Patient satisfaction with health services in Bangladesh

Concern over the quality of health care services in Bangladesh has led to loss of faith in public and private hospitals, low utilization of public health facilities, and increasing outflow of Bangladeshi patients to hospitals in neighbouring countries. Under the circumstances, assessment of the country's quality of health care service has become imperative, in which the patient's voice must begin to play a greater role. This study attempts to identify the determinants of patient satisfaction with public, private and foreign hospitals. A survey was conducted involving inpatients in public and private hospitals in Dhaka City and patients who have experienced hospital services in a foreign country. Their views were obtained through exit polls using probability and non-probability (for foreign hospital patients) sampling procedures. Regression models were derived to identify key factors influencing patient satisfaction in the different types of hospitals. Doctors' service orientation, a composite of 13 measures, is the most important factor explaining patient satisfaction. Policy implications are discussed.     

上海市社区卫生服务中心基本药物目录外用药需求分析

目的 ：分析上海市社区卫生服务中心基本药物目录外的实际用药需求。方法 ：通过分析上海市医疗机构药品集中招标采购数据库,针对社区卫生服务中心的工作人员和就诊患者开展问卷调查,从3个角度定量分析基本药物目录外用药需求。结果 ：基本药物目录外药品通用采购种类数占社区卫生服务中心药品通用名数的比例较高（66.6%）,但采购金额所占比例小（4.4%）;社区卫生服务中心工作人员对基本药物目录外药品的需求频次和紧缺程度上的反映略有差异;当社区患者配不到所需药品时,64%的被调查者会前往二、三级医院配药,12%的选择去药店购买,22%的选择替代药品,2%的选择自行停药。结论 ：社区基本药物目录之外的药品使用需求是普遍的,但集中度极低,多属于＂个性需求＂。     

广州市社区卫生服务机构基本药物可获得性调查

目的:了解城市社区卫生服务机构基本药物的可获得性,为促进基本药物制度的实施提供实证依据和政策建议。方法:选取广州市28个医疗机构进行数据收集,采用国际关于基本药物可获得性的标准方法进行分析和研究。结果:调查的40种药品中,社区卫生服务中心专利品牌药和最低价等效仿制药的可获得性中位数分别是13.16%和42.11%;26个专利药采购价格的中位数是国际参考价格的5.14倍,基本药物的零售价比其采购价高出15%～20%;少数常见病的药品费用超出了大多数人群的经济承受能力。结论:在广州,社区卫生服务中心的基本药物可获得性比较低;药品价格水平高于国际水平;调查涉及的大部分药物可负担性较好。     

山东省社区卫生服务机构医生国家基本药物制度知识-态度-行为调查

了解山东省社区卫生服务机构医生对国家基本药物制度的知识、态度和行为状况。方法:采用多阶段分层随机整群抽样抽取154名社区卫生服务机构医生进行问卷调查。结果:所有医生均表示自己听说过国家基本药物制度。73.4%的医生能准确说出国家基本药物的种类数,80.5%对现行国家基本药物制度满意,92.9%表示处方时会首选基本药物,74.7%曾接受过相关的培训。结论:今后应继续加强对医生群体的宣传和培训工作,并注重工作的针对性和持续性,促使其全面了解国家基本药物制度。     

山东省社区卫生机构基本药物实施现况调查

目的:了解基本药物制度在社区卫生服务机构实施的现状.方法:采用问卷调查和访谈相结合的方法,对山东省43所社区卫生服务机构基本药物推行情况进行调查.结果:实施基本药物制度有效降低了药费,但是存在目录内药品利用率不高、财政补偿不能及时到位、药品采购周期过长、宣传培训力度有待加强等问题.结论:基本药物制度在社区卫生机构实施状况良好,但仍暴露出一些问题,建议继续完善基本药物制度以及出台相关配套政策.     

福州零差率试点社区卫生机构配备和使用基本药物情况跟踪调查

目的：分析福州地区零差率试点社区卫生服务中心配备和使用基本药物情况,了解国家基本药物制度推行过程中存在的问题。方法：通过结构式访谈向相关社区卫生服务中心负责人了解机构配备和使用基本药物情况及其相关问题;采用SPSS进行数据资料分析。结果：8家纳入零差率销售试点的机构不同程度地配备和使用了基本药物,但也存在目录外药品配备和使用比例较高等问题。结论：要不断完善相关配套政策,加强舆论宣传和教育引导,以促进基本药物制度持续良性地运作。     

社区卫生服务患者满意度评价引入第三方评价的分析研究

目的:分析社区卫生服务患者满意度调查研究中,第三方评价对社区卫生服务患者满意度研究的意义.方法:采用分层随机抽样的方法,利用自制的调查问卷,对潍坊市6个社区的502名居民进行了拦截式的调查.结果:科室设置、医疗设备完备性、人员配置、医生数量、老年人健康教育、慢性病康复六个服务项目差别有统计学意义,P值分别为0.034、0.019、0.004、0.050、0.039、0.035,其他项目差别无统计学意义.结论:社区卫生服务患者满意度实施第三方评价更有利于社区卫生服务质量的提高和基层卫生事业的发展.     

Patient satisfaction with health care services at a national institute of ophthalmology

Little is known about how patients in developing countries, such as Vietnam, are satisfied with eye care services. The purpose of this study was to assess the satisfaction with health services and its associated factors among patients attending a national institute of ophthalmology in Vietnam. In a cross‐sectional study utilizing quantitative methods, 500 inpatients and their relatives attending a national institute of ophthalmology in Vietnam were approached for data collection. The results indicated that under 50% of the patients were satisfied with eye care services. However, when classified by level of satisfaction, only 6.8% were very satisfied with all domains of care. There was no significant difference in satisfaction by gender and income, while significant differences by department, residence, and education were found. Patients who were from rural areas, were better educated, and used the services of the glaucoma department, were more satisfied with eye care than those from urban areas, were less educated, and used the services of treatment‐on‐demand department. Multivariable regression detected 2 main factors, gender and location, associated with patient satisfaction. Patients who were female and came from rural and remote areas were more likely to be satisfied than patients who were male and living in urban areas. The study suggests that to continue to improve health care quality, it is important to eliminate differences in providing eye care services regardless of whether patients are male or female, and whether they come from a rural or urban area.     

杭州市拱墅区中医药社区卫生服务满意度调查分析

目的 了解杭州市拱墅区中医药社区卫生服务满意度现状和影响因素.方法 采用随机抽样方法,确定1000名研究对象,采用自制问卷进行满意度调查.运用单因素分析、多因素分析方法对调查对象的中医药社区卫生服务满意度现状及影响因素进行分析.结果 杭州市拱墅区中医药社区卫生服务满意度为83.3%.X2检验结果显示,不同生活状况、体育锻炼情况、自身健康满意度、吸烟情况、中医药方法保健情况、中医药治疗次数和自评医疗技术水平的居民的医药社区卫生服务满意度之间差异均有统计学意义(P<0.05).多因素logistic回归分析结果显示,每天锻炼、不吸烟、总是进行中医药保健、中医药治疗次数大于等于5次、自评医疗技术水平很好、对中医药持正面看法的居民对中医药社区卫生服务满意度较高(均P<0.05).结论 杭州市拱墅区中医药社区卫生服务满意度较高,体育锻炼情况、吸烟情况、中医药方法保健情况、中医药治疗次数、自评医疗技术水平和对中医药的看法是中医药社区卫生服务满意度的重要影响因素.     

天津市宝坻区某镇居民卫生服务满意度基线调查分析——国家科技部十一五规划项目“全科型乡镇卫生院建设”项目

目的:了解农村居民对乡镇卫生院卫生服务的满意情况,为发展和提高农村卫生服务提供理论依据。方法:随机抽取587名口东镇居民,通过问卷调查形式,进行就医满意度调查,并对数据进行描述性分析。结果:本次调查结果显示,农村居民对于乡镇卫生院门诊服务的总体满意度为31.8%,各分类的满意度由高到低依次为:护士满意度(80.3%)、就医便捷程度(72.6%)、城镇居民医保报销情况(52.1%)、收费合理性(44.3%)、服务态度(35.3%)、解释交流(33.7%)、慢病防治知识告知(8.6%)、预防保健服务(8.5%)、药品齐全程度(5.3%)、就医设施和环境(4.8%)、医师技术(4.8%)。结论:满意度最低的五项为医师技术、就医设施和环境、药品齐全程度、慢病防治知识告知、预防保健服务,满意度均不足10%,提示乡镇卫生院应多渠道提高医师自身业务水平,不断提高卫生院预防保健职能,优化卫生院就医条件,增加药品种类,为居民提供更优质的卫生服务,以提高卫生院的整体满意度水平。     

Investigating the job satisfaction of healthcare providers at primary healthcare centres in Lebanon: A national cross‐sectional study

Low job satisfaction is linked to higher staff turnover and intensified shortages in healthcare providers (HCP). This study investigates the level of, and factors associated with, HCP job satisfaction in the national primary healthcare (PHC) network in Lebanon. The study adopts a cross‐sectional design to survey HCP at 99 PHC centres distributed across the country between October 2013 and May 2014. The study questionnaire consisted of four sections: socio‐demographics/professional background, employment characteristics, level of job satisfaction (Measure of Job Satisfaction scale) and level of professional burnout (Maslach Burnout Inventory‐HSS scale). A total of 1,000 providers completed the questionnaire (75.8% response rate). Bivariate and multivariate regression analyses were used to identify factors significantly associated with job satisfaction. Findings of the study highlight an overall mean job satisfaction score of 3.59 (SD 0.54) indicating that HCP are partially satisfied. Upon further examination, HCP were least satisfied with pay, training and job prospects. Gender, age, career plans, salary, exposure to violence, and level of burnout were significantly associated with the overall level of job satisfaction which was also associated with increased likelihood to quit. Overall, the study highlights how compensation, development and protection of PHC HCP can influence their job satisfaction. Recommendations include the necessity of developing a nationally representative committee, led by the Ministry of Public Health, to examine the policies and remuneration scales within the PHC sector and suggest mechanisms to bridge the pay differential with other sectors. The effective engagement of key stakeholders with the development, organisation and evaluation of professional development programmes offered to HCP in the PHC sector remains crucial. Concerned stakeholders should assess and formulate initiatives and programmes that enrich the physical, psychological and professional well‐being of their HCP. The aforementioned suggestions are necessary to strengthen and sustain PHC HCP and support the provision of universal health coverage to the Lebanese population.     

宁波市江北区社区卫生服务居民满意度的实证研究

以居民满意度为基础的评价机制,是社区卫生服务公共政策评价最为基础的方法。本文构筑了一个以客观为基础的评价指标体系,从逻辑起点、逻辑过程、逻辑结果和逻辑效用四个环节对江北区社区卫生服务居民满意度进行了综合评估。结果显示江北社区卫生服务知晓率与认知率、服务利用状况、效果、满意度、收益等主要指标都有了一定的提高,在群众满意基础上的社区卫生服务具有自身发展的内在动力,群众对于社区卫生服务综合配套改革的满意度较高与改革预期的政策目标效用相一致。但依然需要注重社区卫生服务的宣传、强化全科服务的能力、提高服务质量和效率,以进一步推进综合改革向前发展。     

Patient satisfaction with primary health care services in the United Arab Emirates.

OBJECTIVE: This study evaluated the suitability of a patient satisfaction questionnaire to survey health care consumers of traditional Arabic background. DESIGN: A cross-sectional survey using an Arabic language questionnaire that drew upon concepts of patient satisfaction measurement in Western research literature. All participants were interviewed once by experienced interviewers to ascertain their levels of satisfaction with their health care service. SETTING: Patient satisfaction was compared between the only resource-intensive clinic (RIC) in the United Arab Emirates and one resource-thrifty clinic (RTC) located in an adjacent suburb and serving essentially the same population. STUDY PARTICIPANTS: A random sample of patients attending the RIC and RTC over a 5-day period. MAIN OUTCOME MEASURES: Six domains of patient satisfaction were measured. RESULTS: Compared with the RTC (n = 125), the RIC (n = 156) scored significantly higher in continuity (P = 0.001), comprehensiveness (P < 0.001), health education (P = 0.05), effectiveness (P = 0.001), and overall satisfaction (P < 0.001), while accessibility (P = 0.130) and humaneness (P = 0.102) were not significantly different. Humaneness scored the highest and continuity the lowest at both clinics. Older people's satisfaction was higher for comprehensiveness but otherwise the same as those who were younger. More highly educated people's satisfaction was lower for effectiveness, but otherwise the same as those who were less educated. Men and women had equal levels of satisfaction. CONCLUSIONS: The significantly higher patient satisfaction in the RIC compared with the RTC was a strong a priori expectation, suggesting that this satisfaction questionnaire is a useful quality assurance tool in this setting.     

经济欠发达地区农村社区卫生服务模式探索

目的:介绍经济欠发达地区农村社区卫生服务模式并评价该模式对促进农村卫生工作和初级卫生保健的有效性。方法:通过开发领导、培训卫生人员、制定标准及完善制度、开发激励政策等方面对试点进行干预。选取江西省崇义县作为干预组,江西省芦溪县作为对照组。2009年6月和2010年6月分别对两地进行基线调查和追踪调查,评价其实施效果。结果:通过开展社区卫生服务,崇义县卫生机构公共卫生服务数量增加,村卫生机构在3岁以下儿童系统管理、孕产妇产后访视、慢性病人管理等方面开展比例分别由53.1%、51.2%、46.9%上升到77.8%,73.3%、71.1%,居民对医疗服务(就诊、住院)满意度提高;芦溪县没有明显变化。结论:建立了一种通过服务理念、服务模式的改变和激励政策的开发促进农村初级卫生保健工作的工作模式,这种模式适合于经济欠发达地区,政府投入不会太大,也不需涉及机构的转型和太多的体制问题,给欠发达地区农村卫生改革提供了启示和借鉴。     

宁波市江北区社区卫生服务激励机制与工作满意度探讨

社区卫生服务工作人员是否满意、是否能够得到有效的激励是社区卫生服务改革中一个十分关键的问题。宁波市江北区从分配激励、发展激励和责任激励三个方面进行了社区卫生服务员工激励机制的改革。本文构建了由公平指数、发展指数、和谐指数、快乐指数、满意指数构成的社区卫生服务工作人员满意度综合评价体系,来评估江北社区卫生机构人员的满意度。结果显示,员工的发展、快乐与和谐指数得分较高,而公平指数与满意指数得分较低。因此,需要进一步深化对社区卫生服务的改革,通过物质激励和精神激励并重、责任和发展并重、公平和效率并重的激励机制来提升工作满意度。