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Patient satisfaction and perceived quality of care: evidence from a cross-sectional national exit survey of HIV and non-HIV service users in Zambia
OBJECTIVE: To examine the associations between perceived quality of care and patient satisfaction among HIV and non-HIV patients in Zambia. SETTING: Patient exit survey conducted at 104 primary, secondary and tertiary health clinics across 16 Zambian districts. PARTICIPANTS: 2789 exiting patients. P...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710828/ https://www.ncbi.nlm.nih.gov/pubmed/26719321 http://dx.doi.org/10.1136/bmjopen-2015-009700 |
Sumario: | OBJECTIVE: To examine the associations between perceived quality of care and patient satisfaction among HIV and non-HIV patients in Zambia. SETTING: Patient exit survey conducted at 104 primary, secondary and tertiary health clinics across 16 Zambian districts. PARTICIPANTS: 2789 exiting patients. PRIMARY INDEPENDENT VARIABLES: Five dimensions of perceived quality of care (health personnel practice and conduct, adequacy of resources and services, healthcare delivery, accessibility of care, and cost of care). SECONDARY INDEPENDENT VARIABLES: Respondent, visit-related, and facility characteristics. PRIMARY OUTCOME MEASURE: Patient satisfaction measured on a 1–10 scale. METHODS: Indices of perceived quality of care were modelled using principal component analysis. Statistical associations between perceived quality of care and patient satisfaction were examined using random-effect ordered logistic regression models, adjusting for demographic, socioeconomic, visit and facility characteristics. RESULTS: Average satisfaction was 6.9 on a 10-point scale for non-HIV services and 7.3 for HIV services. Favourable perceptions of health personnel conduct were associated with higher odds of overall satisfaction for non-HIV (OR=3.53, 95% CI 2.34 to 5.33) and HIV (OR=11.00, 95% CI 3.97 to 30.51) visits. Better perceptions of resources and services were also associated with higher odds of satisfaction for both non-HIV (OR=1.66, 95% CI 1.08 to 2.55) and HIV (OR=4.68, 95% CI 1.81 to 12.10) visits. Two additional dimensions of perceived quality of care—healthcare delivery and accessibility of care—were positively associated with higher satisfaction for non-HIV patients. The odds of overall satisfaction were lower in rural facilities for non-HIV patients (OR 0.69; 95% CI 0.48 to 0.99) and HIV patients (OR=0.26, 95% CI 0.16 to 0.41). For non-HIV patients, the odds of satisfaction were greater in hospitals compared with health centres/posts (OR 1.78; 95% CI 1.27 to 2.48) and lower at publicly-managed facilities (OR=0.41, 95% CI=0.27 to 0.64). CONCLUSIONS: Perceived quality of care is an important driver of patient satisfaction with health service delivery in Zambia. |
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