ABC | Volume 111, Nº2, August 2018

Original Article Marcolino et al Satisfaction of emergency physicians Arq Bras Cardiol. 2018; 111(2):151-159 Table 1 – Distribution of the physicians according to time since graduation, sex and specialty Characteristics Overall total (n = 137) Non-SAMU (n = 74) SAMU (n = 63) Level II hospitals (n = 28) Level III/IV hospitals (n = 46) Non-SAMU total (n = 74) Time since graduation (years) (median, IQR) 5.3 (1.8-12.7) 2.3 (1.5-5.0)* 11.0 (2.4-23.2)* 5.5 (1.9-15.3)† 5.3 (1.8-10.7)† Male sex 93 (67.9) 13 (46.4) 35 (76.1) 48 (64.9) 45 (71.4) Medical category/specialty Generalist 43 (31.4) 12 (42.9) 8 (17.4) 20 (27.0) 23 (36.5) Specialty 94 (68.6) 16 (57.1) 38 (82.6) 54 (73.0) 40 (63.5) Internal medicine 40 (29.1) 9 (32.1) 18 (39.1)‡ 27 (36.4)‡ 13 (20.6) Pediatrics 13 (9.4) 3 (10.7) 5 (10.8) 8 (10.8) 5 (7.9) Surgery 10 (7.2) 1 (3.5) 4 (8.6)‡ 5 (6.7)‡ 5 (7.9) Gynecology and Obstetrics 10 (7.2) 1 (3.5) 6 (13)‡ 7 (9.4)‡ 3 (4.7) Cardiology 4 (2.9) 0 (0) 0 (0) 0 (0) 4 (6.3) Family Medicine 4 (2.9) 0 (0) 0 (0) 0 (0) 4 (6.3) Others§ 16 (11.6) 2 (7.1) 8 (17.3)‡ 10 (13.5)‡ 6 (9.5) SAMU: mobile emergency care service; IQR: interquartile range. * Comparison of the time since graduation between physicians of level II hospitals and level III/IV hospitals: p ≤ 0.01; † Comparison of the time since graduation between SAMU and non-SAMU physicians: p = 0.64; ‡ Two physicians had multiple specialties: one had two specialties (Internal Medicine and Surgery) and the other, three (Anesthesiology, Gynecology and Obstetrics, Labour Medicine). Both worked at a level III/IV hospital; § Others: Anesthesiology (3, 1 at SAMU and 2 at level III/IV hospital), Cardiovascular Surgery (2, at SAMU), Thoracic Surgery (2, 1 at SAMU and 1 at level III/IV hospital), Intensive Care Medicine (2, 1 at SAMU and 1 at level III/IV hospital), Neurology (1, at level II hospital), Dermatology (1, at level II hospital), Traffic Medicine (1, at SAMU), Labour Medicine (2, at level III/IV hospital), Orthopedics and Traumatology (1, at level III/IV hospital) and Psychiatry (1, at level III/IV hospital). Statistical analysis The statistical analysis was performed by using the IBM SPSS software, version 19.0 (IBM Corp, Armonk, NY). Categorical variables were described as absolute and relative frequency, and continuous variables as measures of central trend and dispersion [median and interquartile range (IQR)]. Data distribution was not normal, as assessed by use of the Kolmogorov-Smirnov test, thus, nonparametric tests were used. The statistical analysis was performed for groups (SAMU versus non-SAMU) and non-SAMU subgroups (level II hospitals versus level III/IV hospitals). Categorical variables were compared by using the chi-square test. The median score for each item, overall scale and domains were calculated and compared by using the nonparametric Mann-Whitney U test to assess the existence of difference, and a 5% significance level was used. The correlation between professional training time and overall satisfaction was assessed by use of Spearman correlation (r s ). Ethical aspects This study was approved by the Ethics Committee of Research of the Universidade Federal de Minas Gerais, number 260/09, aligned with the resolution CNS 466/12. All physicians provided written informed consent to participate in the study. Results Of the 164 professionals, 137 (83.5%) completed the questionnaire. Of the respondents, 63 (46.0%) provided care at SAMU emergency units, and 74 (54.0%), at hospital emergency services. Among these, 28 (37.8%) worked at level II hospitals, and 46 (62.2%), at level III/IV hospitals. Table 1 shows the descriptive characteristics of the groups. The median number of years since graduation was 5.3 (IQR 1.8‑12.7), and it was similar when comparing physicians working at the SAMU emergency units and those at the hospital emergency services, except for those working at level III/IV hospitals. Most physicians were male (67.9%) and specialized (68.6%), and that proportion was higher at level III/IV hospitals when compared to the proportion of specialists at level II hospitals and SAMU units. The most common medical specialties were internal medicine (29.1%), pediatrics (9.5%), surgery (7.2%) and gynecology and obstetrics (7.2%). No statistically significant difference was observed between the groups regarding the distribution in the different specialties (SAMU vs non-SAMU, p = 0.168; level II hospitals vs level III/IV hospitals, p = 0.214). Most respondents showed overall dissatisfaction with the structure of care provided to cardiovascular emergencies in the region, whose median of the overall scale was 2.0 (IQR 2.0‑4.0). When assessing “overall satisfaction” , the dissatisfaction of SAMU physicians was lower (p = 0.01). In addition, the physicians of level III/IV hospitals showed higher “overall satisfaction” as compared to those of level II hospitals (p ≤ 0.05) (Table 2). No statistically significant correlation was observed between professional training time and “overall satisfaction” [r s = 0.112, p = 0.195]. When assessing the scale domains, slightly higher “ satisfaction with the structure of care and diagnosis” 153