The response of health personnel: what Chileans evaluate best in managing the pandemic

What rating do you give the health system during the pandemic? That was one of the questions in the survey carried out by the Andrés Bello University together with Ipsos to find out the perception of Chileans regarding the management of the health care network in emergencies. The answer? 4.3, with 15% of those consulted who highlighted its operation, a third who simply approved it and 54% who evaluated it negatively.

The assessment made by Chileans of the system of hospitals and clinics – which was unified in a network to face the coronavirus – varies depending on the areas of care, as well as the type of insurance and socioeconomic level to which the respondents belong.

Thus, the best grade is obtained by health professionals -medicals, nurses and technicians-, with an average of 5.1, in an item that assesses the response of these teams to the health crisis.

“Chileans, in general, approve of the work of the health teams and that is good news, because it means that they were able -and this was perceived- to maintain the quality of care for their patients, despite the strong pressure on the that were subjected. The people consulted feel that they were cared for with dedication and that is a very important element, a recognition of their work, ”says Héctor Sánchez, director of the Institute of Public Health of the Unab.

But although this segment achieved the highest weighting, the assessment is not without differences: although 45% of those consulted evaluated the work of the staff as excellent -with grades 6 or 7-, another 33% considered it deficient, rating it by below the 4.

“The perception changes considerably according to the type of insurance and the socioeconomic level. People from isapre and with higher incomes evaluate the system with a better grade, since they have a faster response, and even more pleasant than those who come from Fonasa and must wait longer, they have less access to care and a global experience that is less satisfactory ”, adds Sánchez.

The undersecretary of Healthcare Networks, Arturo Zúñiga, stated that “without a doubt, the work that health personnel have done is the most valued and with good reason. The health system in terms of caring for patients, giving them a bed when they have needed it, has been recognized not only by citizens, but also by experts, which is reflected in this survey.

From the Medical College, the metropolitan regional president, Camilo Bass, says that “the weight that we have had to bear as teams has been very powerful, and the recognition of our work by the public is an incentive that motivates us to continue on the front line.”

Another element that was well accepted is telemedicine, as 77% approve of it. “It has helped a lot to contact the public when mobility was restricted, for a health professional to contact a patient and thus maintain regular care,” adds Zúñiga.

At the other extreme, the worst grade that Chileans give to the system refers to the ability to keep attending other pathologies that were not coronavirus. In this item, 65% failed the management of the healthcare network.

In this regard, Luis Castillo, former undersecretary and coordinator of the private Covid-19 network, said that health centers were faced with a disease “that was little known and that ended up permeating all capacity. It was not known how it could affect non-infected patients, because we did not know mortality or its characteristics. Here, the self-criticism is that we should have left a window to solve other health problems, but this was done as a way of protecting citizens ”.

In this regard, Zúñiga adds that “hospitals were heavily focused on coronavirus care and this impaired our ability to provide care for other pathologies, but emergency surgeries, such as heart attacks or cancer surgeries, continued to be treated.” And he adds that “as the cases have fallen, the attention span of our system has been reactivated to a certain extent.”

Héctor Sánchez adds that the survey also warns of matters that are being negatively perceived by the public: “People misjudge crucial aspects, such as the information they are receiving about the disease, the use of beds in the network, emergency care and the organization in the face of the pandemic ”, says the academic, adding that“ there are 53% of the people who consider that they are being treated badly in the emergency room. In short, there is a bulk of people who think that the system is not responding to demand ”.

In turn, Claudio Castillo, an academic at the Usach, affirms that in the context of the pandemic, “only health workers have a better evaluation, which makes it urgent to rethink how the system is organized with a logic of learning from the pandemic, the need for preventive work with universal primary care and coordination between the different levels of care ”. In a general framework, he adds, “the health system does not respond to the expectations of the population without and with a pandemic.”

Another aspect of the survey that generated division is the protection that Chileans have felt from the system against the health emergency. While 50% say they feel very protected, 45% perceive themselves as very unprotected, especially among people with lower incomes and who belong to Fonasa.

When delving into this point, those consulted mainly state that the system is collapsed and that it has shortcomings, such as a lack of concern for the population, that they only serve coronavirus, that the public system provides poor service and that they simply distrust the ability to the net.

“The pandemic has shown that the network is not widening and that will be resolved not only with more resources, but with a change in the care model, which must have more access, be more preventive and with less attention face-to-face, as it has been proven that it can be done and people accept it. Attention, although remote, but timely, allows them to solve the health problem, ”says Sánchez.