Biswas Barnali, Roy Piyal Basu
Department of Geography, Cooch Behar Panchanan Barma University, Cooch Behar, India.
J Patient Cent Res Rev. 2023 Jul 18;10(3):121-127. doi: 10.17294/2330-0698.2013. eCollection 2023 Summer.
Assessment of patient experiences is an essential step to revamp patient-centered care and identify systemic effectiveness as part of universal health coverage. This paper analyzes the variation of health care at different levels of the public health care system in India by measuring patients' experience with the care they have received in the Alipurduar district of India.
From May 2021 to April 2022, stratified sampling technique was applied to collect primary data from 450 patients having different health problems from different levels of the public health care system. In addition, Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey results were used to evaluate patient experience, with the reliability of questions measured by Cronbach's alpha. Collected data were categorized with the help of exploratory factor analysis; after which, analysis of variance and post-hoc tests were applied to understand specific variations in patient experiences.
This study identified that the services delivered in the health centers were not suitable (6.160 out of 10) to fulfill the needs of the patients. Among the three domains of health care services - namely, proficiency, tangibility, and information - the experience of patients significantly varied (P<0.001) when comparing primary, secondary, and tertiary levels of the public health care system.
Patients receiving services from the centers under the tertiary level have expressed lesser satisfaction than those patients who have received care at primary or secondary levels because of excessive patient load, inadequate manpower, and other infrastructure deficits at the tertiary level.
评估患者体验是改进以患者为中心的医疗服务并确定作为全民健康覆盖一部分的系统有效性的重要步骤。本文通过衡量印度阿里布尔杜阿尔地区患者接受医疗服务的体验，分析了印度公共医疗系统不同层面医疗服务的差异。
2021年5月至2022年4月，采用分层抽样技术从公共医疗系统不同层面患有不同健康问题的450名患者中收集原始数据。此外，利用医疗服务提供者和系统消费者评估（CAHPS）调查结果来评估患者体验，问题的可靠性通过克朗巴哈系数进行衡量。收集到的数据借助探索性因素分析进行分类；之后，应用方差分析和事后检验来了解患者体验的具体差异。
本研究发现，健康中心提供的服务（满分10分，得6.160分）无法满足患者需求。在医疗服务的三个领域——即专业性、有形性和信息方面——比较公共医疗系统的初级、二级和三级层面时，患者的体验存在显著差异（P<0.001）。
由于三级层面患者负担过重、人力不足以及其他基础设施短缺，在三级层面中心接受服务的患者比在初级或二级层面接受治疗的患者满意度更低。
