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Public opinion about the health care system in Armenia: findings from a cross-sectional telephone survey.

ABSTRACT: BACKGROUND:Few studies have examined public opinion about the health care system in the former Soviet region. The objective of our study was to evaluate the population's satisfaction with the health care system and identify factors associated with it in Armenia. METHODS:We conducted a cross-sectional telephone survey among 576 adult residents of the capital Yerevan using Random Digit Dialing technique. Simple and multivariate logistic regression explored associations between potential determinants and satisfaction. RESULTS:A substantial proportion of respondents (45.5%) were dissatisfied or very dissatisfied with the health system. About 49% of respondents negatively evaluated the ability of the system to provide equal access to care. About 69% of respondents thought that the responsibility for an individual's health should be equally shared between the individual and the government or that the government's share should be larger. The adjusted odds of satisfaction were higher among individuals with better health status, those who positively rated equal access and respect to patients in the system, those thinking that the responsibility for health should be equally shared between the individual and the government, and those who tended to trust the government. CONCLUSIONS:This study enriched our understanding of factors that shape the population's satisfaction with the health care system in different cultural and political environments. We recommend further exploration of public opinion about those system attributes that are not directly linked to patient experiences with care, but might be equally important for explaining the phenomenon of satisfaction.

SUBMITTER: Harutyunyan T

PROVIDER: S-EPMC7640423 | biostudies-literature | 2020 Nov

REPOSITORIES: biostudies-literature

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Public opinion about the health care system in Armenia: findings from a cross-sectional telephone survey.

Harutyunyan Tsovinar T Hayrumyan Varduhi V

BMC health services research 20201103 1

<h4>Background</h4>Few studies have examined public opinion about the health care system in the former Soviet region. The objective of our study was to evaluate the population's satisfaction with the health care system and identify factors associated with it in Armenia.<h4>Methods</h4>We conducted a cross-sectional telephone survey among 576 adult residents of the capital Yerevan using Random Digit Dialing technique. Simple and multivariate logistic regression explored associations between poten ...[more]

PMID: 33143718

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Project description:BACKGROUND:Despite the substantial attention to primary care (PC), few studies have addressed the relationship between patients' experience with PC and their health status in low-and middle-income countries. This study aimed to (1) test the association between overall patient-centered PC experience (OPCE) and self-rated health (SRH) and (2) identify specific features of patient-centered PC associated with better SRH (i.e., excellent or very good SRH) in 6 Latin American and Caribbean countries. METHODS AND FINDINGS:We conducted a secondary analysis of a 2013 public opinion cross-sectional survey on perceptions and experiences with healthcare systems in Brazil, Colombia, El Salvador, Jamaica, Mexico, and Panama; the data were nationally representative for urban populations. We analyzed 9 features of patient-centered PC. We calculated OPCE score as the arithmetic mean of the PC features. OPCE score ranged from 0 to 1, where 0 meant that the participant did not have any of the 9 patient-centered PC experiences, while 1 meant that he/she reported having all these experiences. After testing for interaction on the additive scale, we analyzed countries pooled for aim 1, with an interaction term for Mexico, and each country separately for aim 2. We used multiple Poisson regression models double-weighted by survey and inverse probability weights to deal with the survey design and missing data. The study included 6,100 participants. The percentage of participants with excellent or very good SRH ranged from 29.5% in Mexico to 52.4% in Jamaica. OPCE was associated with reporting excellent or very good SRH in all countries: adjusting for socio-demographic and health covariates, patients with an OPCE score of 1 in Brazil, Colombia, El Salvador, Jamaica, and Panama were more likely to report excellent or very good SRH than those with a score of 0 (adjusted prevalence ratio [aPR] 1.61, 95% CI 1.37-1.90, p < 0.001); in Mexico, this association was even stronger (aPR 4.27, 95% CI 2.34-7.81, p < 0.001). The specific features of patient-centered PC associated with better SRH differed by country. The perception that PC providers solve most health problems was associated with excellent or very good SRH in Colombia (aPR 1.38, 95% CI 1.01-1.91, p = 0.046) and Jamaica (aPR 1.21, 95% CI 1.02-1.43, p = 0.030). Having a provider who knows relevant medical history was positively associated with better SRH in Mexico (aPR 1.47, 95% CI 1.03-2.12, p = 0.036) but was negatively associated with better SRH in Brazil (aPR 0.71, 95% CI 0.56-0.89, p = 0.003). Finally, easy contact with PC facility (Mexico: aPR 1.35, 95% CI 1.04-1.74, p = 0.023), coordination of care (Mexico: aPR 1.53, 95% CI 1.19-1.98, p = 0.001), and opportunity to ask questions (Brazil: aPR 1.42, 95% CI 1.11-1.83, p = 0.006) were each associated with better SRH. The main study limitation consists in the analysis being of cross-sectional data, which does not allow making causal inferences or identifying the direction of the association between the variables. CONCLUSIONS:Overall, a higher OPCE score was associated with better SRH in these 6 Latin American and Caribbean countries; associations between specific characteristics of patient-centered PC and SRH differed by country. The findings underscore the importance of high-quality, patient-centered PC as a path to improved population health.

Project description:BackgroundIn the last decade surgical care has been propelled into the public health domain with the establishment of a World Health Organisation (WHO) designated programme and key publications. The passing of the historic World Health Assembly Resolution (WHA) acknowledged surgical care as a vital component towards achieving Universal Health Coverage (UHC). We conducted the first worldwide survey to explore the perception of surgical care as a public health issue.MethodThe anonymous, cross sectional survey targeted worldwide participants across a range of professional backgrounds, including non-medical using virtual snowball sampling method (in English) using Google Forms (Google Inc., Mountain View, CA, USA) from 20th February 2019 to 25th June 2019. The survey questions were designed to gauge awareness on Sustainable Development Goals (SDGs), UHC, WHO programmes and key publications on surgical care as well as perception of surgical care as a priority topic in public health.ResultsThe survey was completed by 1954 respondents from 118 countries. Respondents were least aware of surgical care as a teaching topic in public health courses (27%; n = 526) and as a WHO programme (20%; n = 384). 82% of respondents were aware of UHC (n = 1599) and of this 72% (n = 1152) agreed that surgical care fits within UHC. While 77% (n = 1495) of respondents were aware of SDGs, only 19% (n = 370) agreed that surgery was a priority to meet SDGs. 48% (n = 941) rated surgical care as a cost-effective component of Primary Health Care. 88% (n = 1712) respondents had not read the WHA Resolution on 'Strengthening emergency and essential surgical care and anaesthesia as a component of UHC'.ConclusionThere is still a widespread gap in awareness on the importance of surgical care as a public health issue amongst our respondents. Surgical care was not seen as a priority to reach the SDGs, less visible as a WHO programme and not perceived as an important topic for public health courses.

Project description:BackgroundDuring the COVID-19 pandemic, protective measures have been prescribed to prevent or slow down the spread of the SARS-CoV-2 virus and protect the population. Individuals follow these measures to varying degrees. We aimed to identify factors influencing the extent to which protective measures are adhered to.MethodsA cross-sectional survey (telephone interviews) was undertaken between April and June 2021 to identify factors influencing the degree to which individuals adhere to protective measures. A representative sample of 1,003 people (age >16 years) in two Austrian states (Carinthia, Vorarlberg) was interviewed. The questionnaire was based on the Health Belief Model, but also included potential response-modifying factors. Predictors for adherent behavior were identified using multiple regression analysis. All predictors were standardized so that regression coefficients (β) could be compared.ResultsOverall median adherence was 0.75 (IQR: 0.5-1.0). Based on a regression model, the following variables were identified as significant in raising adherence: higher age (β = 0.43, 95%CI: 0.33-0.54), social standards of acceptable behavior (β = 0.33, 95%CI: 0.27-0.40), subjective/individual assessment of an increased personal health risk (β = 0.12, 95%CI: 0.05-0.18), self-efficacy (β = 0.06, 95%CI: 0.02-0.10), female gender (β = 0.05, 95%CI: 0.01-0.08), and low corona fatigue (behavioral fatigue: β = -0.11, 95%CI: -0.18 to -0.03). The model showed that such aspects as personal trust in institutions, perceived difficulties in adopting health-promoting measures, and individual assessments of the risk of infection, had no significant influence.ConclusionsThis study reveals that several factors significantly influence adherence to measures aimed at controlling the COVID-19 pandemic. To enhance adherence, the government, media, and other relevant stakeholders should take the findings into consideration when formulating policy. By developing social standards and promoting self-efficacy, individuals can influence the behavior of others and contribute toward coping with the pandemic.

Project description:ObjectiveAlthough distance has been identified as an important barrier to care, evidence for an effect of distance to care on child mortality is inconsistent. We investigated the association of distance to care with self-reported care seeking behaviours, neonatal and post-neonatal under-five child mortality in rural areas of Burkina Faso.MethodsWe performed a cross-sectional survey in 14 rural areas from November 2014 to March 2015. About 100 000 women were interviewed on their pregnancy history and about 5000 mothers were interviewed on their care seeking behaviours. Euclidean distances to the closest facility were calculated. Mixed-effects logistic and Poisson regressions were used respectively to compute odds ratios for care seeking behaviours and rate ratios for child mortality during the 5 years prior to the survey.ResultsThirty per cent of the children lived more than 7 km from a facility. After controlling for confounding factors, there was a strong evidence of a decreasing trend in care seeking with increasing distance to care (P ≤ 0.005). There was evidence for an increasing trend in early neonatal mortality with increasing distance to care (P = 0.028), but not for late neonatal mortality (P = 0.479) and post-neonatal under-five child mortality (P = 0.488). In their first week of life, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 1.00, 1.39; P = 0.056). In the late neonatal period, despite the lack of evidence for an association of mortality with distance, it is noteworthy that rate ratios were consistent with a trend and similar to or larger than estimates in early neonatal mortality. In this period, neonates living 7 km or more from a facility had an 18% higher mortality rate than neonates living within 2 km of a facility (RR = 1.18; 95%CI 0.92, 1.52; P = 0.202). Thus, the lack of evidence may reflect lower power due to fewer deaths rather than a weaker association.ConclusionWhile better geographic access to care is strongly associated with increased care seeking in rural Burkina Faso, the impact on child mortality appears to be marginal. This suggests that, in addition to improving access to services, attention needs to be paid to quality of those services.

Dataset Information

Public opinion about the health care system in Armenia: findings from a cross-sectional telephone survey.

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Public opinion about the health care system in Armenia: findings from a cross-sectional telephone survey.

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