ABC | Volume 111, Nº2, August 2018

Original Article Satisfaction of Emergency Physicians with the Care Provided to Patients with Cardiovascular Diseases in the Northern Region of Minas Gerais Milena Soriano Marcolino, 1,2 João Antonio de Queiroz Oliveira, 1,2 Grace Kelly Matos e Silva, 1 Thatiane Dantas Dias, 1 Barbara Campos Abreu Marino, 1 André Pires Antunes, 3 Antonio Luiz Ribeiro, 1,2 Clareci Silva Cardoso 4 Telehealth Center, University Hospital, Universidade Federal de Minas Gerais (UFMG), 1 Belo Horizonte, MG - Brazil Medical School, Universidade Federal de Minas Gerais, 2 Belo Horizonte, MG - Brazil Universidade Estadual de Montes Claros, 3 Montes Claros, MG - Brazil Universidade Federal de São João del-Rei, 4 Divinópolis, MG - Brazil Mailing Address: Milena Soriano Marcolino • Avenida Professor Alfredo Balena, 190, sala 246. Postal Code 30130-100, Santa Efigênia, Belo Horizonte, MG – Brazil E-mail: milenamarc@gmail.com , milenamarc@ig.com.br Manuscript received January 30, 2018, revised manuscript March 26, 2018, accepted April 11, 2018 DOI: 10.5935/abc.20180143 Abstract Background: The dissatisfaction of health professionals in emergency services has a negative influence on both the quality of care provided for acute myocardial infarction (AMI) patients and the retention of those professionals. Objective: To assess physicians’ satisfaction with the structure of care and diagnosis at the emergency services in the Northern Region of Minas Gerais before the implementation of the AMI system of care. Methods: This cross-sectional study included physicians from the emergency units of the ambulance service (SAMU) and level II, III and IV regional hospitals. Satisfaction was assessed by using the CARDIOSATIS-Team scale. The median score for each item, the overall scale and the domains were calculated and then compared by groups using the non‑parametric Mann-Whitney test. Correlation between time since graduation and satisfaction level was assessed using Spearman correlation. A p value < 0.05 was considered significant. Results: Of the 137 physicians included in the study, 46% worked at SAMU. Most of the interviewees showed overall dissatisfaction with the structure of care, and the median score for the overall scale was 2.0 [interquartile range (IQR) 2.0‑4.0]. Most SAMU physicians expressed their dissatisfaction with the care provided (54%), the structure for managing cardiovascular diseases (52%), and the technology available for diagnosis (54%). The evaluation of the overall satisfaction evidenced that the dissatisfaction of SAMU physicians was lower when compared to that of hospital emergency physicians. Level III/IV hospital physicians expressed greater overall satisfaction when compared to level II hospital physicians. Conclusion: This study showed the overall dissatisfaction of the emergency physicians in the region assessed with the structure of care for cardiovascular emergencies. (Arq Bras Cardiol. 2018; 111(2):151-159) Keywords: Cardiovascular Diseases; Myocardial Infartion; Acute Coronary Syndrome; Epidemiology; Health Profile; Quality Indicators, Health Care; Emergency Medical Services. Introduction The recent decades have witnessed a significant reduction in mortality from cardiovascular diseases resulting from the advances in primary prevention and treatment of acute coronary syndrome. 1-4 Despite being a worldwide trend, it is more evident in developed countries, where proper and timely treatment is available. 5 The “S istema de Informação de Mortalidade (SIM) of the Ministério da Saúde” (Brazilian Health Ministry Mortality Information System (SIM)) recorded, in 2015, approximately 350 000 deaths from cardiovascular diseases, which, in Brazil, remain the leading cause of proportional mortality, accounting for 27.6% of the deaths in 2015. Additionally, it is the major cause of years of life lost due to premature death. 6 Of the cardiovascular diseases, acute myocardial infarction (AMI) is themost frequent cause of death (26.0%), 6 andmortality at public healthcare services is higher than at private healthcare services. 7 That difference may be attributed to difficulties experienced by AMI patients to have access to intensive care, reperfusion methods and the therapeutic measures established for AMI. 7,8 Such difficulties can have a negative impact on the satisfaction of emergency healthcare professionals, which might impact negatively the retention of those professionals in regions lacking healthcare structure. The current crisis in emergency services is well known. 9 Thus, assessing the factors related to it, such as the satisfaction of healthcare professionals with healthcare structure, is paramount. The Northern Region of Minas Gerais comprises 89 municipalities, occupying an area of approximately 151