Análisis de la variabilidad en la atención hospitalaria por disparidad en cuidados intensivos neonatales. Un estudio multicentrico
Analysis of variability in hospital care due to disparity in neonatal intensive care. A multicenter studyContenido principal del artículo
El estudio tuvo como objetivo analizar la evidencia científica sobre la implementación de sistemas de gestión de calidad (SGC), como la norma ISO 9001:2015 y los modelos integrados de gestión, en unidades de cuidados intensivos (UCI), y su contribución a la mitigación de las disparidades en la atención hospitalaria. Se desarrolló una revisión bibliográfica narrativa con enfoque sistemático, basada en fuentes científicas de las bases de datos PubMed, Scopus, Web of Science y SciELO, complementadas con literatura institucional de la OMS y la Joint Commission. Los resultados evidenciaron que la adopción de SGC favorece la estandarización de protocolos clínicos, la reducción de la variabilidad asistencial y el fortalecimiento de la cultura de seguridad y equidad. Los hospitales con sistemas certificados mostraron mayor cohesión organizativa, compromiso del personal y mejora en los indicadores de desempeño. No obstante, se identificaron barreras regulatorias, limitaciones en la sostenibilidad de las certificaciones y sesgos algorítmicos en herramientas digitales aplicadas en UCI. Se concluye que los sistemas de gestión de calidad constituyen una herramienta eficaz para promover la equidad y reducir las desigualdades estructurales en la atención crítica, siempre que integren indicadores de equidad, competencia cultural y ética profesional. Su implementación contribuye al cumplimiento de los Objetivos de Desarrollo Sostenible 3 y 10, orientados a garantizar salud, bienestar y reducción de desigualdades.
The study aimed to analyze the scientific evidence on the implementation of quality management systems (QMS), such as the ISO 9001:2015 standard and integrated management models, in intensive care units (ICUs), and their contribution to mitigating disparities in hospital care. A narrative literature review was conducted using a systematic approach, based on scientific sources from the PubMed, Scopus, Web of Science, and SciELO databases, supplemented by institutional literature from the WHO and the Joint Commission. The results showed that the adoption of QMS promotes the standardization of clinical protocols, reduces variability in care, and strengthens a culture of safety and equity. Hospitals with certified systems showed greater organizational cohesion, staff commitment, and improvement in performance indicators. However, regulatory barriers, limitations in the sustainability of certifications, and algorithmic biases in digital tools applied in ICUs were identified. It is concluded that quality management systems are an effective tool for promoting equity and reducing structural inequalities in critical care, provided that they integrate indicators of equity, cultural competence, and professional ethics. Their implementation contributes to the fulfillment of Sustainable Development Goals 3 and 10, aimed at ensuring health, well-being, and the reduction of inequalities.
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