Alemu Ayenew Takele, Walle Ayinengida Adamu, Atnafu Desta Debalkie
Department of Health System Management and Health Economics, School of Public Health, Bahir Dar University, Bahir Dar, Ethiopia.
Patient Prefer Adherence. 2020 Sep 18;14:1649-1658. doi: 10.2147/PPA.S264106. eCollection 2020.
Poor quality of pediatric healthcare services at health facilities is a major contributing factor to child morbidity and mortality in low- and middle-income countries, including Ethiopia, and it brings parental dissatisfaction. Eliciting parents' perception is an important method used to assess functionality or quality of pediatric healthcare services. Thus, the objective of this study was to assess the perceived quality of pediatric healthcare services and to identify factors for it in Felege-Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia.
A facility-based cross-sectional study was conducted among parents of childhood patients from September 15, 2019 to October 15, 2019; 407 participants were recruited. Stratified random sampling was used to select respondents and data were collected using face-to-face interviews. Frequencies, percentages, and means with standard deviations were used to describe profiles of respondents. Both bi-variable and multivariable logistic regressions were used to model the odds of perceived quality of pediatric healthcare services.
The proportion of perceived quality of pediatric healthcare services was 57.6% (95% CI:52.6-62.3%). College and above parental education status (AOR=5.22, 95% CI:2.39-11.38), urban residency (AOR=3.35, 95% CI:1.97-5.72), outpatient services (AOR=2.52, 95% CI:1.35-4.71), and surgical illnesses (AOR=2.18, 95% CI:1.28-3.73) were independent determinants for increased parental lower perceived level of quality. The odd of parental lower perceived level of quality was 2.42-times greater in those parents who did not prefer the hospital for revisiting (AOR=2.42, 95% CI:1.36-4.30).
Perceived quality of healthcare services in the hospital was low compared to the national plan which reflected that childhood patients did not receive optimal care. Educational status, place of residence, service delivering unit, illness type, and intention of hospital preference were independent determinants for parental perceived quality of pediatric healthcare service delivery. Continuous and periodic parental feedback should be considered in order to assess their satisfaction which in turn is an insight for quality improvement to be taken by the facility managers.
在包括埃塞俄比亚在内的低收入和中等收入国家，医疗机构儿科医疗服务质量低下是导致儿童发病和死亡的主要因素，并且会引起家长不满。了解家长的看法是评估儿科医疗服务功能或质量的重要方法。因此，本研究的目的是评估西北埃塞俄比亚费莱格 - 希沃特综合专科医院儿科医疗服务的感知质量，并确定其影响因素。
于2019年9月15日至2019年10月15日对儿童患者的家长进行了一项基于机构的横断面研究；招募了407名参与者。采用分层随机抽样选择受访者，并通过面对面访谈收集数据。使用频率、百分比以及带有标准差的均值来描述受访者的特征。采用双变量和多变量逻辑回归对儿科医疗服务感知质量的几率进行建模。
儿科医疗服务感知质量的比例为57.6%（95%置信区间：52.6 - 62.3%）。父母教育程度为大专及以上（调整后比值比[AOR]=5.22，95%置信区间：2.39 - 11.38）、城市居住（AOR=3.35，95%置信区间：1.97 - 5.72）、门诊服务（AOR=2.52，95%置信区间：1.35 - 4.71）以及外科疾病（AOR=2.18，95%置信区间：1.28 - 3.73）是父母对质量感知水平降低的独立决定因素。那些不倾向于再次前往该医院的家长，其对质量感知水平较低的几率要高2.42倍（AOR=2.42，95%置信区间：1.36 - 4.30）。
与国家计划相比，该医院医疗服务的感知质量较低，这反映出儿童患者未得到最佳护理。教育程度、居住地点、服务提供科室、疾病类型以及医院偏好意向是父母对儿科医疗服务提供质量感知的独立决定因素。应考虑持续定期收集家长反馈，以评估他们的满意度，这反过来可为机构管理者进行质量改进提供参考。
