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.     

Patient satisfaction with transgender health services

Measuring patient satisfaction (i.e., patients' subjective evaluation of health care services received) is increasingly important in assessing health care outcomes because of the current emphasis on greater partnership between providers (therapist, doctor, staff) and consumers (patients) in health care. In care of transgender persons, achieving good patient satisfaction is particularly challenging given the primary role mental health professionals play as arbiters of who has access to sex reassignment and when such candidates are ready. Dependence on a mental health professional in this "gate-keeping" role is perceived by some members of the transgender community as unnecessarily pathologizing. This study compared satisfaction ratings of 180 transgender and 837 other sexual health patients with psychotherapeutic, psychiatric, and sexual medicine services provided at a university-based sexual health clinic. Five consecutive surveys conducted during 1993-2002 showed high patient satisfaction. We found few significant differences between transgender and other sexual health patients, except that in 1995, transgender patients had higher satisfaction on their perceived ability to handle the problems that originally had led them to therapy. Survey results helped target areas in need of improvement (e.g., friendliness and courtesy of staff, handling of phone calls), and efforts by the providers to improve services resulted in significant increases in patient satisfaction. These findings put individual complaints in perspective and showed that despite the challenges inherent in providing transgender care good satisfaction can be achieved. We encourage providers to implement quality assurance and improvement procedures to give patients the opportunity to provide feedback and have a voice in shaping their own health care.     

The prisoner as patient - a health services satisfaction survey

Background  

There is evidence for higher morbidity among prison inmates than in the general population. Despite this, patient satisfaction with the prison health services is scarcely investigated. The aim of the present study was to investigate patient satisfaction with prison health services in Norway and to analyze possible patient and service effects.     

大学生高校社区卫生服务满意度调查

探讨大学生对高校社区卫生服务的满意度及相关因素与作用机制,为提升高校社区卫生服务的水平提供参考.方法 采取定性与定量相结合的方法进行调查.使用自设问卷和访谈提纲,对北京和济南通过偶遇法选取的研究对象进行调查,使用秩和检验、非条件Logistic回归等方法进行分析.结果 大学生对高校社区卫生服务的总体满意度介于一般与较为满意之间,均分为3.24分;满意率较高的为服务价格(50.9%)与服务质量(31.6%),较低的为服务内容(l0.8%)与报销流程(11.7%);对本校社区卫生服务的了解程度、服务质量、服务态度、服务内容对大学生高校社区卫生服务满意度的影响均有统计学意义(P值均<0.05).结论 应改善高校社区卫生服务质量与态度,丰富服务内容,多方面提升大学生满意度.     

Marketing health services: the engineering of satisfaction

Service marketing is the engineering of satisfaction, and the key to success is to identify and influence potential customers' expectations and then to fulfill those expectations. Patient satisfaction largely determines both a program's revenues and expenditures and the effectiveness of care received by patients. A program's ability to satisfy patients rests upon three basic elements: research, design, and communication. Research should be on two levels. The first is basic market assessment and analysis, and should reveal overall market potential by focusing on consumers' expectations, unmet needs, and level of satisfaction. From this stage of research, the organization should be able to identify current programs that are secure and stable, those which have significant growth potential, those which are threatened by competition, and those which have little future. This research also should indicate the potential for new programs and for new markets for existing programs. The second level of research focuses on a specific program (whether current or proposed) and is the basis for program design. The organization can tailor the program to consumers' expectations in everything from services provided to price of parking and other amenities. Research also provides a basis for communications. Not only can communications influence a potential customer to try a provider, but also care providers can use communications during and after the service experience to reinforce what might have been a casual decision. Ideally, all communication that occurs between patients and providers should serve marketing as well as diagnostic and therapeutic purposes. It can shape patients' expectations, reinforce satisfaction when those expectations have been fulfilled, and convey the provider's caring and concern.     

Correlates of patient satisfaction with mental health services in a health maintenance organization

To assess the level and determinants of patient satisfaction with prepaid mental health services, the authors surveyed 124 adult patients who five years earlier had been seen at least once by a mental health professional. Of the 44 percent who returned questionnaires, approximately one third reported satisfaction, one third dissatisfaction, and one third were unsure. Most patients sought help for chronic situational problems and tended to use the services repeatedly over time. Satisfaction was most strongly correlated with the patients' perceptions of their rapport with the provider and slightly less so with their perceptions of the provider's technical competence. Patient characteristics, diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders (DSM 3), and systems issues were of no predictive value. Patients who presented with symptomatic distress not clearly linked to circumstances were likely to be dissatisfied with treatment.     

卫生服务的效率及其测量

效率是卫生服务部分经济学评价的重要原则之一,包括3层含义：技术效率、成本－效果和配置效率,文章阐述了对有关概念的不同理解及各种测量方法。常用以下方法测量技术效率：比率分析法、秩和比法、综合指数法和数据包络分析（DEA）等;用生产函数来测量经济效率;用成本效果分析（CEA）、成本效用分析（CUA）和成本效果分析（CBA）评价成本结果。评价配置效率的指标主要有：医疗和预防服务的比例、基本医疗和非基本医疗服务的比例、卫生总费用的流向等。     

Evaluation of individuals’ satisfaction with health care services in Turkey

Objectives

To demonstrate whether features related to the institution and service provider affect individuals’ level of satisfaction regarding the public health care services they receive.

Consumer satisfaction: a model for health services administrators

Health care administrators should recognize that the economic quality and behavioral quality dimensions comprising consumer satisfaction are conceptually independent in nature and may be empirically independent as well.     

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.     

The treatment received by public health services users in Mexico]

OBJECTIVE: To document the fact that differences in the treatment received by health services users in Mexico are mainly dependent on the type of provider, regardless of the users' socioeconomic status.METHODS: The data were obtained by means of a survey of 18 018 users who visited 73 health services in 13 states within Mexico. They were asked to grade the way the institution had performed in seven of the eight domains that define appropriate user treatment (autonomy, confidentiality, communication, respectful manner, condition of basic facilities, access to social assistance networks, and free user choice). The questionnaire included some vignettes to help determine user expectations. A composite ordinal probit model was applied; the perception of quality in connection with each of the appropriate treatment domains was the independent variable, whereas gender, educational level, age, type of provider, and user expectations were used as control variables.RESULTS: The type of provider was the main factor that determined users' perceptions regarding the treatment they received when visiting health services in Mexico. Institutions belonging to the social security system performed the worst, while the services provided under the program targeting the rural population (IMSS Oportunidades) received the highest scores. Overall, the domain that was most highly ranked was respectful manner, whereas the lowest score was given to the ability to choose the provider. Men felt they had been able to communicate better than women, while respectful manner, communication, and social support showed a significant negative association with educational level (P < 0.05).CONCLUSIONS: Differences were noted in the way different public health service providers in Mexico treat their users, regardless of the latter's socioeconomic status. Social security system providers showed the greatest deficiencies in this respect. Respectful manner was the domain that received the highest scores in the case of all providers. Organizational changes need to be made, since the shortcomings detected are not solely determined by factors related to health personnel, but also by certain aspects of the way the health system is structured in Mexico.     

非政府举办社区卫生服务机构患者满意度调查

目的了解某市社区居民对社区卫生服务满意度的评价并提出社区卫生服务改善的思路。方法选择2010年9月在该市的20个非政府举办社区卫生服务机构就诊的患者350例,对他们进行问卷调查,主要包括就诊者到社区卫生服务机构就诊的目的、就诊者对社区卫生服务机构的满意度。结果有12.3%的居民对社区卫生服务总体非常满意,有64.3%的社区居民对社区卫生总体评价为满意,对总体服务评价为不满意的为0,分析显示,不同职业的就医者对社区卫生服务满意度有显著区别。结论该市社区卫生服务获得了比较好的评价,但还存在较大的改善空间,社区卫生服务管理者应该采取积极的措施提高其服务质量。     

Patient satisfaction and experience with health services and quality of care

This article discusses the use of patient satisfaction and personal health care experiences as a measure of health care quality. It also presents a field-proven patient experience and satisfaction assessment methodology known as the Patient Experience Survey (PES) that has been employed throughout the country for the last decade. Finally, it offers recommendations and comments on the use of patient satisfaction data in quality assessment and improvement.     

Patient satisfaction: refinement of the instrument for health services evaluation

This study reviewed the literature on Patient's Satisfaction in published articles in national and international bulletins. The concepts and dimensions of satisfaction have been identified since it is important to measure patient's opinions on satisfaction, which we consider prominent points. Once we have accomplished the analysis of several studies in this context, to serve as a basis for future research geared at measuring patient's satisfaction, comparative analysis of correlated subjects has been done, when several questionnaires on Services Evaluation and Patient's Self-Evaluation on Satisfaction were studied getting to a consensus that they could serve as subsidy for the orientation and development in this kind of research with little adaptation and improvement.     

抚州市基本公共卫生服务居民满意度及影响因素分析

目的：了解居民对基本公共卫生服务的满意度及其相关的影响因素,为更好的开展基本公共卫生服务项目提供依据。方法采用自行设计的调查问卷对全市34家基层医疗机构辖区居民进行问卷调查,计算基本公共卫生服务满意度,采用多元线性回归分析法分析居民满意度的影响因素。结果共调查研究对象3378名,满意度介于66.49%~77.53%之间,健康档案管理的管理满意度最高,对重症精神疾病患者管理满意度最低,医疗机构服务内容、服务态度和技术水平及被调查对象的学历水平是居民满意度的影响因素。结论在国家财政允许的情况下,有必要进一步加大对基本公共卫生服务项目的投入力度,扩大基本公共卫生服务的覆盖面和内容,加强培训提高服务提供人员的业务素质,让更多的服务惠及居民,提升居民对基本公共卫生项目的满意度。