Afework Senait, Mariam Damen Haile, Demeke Berhanu
Department of Community Health, Faculty of Medicine, Addis Ababa University, P.O. Box 11950, Addis Ababa, Ethiopia.
Ethiop Med J. 2003 Jul;41(3):267-78.
Involvement of the private sector in provision of health services has progressively increased in many developing countries including Ethiopia. Promotion of the private sector involvement is also one of the elements in the health care financing strategy in Ethiopia. A cross sectional descriptive study was done on quality of care in private clinics in Addis Ababa during the period of April, 2000. Different levels of clinics were randomly selected and assessments were done on structural aspects, performance of health workers in polyclinic outpatient department and patients satisfaction with the medical care given. It was found that most clinics fulfill the requirements of the Ministry of Health (MOH) with regard to staffing, equipment and medications. Nevertheless few clinics were found not to fulfill the minimum requirements put in the guideline. With regard to performance, various aspects of mal-performance were observed where the highest problem was concerning treatments given to patients. High rates of satisfaction were generally reported in all aspects of medical care that include: waiting time, cleanliness of facilities and equipment, courtesy and competence of providers and the effectiveness of the services provided. Relatively lower proportion of respondents has reported dissatisfaction with the services provided. The aspects of the private sector services for which dissatisfaction was reported were too high service charge and too little information given about nature and prospect of diseases. These imply that the private facilities included in the study are generally doing well in terms of structural as well as in most process attributes of quality while provider-patient interaction and competitive pricing of services seem to be areas that need improvement. Findings are discussed in comparison with findings in public and private health facilities in Ethiopia and other countries. In addition, the inclusion of periodic assessment of process of care in quality control measures is recommended.
在包括埃塞俄比亚在内的许多发展中国家,私营部门参与提供卫生服务的程度已逐渐提高。促进私营部门的参与也是埃塞俄比亚卫生保健筹资战略的要素之一。2000年4月期间,针对亚的斯亚贝巴私立诊所的医疗质量开展了一项横断面描述性研究。随机选择了不同级别的诊所,并对其结构方面、综合门诊部医护人员的表现以及患者对所提供医疗服务的满意度进行了评估。结果发现,大多数诊所符合卫生部在人员配备、设备和药品方面的要求。然而,发现少数诊所未达到指南规定的最低要求。在表现方面,观察到了各种不良表现,其中最严重的问题涉及对患者的治疗。总体而言,在医疗服务的各个方面,包括:等待时间、设施和设备的清洁程度、提供者的礼貌和能力以及所提供服务的有效性,满意度都很高。相对较低比例的受访者表示对所提供的服务不满意。报告不满意的私营部门服务方面包括服务收费过高以及关于疾病性质和预后的信息过少。这些表明,本研究中纳入的私营机构在结构以及质量的大多数过程属性方面总体表现良好,而医患互动和服务竞争定价似乎是需要改进的领域。将研究结果与埃塞俄比亚及其他国家公立和私立卫生机构的研究结果进行了比较讨论。此外,建议在质量控制措施中纳入对护理过程的定期评估。