Materiales y Métodos. Se desarrolló un estudio transversal analítico que incluyó médicos del Ministerio de Salud (MINSA), la Seguridad Social (EsSalud) y el subsector privado. Se midió la frecuencia de VLETA durante toda la práctica profesional, en los últimos doce meses y en el último mes. Se midieron variables relacionadas al médico, al agresor y al servicio de salud. Se estimaron razones de prevalencia (RPs) cruda y ajustada mediante un modelo lineal generalizado familia Poisson con bootstrap no paramétrico. Resultados. Participaron 406 médicos. El 31,5% fueron víctimas de VLETA al menos una vez durante su práctica profesional; 19,9% en los últimos doces meses y 7,6% en el último mes. La probabilidad de ser amenazado en los últimos doce meses aumentó si el médico era varón (RPa:1,7;IC95%:1,1-2,8), egresado de una universidad peruana fuera de Lima Metropolitana (RPa:1,5; IC95%:1,1-2,4), laboraba en MINSA (RPa:7,9;IC95%:2,24-50,73) o en EsSalud (RPa:8,68; IC95%:2,26-56,17), y atendía en emergencia (RPa:1,9;IC95%:1,2-3,6) o en sala de operaciones (RPa:1,6 IC95%:1,1-2,3). La edad, los años de práctica profesional o ser médico residente no se asociaron a VLETA. Conclusiones. En los hospitales estudiados, una alta proporción de médicos ha sido víctima de VLETA. Laborar en servicios públicos aumenta dicha probabilidad. Se sugiere implementar estrategias de prevención primaria, identificación y soporte en los establecimientos hospitalarios.

Objectives. To calculate the frequency and factors associated with external workplace violence (EWV) against doctors in health inpatient services in the metropolitan area of Lima (Spanish: Lima Metropolitana), Peru. Materials and methods. A cross-sectional analytic study, which included doctors from the Ministry of Health (MINSA), Social Security (EsSalud), and the private subsector, was carried out. The frequency of EWV was measured throughout the entire professional practice during the previous 12 months and during the last month. Variables related to the doctor, assailant, and health service were measured. Raw and adjusted prevalence ratios (PR) were calculated by means of a Poisson-family generalized linear model with non-parametric bootstrapping. Results. A total of 406 doctors participated; 31.5% were victims of EWV at least once during their professional practice, with 19.9% over the past 12 months and 7.6% during the last month. The chances of being threatened in the last 12 months increased if the doctor was male (adjusted PR [aPR]: 1.7; 95% confidence interval [CI] = 1.1- 2.8), had graduated from a Peruvian university outside of the metropolitan area of Lima (aPR: 1.5; 95% CI = 1.1-2.4), worked at MINSA (aPR: 7.9; 95% CI = 2.24-50.73) or EsSalud (RR: 8.68; 95% CI = 2.26-56.17), and worked in the emergency (aPR: 1.9; 95% CI = 1.2-3.6) or operating room (aPR: 1.6; 95% CI = 1.1-2.3). Age, years of professional practice, or being a medical resident were not associated with EWV. Conclusion. In the hospitals studied, a large number of doctors have been victims of EWV. Working in public services increases the possibility of violence. Implementation of support, identification, and primary prevention strategies in hospitals is recommended.