What Factors Affect Patient Satisfaction in Public Sector Hospitals: Evidence from an Emerging Economy.
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ABSTRACT:
SUBMITTER: Hussain A
PROVIDER: S-EPMC6466114 | biostudies-other | 2019 Mar
REPOSITORIES: biostudies-other
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What Factors Affect Patient Satisfaction in Public Sector Hospitals: Evidence from an Emerging Economy.
Hussain Abid A Sial Muhammad Safdar MS Sial Muhammad Safdar MS Usman Sardar Muhammad SM Hwang Jinsoo J Jiang Yushi Y Shafiq Awaisra A
International journal of environmental research and public health 20190319 6
Patient satisfaction can identify specific areas of improvement in public sector hospitals. However, the Pakistani healthcare system, and quality of service delivery is rarely assessed through the perspective of patient satisfaction. Our study demonstrated the performance of public healthcare systems in Pakistan by interacting with physical services (tangible and environmental), doctor⁻patient communication, and pharmacy and laboratory services based on patient satisfaction. Primary data were co ...[more]
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Project description:Background:A comprehensive understanding of the extent of patient satisfaction and its determinants are crucial in improving the quality of service. Hence, this research was designed to measure patient satisfaction with pharmacy service. Methods:A cross-sectional study was conducted among 422 patients to assess satisfaction with pharmacy service in public hospitals located in Eastern Ethiopia from September to January 2018. Data were collected through an exit interview using structured questionnaires. Then, it was entered into EpiData version 3.1 and exported to STATA version 14.2 for analysis. Associations between dependent and independent variables were assessed by multiple logistic regression using an adjusted odds ratio at a 95% confidence interval and the p values of less than 0.05. Results:A total of 407 samples were included in the final analysis. The mean overall satisfaction of clients measured out of five was 2.29 (standard deviation?±?0.56). The proportion of overall satisfaction was 46.19%. Patients within the age range of 26-35?years and 36-50?years were found to have 50% (adjusted odds ratio?=?0.5, 95% confidence interval: 0.3, 0.9) and 60% (adjusted odds ratio?=?0.4, 95% confidence interval: 0.2, 0.8) decreased likelihood of satisfaction compared with patients within the range of 18-25?years, respectively. Likewise, patients who attended only secondary education compared to their counterpart (a certificate and above) were less likely to be satisfied (adjusted odds ratio?=?0.4, 95% confidence interval: 0.2, 0.8). In contrast, rural dwellers and patients who collected all their medications from the respective hospital were found to be more satisfied compared with their equivalent (adjusted odds ratio?=?3, 95% confidence interval: 1.8, 5.2) and (adjusted odds ratio?=?2.2, 95% confidence interval: 1.4, 3.5), respectively. Conclusion:Patient satisfaction with pharmacy service was found to be very low considering the current health-care system movement toward delivering quality service. Hence, health-care providers and administrators should give due attention to contributing factors in order to improve the quality of service and ultimately increase patient satisfaction.
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Project description:BackgroundPatient expectations have been recognized as a factor for patient satisfaction in medical consultations. Although various studies explored the relationship between patient expectations and patient satisfaction in developed countries, there is a lack of research evidence in Ethiopia where the meeting of patient expectations could relate to satisfaction.ObjectiveTo assess the relationship between patients' expectations and their satisfaction in the consultation of patients at the outpatient department.Study designData were collected regarding preconsultation expectations and postconsultation experiences of adult patients attending nine public hospitals. A systematic random sampling method was used where every fifth patient attending an outpatient department was selected. The patients were interviewed before consultation and after consultation to assess whether their pre-consultation expectations were met and to assess how satisfied they were with the consultation. Cronbach's alpha statistic was used to assess the reliability of the expectation questionnaires, and paired t-test was used to assess any differences between previsit expectations and postvisit experiences. Logistic regression techniques were used to assess variables considered as independent factors for patient satisfaction.ResultsA total of 776 patients were interviewed, giving a response rate of 92.3%. About 93.7% mentioned a diagnosis for their condition as a reason for their current hospital visits. There is a significant difference between preconsultation expectation and postconsultation expectation. Postconsultation expectation, perceived health status, and perceived control on health were factors identified as increasing patient satisfaction. In addition, the presence of any disappointments or worries, previous experience in health care, and extent of influence on the consultation had a negative influence on satisfaction.ConclusionPostconsultation expectation impacts patient satisfaction. Health care service providers should emphasize the actual experience of consultation.
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Project description:ObjectiveStudies in sub-Saharan Africa have shown that patient satisfaction with referral procedures and systems is low due to multiple factors. Despite the challenges on patient satisfaction with referral service in Ethiopia, there are only limited studies on overall satisfaction and associated factors with referral services of the hospitals. The purpose of this study was to determine patient satisfaction with referral services and related characteristics among patients referred to referral hospitals in Central Ethiopia, in the year 2021.MethodsA facility-based multi-center cross-sectional study was conducted at public hospitals in and around Addis Ababa using both quantitative and qualitative data collection methods. The hospitals were selected using a simple random sampling method from the list. Data were collected from 317 referral forms and chart reviews, 310 patient interviews, 27 focused group discussions, and 16 insider observations. The collected data were coded and entered into EPI INFO version 7 and transferred to SPSS version 25 for further analysis. Both binary and multivariable logistic regression models were computed to see the association between independent versus outcome variables. The findings were taken as significant with a p value of <0.05 at 95% confidence interval and results were presented with text, graphs, figures, and tables.ResultOverall level of patients' satisfaction of referral services in Central Ethiopia was 73.5%, confidence interval (67.9%-81.1 %,) and near 85% of the participants had got an examination by the respective health care worker on arrival. This study identified that factors that increase odds of patient satisfaction toward referral services were status of communication (adjusted odd ratio 44.09 (95% confidence interval, 5.47, 355.68), perceived level of experience of health providers who handle the referral process (adjusted odd ratio 6.42 (95% confidence interval, 1.20, 34.42) and coordination status of the hospitals during referral acceptance (adjusted odd ratio 35.50 (95% confidence interval, 4.87, 258.60) and these were significantly associated with patient's satisfaction toward referral services. Referral without communication among hospitals was stated as the leading challenge by focused group discussants and very limited practice on referral feedback was reported by insider observers.ConclusionThis study determined that the overall level of patient satisfaction toward referral services in Central Ethiopia was moderate with identified factors that increase odds of patient satisfaction toward referral system being the way of communication, health provider's experience, and coordination status of the hospitals on referral acceptance. Hence, policymakers and the ministry of health would better consider the aforementioned factors during referral program development and training for improvement of patients' satisfaction with referral services.
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Project description:Background:Poor job satisfaction has been associated with less productivity and high staff turnover. Various factors are thought to contribute for job dissatisfaction among pharmacy professionals and very limited studies have been conducted in eastern part of Ethiopia. Therefore, the current study was aimed to assess the level of job satisfaction among pharmacy professionals and its predictors. Methods:A cross-sectional study was conducted among 232 pharmacy professionals to assess level of job satisfaction in public hospitals located in the eastern Ethiopia. The data were collected using self- administered semi-structured questionnaires. Data were entered into Epi-Data version 3.1 and exported to STATA version 14.2 for analysis. Associations between the dependent and independent variables were assessed by multivariate analysis using an Adjusted Odds Ratio (AOR) at a 95% confidence interval (CI) and p-value less than 0.05 was considered as significant. Results:A total 220 questionnaires were found complete and included in the analysis. The mean age of participants was 27.6(SD + 4.1). More than half of the respondents (55.4%) had a bachelor degree and the majority (86.4%) were working less than 40?h per week, mostly in dispensing units (75.4%). About one third of the participants (32.7, 95% CI; 26.8-39.2) were found to be satisfied with their job. Age category of 20 to 25?years in reference to age greater than 30?years (AOR?=?3.5, 95% CI; 1.1-9.7), holding a bachelor degree in reference to having diploma (AOR?=?4.2, 95% CI; 1.8-10.00), working for more than 40?h per week (AOR?=?6.2, 95% CI, 2.4-16), and working in dispensing units (AOR?=?2.4, 95% CI; 1.1-5.5) were found to have strong association with job dissatisfaction. Conclusion:In this study, the job satisfaction levels of pharmacy professionals were found to be very low. The age category of 20 to 25, holding a bachelor degree, working for more than 40?h per week, and working in dispensing unit were found to be strong predictors of job dissatisfaction. Hence, pharmacy directors and hospital administrators should work to reduce unnecessary workload on the staffs and create good working climate.
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Project description:By actively coping with changes, a government providing public services can also improve the quality of those public services and help citizens improve their quality of life in the face of rapidly changing social structures, environments, and values. Accordingly, this study will typologize public innovation capacity (PIC) in terms of the individual, middle manager, and organizational levels. This study typologizes public innovation capacity in terms of the individual, middle manager, and organizational levels through mini-round Delphi analysis and exploratory factor analysis and confirmatory factor analysis using survey. This capacity is a precondition of the specificity of the public sector (generating public interest by providing public services) and universal value of HR (human resource) research (creating performance). It provides the basic capacity within the public sector to enhance the quality of public services and create positive outcomes.
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Project description:Previous studies have identified hospitals with poor performance on cardiac process measures. How these hospitals fare in other domains, such as patient satisfaction, remains unknown.We used Hospital Compare data to identify hospitals reporting acute myocardial infarction (AMI) and heart failure (HF) process measures during 2006 to 2008, and calculated respective composite performance scores. Using these scores, we classified hospitals as low-performing (bottom decile for all 3 years), top-performing (top decile for all 3 years), and intermediate (all others). We used Hospital Consumer Assessment of Healthcare Providers and Systems 2008 data to compare overall satisfaction between low, intermediate, and top-performing hospitals. Low-performing hospitals had fewer beds, fewer nurses per patient, and were more likely rural, safety-net hospitals located in the South, compared with intermediate and top-performing hospitals (P<0.01 for all). After adjusting for hospital characteristics, patients were less likely to recommend low-performing hospitals to family or friends, relative to intermediate and top-performing hospitals (AMI: 58.8% versus 63.9% versus 68.8%, HF: 61.3% versus 64.0% versus 66.8%; P<0.001 for all), or provide an overall rating of ? 9 out of 10 (AMI: 56.7% versus 60.7% versus 64.9%, HF: 57.8% versus 61.1% versus 63.6%; P<0.01 for all). Despite the association between the hospital's performance on process measures and patient satisfaction, we noted discordance between these measures (kappa statistic <0.20).Hospitals with consistently poor performance on cardiac process measures also have lower patient satisfaction on average, suggesting that these hospitals have overall poor quality of care. However, there is discordance between the 2 measures in profiling hospital quality.
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Project description:Antimicrobial resistance (AMR) is a serious global public-health threat. Evidence suggests that antimicrobial stewardship (AMS) is a valuable tool to facilitate rational antibiotic use within healthcare facilities. A cross-sectional situational analysis using a questionnaire was conducted to determine the current status of antimicrobial stewardship (AMS) activities in all public-sector hospitals in KwaZulu-Natal (KZN). The survey had a 79% (57, N = 72) response rate. A total of 75% of hospitals had an antimicrobial stewardship committee (AMSC), 47% (20, N = 43) had a formal written statement of support from leadership, and 7% (3, N = 43) had budgeted financial support. Only 37% (16, N = 43) had on-site or off-site support from a clinical microbiologist, and 5% (2, N = 43) had an on-site infectious disease (ID) physician. Microbiologist input on pathogen surveillance data (aOR: 5.12; 95% CI: 4.08-22.02; p-value = 0.001) and microbiological investigations prior to the commencement of antibiotics (aOR: 5.12; 95% CI: 1.08-42.01; p-value = 0.041) were significantly associated with having either on- or off-site microbiology support. Respondents that had a representative from microbiology on the AMSC were significantly associated with having and interrogating facility-specific antibiograms (P = 0.051 and P = 0.036, respectively). Those facilities that had access to a microbiologist were significantly associated with producing an antibiogram (aOR: 4.80; 95% CI: 1.25-18.42; p-value = 0.022). Facilities with an ID physician were significantly associated with having a current antibiogram distributed to prescribers within the facility (P = 0.010) and significantly associated with sending prescribers personalized communication regarding improving prescribing (P = 0.044). Common challenges reported by the facilities included suboptimal hospital management support; a lack of clinicians, pharmacists, nurses, microbiologists, and dedicated time; the lack of a multidisciplinary approach; low clinician buy-in; inadequate training; a lack of printed antibiotic guidelines; and financial restrictions for microbiological investigations. The survey identified the need for financial, IT, and management support. Microbiology and infectious disease physicians were recognized as scarce human resources.
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Project description:BackgroundUnderstanding the experiences and expectations of women across the continuum of antenatal, perinatal, and postnatal care is important to assess the quality of maternal care and to determine problematic areas which could be improved. The objective of this study was to identify the factors associated with maternal satisfaction with hospital-based perinatal care in Serbia.MethodsOur survey was conducted from January 2009 to January 2010 using a 28-item, self-administered questionnaire. The sample consisted of 50% of women who expected childbirths during the study period from all 76 public institutions with obstetric departments in Serbia. The following three composite outcome variables were constructed: satisfaction with technical and professional aspects of care; communication and interpersonal aspects of care; and environmental factors.ResultsWe analyzed 34,431 completed questionnaires (84.2% of the study sample). The highest and lowest average satisfaction scores (4.43 and 3.25, respectively) referred to the overall participation of midwives during delivery and the quality of food served in the hospital, respectively. Younger mothers and multiparas were less concerned with the environmental conditions (OR = 0.55, p = 0.006; OR = 1.82, p = 0.004). Final model indicated that mothers informed of patients' rights, pregnancy and delivery through the Maternal Counseling Service were more likely to be satisfied with all three outcome variables. The highest value of the Pearson's coefficient of correlation was between the overall satisfaction score and satisfaction with communication and interpersonal aspects of care.ConclusionsOur study illuminated the importance of interpersonal aspects of care and education for maternal satisfaction. Improvement of the environmental conditions in hospitals, the WHO program, Baby-friendly Hospital, and above all providing all pregnant women with antenatal education, are recommendations which would more strongly affect the perceptions of quality and satisfaction with perinatal care in Serbian public hospitals by women.
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Project description:This study aimed to describe the status and related factors of evidence-based practice (EBP) competency among nurses in China. A convenience sample of 1036 nurses were recruited from 13 public hospitals in Shanghai through an anonymous online survey. Nurses' demographic data, working data, and evidence-based nursing (EBN)-related conditions were collected by a structured questionnaire and EBP competency was assessed using the Chinese version of Evidence-based Nursing Competency Rating Scale (EBNCRS). The original score of EBNCRS among nurses was not good. The original score of evidence searching, critical appraisal, and synthesis subscale was lower than the original score of evidence transfer, situation assessment, and evidence implementation subscale. Nurses' age, hospital level, and perceived EBN knowledge were identified as significant related factors of EBP competency. There is an urgent need to upgrade the EBP competency of nurses in Shanghai, especially competency in evidence transfer, situation assessment, and evidence implementation.
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Project description:The COVID-19 pandemic is damaging economies across the world, including financial markets and institutions in all possible dimensions. For banks in particular, the pandemic generates multifaceted crises, mostly through increases in default rates. This is likely to be worse in developing economies with poor financial market architecture. This paper utilizes Bangladesh as a case study of an emerging economy and examines the possible impacts of the pandemic on the country’s banking sector. Bangladesh’s banking sector already has a high level of non-performing loans (NPLs) and the pandemic is likely to worsen the situation. Using a state-designed stress testing model, the paper estimates the impacts of the COVID-19 pandemic on three particular dimensions—firm value, capital adequacy, and interest income—under different NPL shock scenarios. Findings suggest that all banks are likely to see a fall in risk-weighted asset values, capital adequacy ratios, and interest income at the individual bank and sectoral levels. However, estimates show that larger banks are relatively more vulnerable. The decline in all three dimensions will increase disproportionately if NPL shocks become larger. Findings further show that a 10% NPL shock could force capital adequacy of all banks to go below the minimum BASEL-III requirement, while a shock of 13% or more could turn it to zero or negative at the sectoral level. Findings call for immediate and innovative policy measures to prevent a large-scale and contagious banking crisis in Bangladesh. The paper offers lessons for other developing and emerging economies similar to Bangladesh. Electronic supplementary material The online version of this article (10.1007/s43546-020-00013-w) contains supplementary material, which is available to authorized users.
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