Predictors of patient satisfaction in an emergency care centre in central Saudi Arabia: a prospective study

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Abstract

Aim

This study aimed to (i) assess the level of patient satisfaction and its association with different sociodemographic and healthcare characteristics in an emergency care centre (ECC) in Saudi Arabia and (ii) to identify the predictors of patients' satisfaction.

Methods

A prospective cohort study of 390 adult patients with Canadian triage category III and IV who visited ECC at King Abdulaziz Medical City, Riyadh, Saudi Arabia, between 1 July and end of September 2011 was conducted. All patients were followed up from the time of arrival at the front desk of ECC until being seen by a doctor, and were then interviewed. Patient satisfaction was measured using a previously validated interview-questionnaire, within two domains: clarity of medical information and relationship with staff. Patient perception of health status after as compared with before the visit, and overall life satisfaction were also measured. Data on patient characteristics and healthcare characteristics were collected. Multiple linear regression analysis was used, and significance was considered at p≤0.05.

Results

One-third (32.8%) of patients showed high level of overall satisfaction and 26.7% were unsatisfied, with percentage mean score of 70.36% (17.40), reflecting moderate satisfaction. After adjusting for all potential confounders, lower satisfaction with the ED visit was significantly associated with male gender (p<0.001), long waiting time (p=0.032) and low perceived health status compared with status at admission (p<0.001). Overall life satisfaction was not a significant predictor of patient satisfaction.

Conclusions

An appreciation of waiting time as the only significant modifiable risk factor of patient satisfaction is essential to improve the healthcare services, especially at emergency settings.

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Most cited references 15

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Predictors of patient satisfaction with hospital health care

José Quintana, Nerea Gonzalez, Amaia Bilbao … (2006)

Background We used a validated inpatient satisfaction questionnaire to evaluate the health care received by patients admitted to several hospitals. This questionnaire was factored into distinct domains, creating a score for each to assist in the analysis. We evaluated possible predictors of patient satisfaction in relation to socio-demographic variables, history of admission, and survey logistics. Methods Cross-sectional study of patients discharged from four acute care general hospitals. Random sample of 650 discharged patients from the medical and surgical wards of each hospital during February and March 2002. A total of 1,910 patients responded to the questionnaire (73.5%). Patient satisfaction was measured by a validated questionnaire with six domains: information, human care, comfort, visiting, intimacy, and cleanliness. Each domain was scored from 0 to 100, with higher scores indicating higher levels of patient satisfaction. Results In the univariate analysis, age was related to all domains except visiting; gender to comfort, visiting, and intimacy; level of education to comfort and cleanliness; marital status to information, human care, intimacy, and cleanliness; length of hospital stay to visiting and cleanliness, and previous admissions to human care, comfort, and cleanliness. The timing of the response to the mailing and who completed the questionnaire were related to all variables except visiting and cleanliness. Multivariate analysis confirmed in most cases the previous findings and added additional correlations for level of education (visiting and intimacy) and marital status (comfort and visiting). Conclusion These results confirm the varying importance of some socio-demographic variables and length of stay, previous admission, the timing of response to the questionnaire, and who completed the questionnaire on some aspects of patient satisfaction after hospitalization. All these variables should be considered when evaluating patient satisfaction.

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How does satisfaction with the health-care system relate to patient experience?

Emre Özaltin, Christopher K L Murray, Sara Bleich (2009)

To explore what determines people's satisfaction with the health-care system above and beyond their experience as patients. Data on health system responsiveness, which refers to the manner and environment in which people are treated when they seek health care, provides a unique opportunity to better understand the determinants of people's satisfaction with the health-care system and how strongly this is influenced by an individual's experience as a patient. The data were obtained from 21 European Union countries in the World Health Survey for 2003. Additive ordinary least-squares regression models were used to assess the extent to which variables commonly associated with satisfaction with the health-care system, as recorded in the literature, explain the variation around the concept of satisfaction. A residual analysis was used to identify other predictors of satisfaction with the health-care system. Patient experience was significantly associated with satisfaction with the health-care system and explained 10.4% of the variation around the concept of satisfaction. Other factors such as patient expectations, health status, type of care, and immunization coverage were also significant predictors of health system satisfaction; although together they explained only 17.5% of the observed variation, while broader societal factors may largely account for the unexplained portion of satisfaction with the health-care system. Contrary to published reports, people's satisfaction with the health-care system depends more on factors external to the health system than on the experience of care as a patient. Thus, measuring the latter may be of limited use as a basis for quality improvement and health system reform.

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Adjusting for patient characteristics when analyzing reports from patients about hospital care.

Michael Cleary, J Hargraves, Adelbert B James … (2001)

To determine which patient characteristics are associated with reports and ratings of hospital care, and to evaluate how adjusting reports and ratings for hospital differences in such variables affects comparisons among hospitals. A telephone survey of a sample of patients hospitalized in 22 hospitals in a single city and a statewide mail survey of hospitalized patients. The surveys assessed: respect for patients' preferences, coordination of care, information exchange between patient and providers, physical care, emotional support, involvement of family and friends, and transition and continuity. The surveys also asked patients to rate their doctors, nurses, and other hospital staff. The variables with the strongest and most consistent associations with patient-reported problems were age and reported health status. Patient gender and education level also sometimes predicted reports and/or ratings. Models including these variables explained only between 3% and 8% of the variation in reports and ratings. The impact of adjusting for patient characteristics on hospital rankings was small, although a larger impact would be expected when comparing hospitals with more variability in types of patients. Nevertheless, we recommend adjusting at least for the most important predictors, such as age and health status. Such adjustment helps alleviate concerns about bias. It also may be useful to present data for certain groups of patients (ie, medical, surgical, obstetric) separately to facilitate interpretation and quality improvement efforts.

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Author and article information

Journal

Journal ID (nlm-ta): Emerg Med J

Journal ID (iso-abbrev): Emerg Med J

Journal ID (hwp): emermed

Journal ID (publisher-id): emj

Title: Emergency Medicine Journal : EMJ

Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )

ISSN (Print): 1472-0205

ISSN (Electronic): 1472-0213

Publication date (Print): January 2017

Publication date (Electronic): 01 August 2016

Volume: 34

Issue: 1

Pages: 27-33

Affiliations

[1 ]King Abdullah International Medical Research Center, King Saud Bin-Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia

[2 ]College of Medicine, King Saud bin Abdulaziz University for Health Sciences , Riyadh, Saudi Arabia

[3 ]Emergency Care Center, King Saud University, College of Medicine , Riyadh, Saudi Arabia

[4 ]Department of Oncology, King Abdulaziz Medical City, Ministry of National Guard Health Affairs , Riyadh, Saudi Arabia

Author notes

[Correspondence to ] Professor Mostafa A Abolfotouh, King Abdullah International Medical Research Center (Mail Code 1515), King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Ministry of National Guard—Health Affairs, P.O. Box 22490, Riyadh 11426, Saudi Arabia; mabolfotouh@ 123456gmail.com

This work was presented at the 3rd Research Summer School programme of KAIMRC.

Article

Publisher ID: emermed-2015-204954

DOI: 10.1136/emermed-2015-204954

PMC ID: 5256124

PubMed ID: 27480456

SO-VID: f511b052-967e-49a8-8e22-a48d2dd7cf7a

Copyright © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

License:

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

History

Date received : 20 April 2015

Date revision received : 20 June 2016

Date accepted : 8 July 2016

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ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: emergency care systems,emergency department management,patient support,triage,quality

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ScienceOpen disciplines: Emergency medicine & Trauma

Keywords: emergency care systems, emergency department management, patient support, triage, quality

Predictors of patient satisfaction in an emergency care centre in central Saudi Arabia: a prospective study

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Abstract

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Preventive and Emergency Medicine Insights

Most cited references 15

Predictors of patient satisfaction with hospital health care

How does satisfaction with the health-care system relate to patient experience?

Adjusting for patient characteristics when analyzing reports from patients about hospital care.

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