ABSTRACT
La terapia intensiva es una especialidad en continuo crecimiento. En Ecuador se desconoce la realidad de sus recursos humanos. Objetivos Determinar las caracteriÌsticas del recurso profesional meÌdico en las unidades de terapia intensiva (UTI) del Distrito Metropolitano de Quito (DMQ) y sus condiciones laborales. DisenÌo Transversal. Lugar y sujetos MeÌdicos tratantes y residentes (postgradistas y asistenciales) que laboran de 41 UTI del DMQ. Mediciones principales Censo y entrevista directa sobre datos demograÌficos, estudios realizados, carga laboral, guardias nocturnas, ingresos econoÌmicos, capacitacioÌn continua y expectativa futura en la especialidad. Resultados Se entrevistaron 103 meÌdicos tratantes y 132 residentes (44 postgradistas y 88 asistenciales). La mayoriÌa fueron de sexo masculino (76.2%). El 63.1% de los tratantes laboran en dos o maÌs unidades UTI y el 73.5% de residentes en una sola UTI. Los tratantes laboran una mediana de 222 (Q1-Q3: 160 - 280) horas/mes y los residentes de 247 (190 - 300) horas/ mes, superando las 15 horas/diÌa cada semana. Los ingresos mensuales fueron de US$ 3500 (2552 4500) y 1500 (1213 1995) para los tratantes y residentes respectivamente. La correlacioÌn entre carga laboral e ingresos econoÌmicos fue baja. El 58.3% de los tratantes teniÌan tiÌtulo de la universitario, con un tiempo medio de experiencia de 10 anÌos. Los residentes postgradistas teniÌan mayor experiencia en aÌreas criÌticas que los residentes asistenciales (86.4% vs. 52.3%) pero similar capacitacioÌn previo su ingreso a UTI (40.9% vs. 48.9%). La asistencia a cursos de actualizacioÌn fue baja. El 22.3% de los tratantes y 12.9% de los residentes respondieron tener afiliacioÌn a la seguridad social y otros beneficios. El 80.6% de tratantes volveriÌan a escoger la especialidad y 63.6% de los residentes asistenciales estariÌa interesado en continuar sus estudios en la especialidad. Conclusiones Este estudio es el primero en abordar la realidad laboral de las UTI del DMQ. Las condiciones laborales se perciben difiÌciles y poco atractivas. Existe una sobrecarga laboral sin correspondencia en los ingresos econoÌmicos y la formacioÌn acadeÌmica y formacioÌn continua luce insuficiente. Sin embargo, la mayoriÌa de meÌdicos estaÌn motivados por continuar en la especialidad.
Intensive care is a specialty in continuous growth. In Ecuador is unknown the current status of its human resources. Objective To determine the characteristics of the medical staff in the intensive care units (ICU) of the Metropolitan District of Quito (MDQ) and their working conditions. Design Cross sectional study Subjects and setting Attending physicians and residents who work at 41 ICU in Quito-Ecuador. Main measurements Demographic data, previous medical formation, workload, night guards, income, ongoing training and future life expectative. Results We interviewed 103 attending physicians and 132 residents (44 postgra- duate students). Most were males (76.2%). 63.1% of attendants work in two or more ICU and 73.5% of residents in a single ICU. Attendants work a median of 222 (Q1-Q3: 160 - 280) hours/month and residents 247 (190 - 300) hours/month, exceeding 15 hours/day each week. The monthly income was US$ 3500 (2552 - 4500) and US$1500 (1213 - 1995) for attendants and residents respectively. The correlation between workload and income was low. 58.3% of attendants had a university title as specialist, with an average of 10 years experience. The postgraduate students had more experience in critical medical areas than other residents (86.4% vs. 52.3%) but similar training prior to ICU job (40.9% vs. 48.9%). Medical education in training courses was low. 22.3% of attendants and 12.9% of residents had affiliation to the social security and other benefits. 80.6% of attendants would choose again the specialty and 63.6 % of residents would be interested in continuing their studies in the specialty. Conclusion This study is the first to deal with the current status of working conditions in ICU of MDQ. Working conditions are perceived difficult and unattractive. There is a work overload mismatched in incomes and academic training and continued medical education looks insufficient. However, most physicians are motivated to continue in the specialty. Abstract Medical staff and working conditions in intensive care units of the Metropolitan District of Quito - Ecuador