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      Determinants of patient satisfaction with outpatient health services at public and private hospitals in Addis Ababa, Ethiopia

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          Abstract

          Background

          Patients have explicit desires or requests for services when they visit hospitals. However, inadequate discovery of their needs may result in patient dissatisfaction. This study aimed to determine the levels and determinants of patient satisfaction with outpatient health services provided at public and private hospitals in Addis Ababa, Central Ethiopia.

          Methods

          A comparative cross-sectional study was conducted from 27 March to 30 April 2010. The study included 5 private and 5 public hospitals. Participants were selected using systematic random sampling. A pre-tested and contextually prepared structured questionnaire was used to conduct interviews. Descriptive statistics, analysis of variance, factor analysis and multiple linear regressions were performed using computer software (SPSS 16.0).

          Results

          About 18.0% of the patients at the public hospitals were very satisfied whilst 47.9% were just satisfied with the corresponding proportions a bit higher at private hospitals. Self-judged health status, expectation about the services, perceived adequacy of consultation duration, perceived providers’ technical competency, perceived welcoming approach and perceived body signalling were determinants of satisfaction at both public and private hospitals.

          Conclusions

          Although patients at the private hospitals were more satisfied than those at the public hospitals with the health care they received, five of the predictors of patient satisfaction in this study were common to both settings. Thus, hospitals in both categories should work to improve the competencies of their employees, particularly health professionals, to win the interests of the clients and have a physical structure that better fits the expectations of the patients.

          Abstrait

          Les facteurs de satisfaction des patients quant aux soins ambulatoires dans les hôpitaux publics et privés à Addis Abeba, Éthiopie

          Contexte

          Les patients ont des souhaits et des demandes explicites concernant les services lors des visites à l'hôpital. Cependant, une réponse inappropriée à leurs besoins peut entraîner l'insatisfaction du patient. Cette étude a pour but de déterminer les niveaux et les facteurs de satisfaction du patient quant aux soins ambulatoires fournis dans les hôpitaux publics et privés à Addis Abeba, en Éthiopie centrale.

          Méthodes

          Une étude transversale comparative a été réalisée du 27 mars au 30 avril 2010. L’étude concernait 5 hôpitaux publics et 5 hôpitaux privés. Les participants ont été sélectionnés en utilisant la technique systématique d’échantillonnage aléatoire. Un questionnaire pré-testé et mis en contexte a été utilisé pour mener à bien les entretiens. Les statistiques descriptives, l'analyse de la variance, l'analyse des facteurs et la régression linéaire multiple sont effectuées au moyen d'un logiciel informatique (SPSS 16.0).

          Résultats

          Près de 18% des patients des hôpitaux publics étaient très satisfaits alors que 47.9% étaient seulement satisfaits, les proportions étant légèrement supérieures dans les hôpitaux privés. L’état de santé auto-déclaré, les attentes concernant les services, la perception de la pertinence de la durée des consultations, la perception de la compétence technique des fournisseurs de soins, la perception de l'accueil et la perception du langage corporel étaient déterminants pour la satisfaction, dans les hôpitaux privés comme publics.

          Conclusions

          Bien que les patients des hôpitaux privés soient plus satisfaits que ceux des hôpitaux publics quant aux soins de santé qu'ils ont reçus, cinq des indicateurs de satisfaction des patients de cette étude étaient communs aux deux contextes. Ainsi, les hôpitaux des deux catégories devraient faire un effort afin d'améliorer la compétence de leurs employés, en particulier les professionnels de la santé, de concilier les intérêts de leurs clients et de disposer d'une infrastructure physique mieux adaptée aux attentes des patients.

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          Most cited references30

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          Patient satisfaction: a valid concept?

          Over the past 10 yr consumer satisfaction has gained widespread recognition as a measure of quality in many public sector services. This has become manifest in the NHS in the call by the 1983 NHS Management inquiry to ascertain how well the service is being delivered at local level by obtaining the experience and perceptions of patients and the community. Patient satisfaction is now deemed an important outcome measure for health services; however, this professed utility rests on a number of implicit assumptions about the nature and meaning of expressions of 'satisfaction'. Through a review of past research findings this paper suggests that patients may have a complex set of important and relevant beliefs which cannot be embodied in terms of expressions of satisfaction. Consequently, many satisfaction surveys provide only an illusion of consumerism producing results which tend only to endorse the status quo. For service providers to meaningfully ascertain the experience and perceptions of patients and the community then research must first be conducted to identify the ways and terms in which those patients perceive and evaluate that service.
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            Patient satisfaction: a review of issues and concepts.

            This review presents issues arising from an analysis of over 100 papers published in the field of patient satisfaction. The published output appearing in the medical and nursing literature which incorporated the term "patient satisfaction" rose to a peak of over 1000 papers annually in 1994, reflecting changes in service management especially in the U.K. and U.S.A. over the past decade. An introductory section discusses the setting and measurement of patient satisfaction within this wider context of changes in service delivery. Various models are examined that have attempted to define and interpret the idea of determining individual perceptions of the quality of health care delivered. Determinants of satisfaction are examined in relation to the literature on expectations, and demographic and psychosocial variables. These are distinguished from the multidimensional components of satisfaction as aspects of the delivery of care, identified by many authors. The review highlights the complexity and breadth of the literature in this field, the existence of which is often not acknowledged by researchers presenting the findings of studies.
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              Patients' experiences and satisfaction with health care: results of a questionnaire study of specific aspects of care.

              To determine what aspects of healthcare provision are most likely to influence satisfaction with care and willingness to recommend hospital services to others and, secondly, to explore the extent to which satisfaction is a meaningful indicator of patient experience of healthcare services. Postal survey of a sample of patients who underwent a period of inpatient care. Patients were asked to evaluate their overall experience of this episode of care and to complete the Picker Inpatient Survey questionnaire on specific aspects of their care. Patients aged 18 and over presenting at five hospitals within one NHS trust in Scotland. 3592 questionnaires were mailed to patients' homes within 1 month of discharge from hospital during a 12 month period. Two reminders were sent to non-responders; 2249 (65%) questionnaires were returned. Almost 90% of respondents indicated that they were satisfied with their period of inpatient care. Age and overall self-assessed health were only weakly associated with satisfaction. A multiple linear regression indicated that the major determinants of patient satisfaction were physical comfort, emotional support, and respect for patient preferences. However, many patients who reported their satisfaction with the care they received also indicated problems with their inpatient care as measured on the Picker Inpatient Survey; 55% of respondents who rated their inpatient episode as "excellent" indicated problems on 10% of the issues measured on the Picker questionnaire. The evidence suggests that patient satisfaction scores present a limited and optimistic picture. Detailed questions about specific aspects of patients' experiences are likely to be more useful for monitoring the performance of various hospital departments and wards and could point to ways in which delivery of health care could be improved.
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                Author and article information

                Journal
                Afr J Prim Health Care Fam Med
                Afr J Prim Health Care Fam Med
                PHCFM
                African Journal of Primary Health Care & Family Medicine
                AOSIS OpenJournals
                2071-2928
                2071-2936
                24 August 2012
                2012
                : 4
                : 1
                : 384
                Affiliations
                [1 ]College of Medicine and Health Sciences, Arbaminch University, Ethiopia
                [2 ]Department of Health Services Management, Jimma University, Ethiopia
                Author notes
                Correspondence to: Mirkuzie Woldie, Email: mirkuziewise@ 123456gmail.com , Postal Address: PO Box 1637, Jimma, Ethiopia

                How to cite this article: Tateke T, Woldie M, Ololo S. Determinants of patient satisfaction with outpatient health services at public and private hospitals in Addis Ababa, Ethiopia. Afr J Prm Health Care Fam Med. 2012;4(1), Art. #384, 11 pages. http://dx.doi.org/10.4102/phcfm.v4i1.384

                Article
                PHCFM-4-384
                10.4102/phcfm.v4i1.384
                4565136
                79f293ba-a6ac-4c1a-83e7-f61f5d8b12f6
                © 2012. The Authors

                AOSIS OpenJournals. This work is licensed under the Creative Commons Attribution License.

                History
                : 18 August 2011
                : 02 April 2012
                Categories
                Original Research

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