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加纳库马西选定医疗机构门诊部护理质量的患者满意度。

Patient satisfaction with quality of care at out-patient departments in selected health facilities in Kumasi, Ghana.

机构信息

Department of Health Policy, Management, and Economics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

Department of Epidemiology and Biostatistics, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.

出版信息

BMC Health Serv Res. 2024 Sep 4;24(1):1027. doi: 10.1186/s12913-024-11399-w.

Abstract

BACKGROUND

Health care is an indispensable element for economic growth and development of individuals and nations. Healthcare service quality is associated with patient satisfaction, ensuring the safety and security of patients, reducing mortality and morbidity, and improving the quality of life. Patient satisfaction with health service is linked to increased utilization following contendness with healthcare received from health providers. There is an increasing public perception of poor quality of care among patients visiting public health facilities in Ghana which translates into service dissatisfaction. Meanwhile, patient dissatisfaction will more likely result in poor utilization, disregard for medical advice, and treatment non-adherence. The study was conducted to assess patients' satisfaction with quality of care at the outpatient departments of selected health facilities in Kumasi, Ghana.

METHODS

An institutional-based analytical cross-sectional study was conducted among patients (aged ≥ 18 years) visiting outpatient departments of selected health facilities in Kumasi from October - December, 2019. A systematic sampling technique was adopted to collect quantitative information from 385 respondents using a structured questionnaire. At 95% confidence interval and 5% alpha level, two-level logistic regression models were performed. Model I estimated the crude associations and the effect of covariates was accounted for in Model II. The results were presented in odds ratio with a corresponding 95% confidence interval. All analysis were performed using STATA statistical software version 16.0.

RESULTS

Out of the 385 participants, 90.9% of the participants were satisfied with the services they received. Being married [AOR = 3.06, 95%CI = 1.07-8.74], agreeing that the facility is disability-friendly [AOR = 7.93, 95%CI = 2.07-14.43], facility has directional signs for navigation [AOR = 3.12, 95%=1.92-10.59] and the facility has comfortable and attractive waiting area [AOR = 10.02, 95%CI = 2.35-22.63] were associated with satisfaction with health service among patients. Spending more than 2 h at the health facility [AOR = 0.45, 95%CI = 0.04-0.93] and having perceived rude and irritating provider [AOR = 0.14, 95%CI = 0.04-0.51] had lower odds of satisfaction with health service received.

CONCLUSION

There is a high patient satisfaction with services received at out-patient departments which is influenced by a multiplicity of factors; being married, and agreeing that the facility is disability-friendly, has directional signs for navigation, and the waiting area is comfortable and attractive. The study findings call for the need to develop and implement health delivery interventions and strategies (i.e. patient-centered interventions, disability-friendly facilities, and sustainability and improvement of quality service) to improve and sustain patient satisfaction levels with health care service. These strategies must be directed towards addressing inequalities in infrastructural development and inputs needed for healthcare delivery in the health system.

摘要

背景

医疗保健是个人和国家经济增长和发展不可或缺的要素。医疗服务质量与患者满意度相关,确保患者的安全和保障,降低死亡率和发病率,并提高生活质量。患者对医疗服务的满意度与对从医疗服务提供者那里获得的医疗服务的满意度相关,这会增加患者的利用率。越来越多的公众认为加纳公立卫生设施的护理质量差,这导致了服务满意度降低。同时,患者的不满可能会导致利用率降低、忽视医疗建议和治疗不依从。本研究旨在评估加纳库马西选定卫生设施的门诊部门的患者对医疗服务质量的满意度。

方法

这是一项在 2019 年 10 月至 12 月期间,在库马西选定卫生设施的门诊部门就诊的年龄≥18 岁的患者中进行的基于机构的分析性横断面研究。采用系统抽样技术,从 385 名受访者中收集了定量信息,使用的是结构式问卷。在 95%置信区间和 5%α水平下,进行了两级逻辑回归模型分析。模型 I 估计了原始关联,模型 II 中考虑了协变量的影响。结果以比值比(OR)和相应的 95%置信区间(CI)表示。所有分析均使用 STATA 统计软件版本 16.0 进行。

结果

在 385 名参与者中,90.9%的参与者对他们所接受的服务感到满意。已婚(OR=3.06,95%CI=1.07-8.74)、同意设施对残疾人士友好(OR=7.93,95%CI=2.07-14.43)、设施有明确的导向标志(OR=3.12,95%CI=1.92-10.59)和设施有舒适且有吸引力的等候区(OR=10.02,95%CI=2.35-22.63)与患者对卫生服务的满意度有关。在卫生机构花费超过 2 小时(OR=0.45,95%CI=0.04-0.93)和认为医务人员粗鲁无礼(OR=0.14,95%CI=0.04-0.51)的患者,对所接受的卫生服务的满意度较低。

结论

门诊部门的患者对所接受的服务满意度很高,这受到多种因素的影响,包括已婚、同意设施对残疾人士友好、有明确的导向标志、等候区舒适且有吸引力。研究结果表明,需要制定和实施医疗服务提供干预措施和策略(即以患者为中心的干预措施、对残疾人士友好的设施以及可持续和改进的服务质量),以提高和维持患者对医疗服务的满意度。这些策略必须针对卫生系统中医疗保健提供所需的基础设施发展和投入方面的不平等问题。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5b20/11375930/70299f3ce7c2/12913_2024_11399_Fig1_HTML.jpg

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