Patient satisfaction with health care service providers in Pakistan. A review of public sector hospitals of Lahore

Abstract

Background:

Appropriate and improved strategies for quality assurance in the Punjab Public sector hospitals, Pakistan can be evolved with the appropriate understanding of factors influencing quality of medical service. Patient satisfaction is itself a critical controversy for the healthcare professionals/Government. Patient satisfaction is a complicated attitude because a horde of variables have been pinpointed as its interpreters. However, the study is aimed to ascertain the factors affecting the quality Healthcare services providers within Lahore Public Sector Hospitals, Punjab, Pakistan.

Objective of the Study:

The study was conducted chastely in the public interest and in order to facilitate the Govt. of Punjab, Pakistan to deal with its maximum potential to bring about ultimate satisfaction level of the patients with a foremost objective of providing fairly, attainable and effective healthcare services.

The study was conducted

- To analyze factors impacting patient satisfaction in Public sector hospitals
- To rank the most important factors affecting patient satisfaction
- To evaluate the necessary steps taken by the hospital administrators for patient satisfaction.

Research Approach:

This study identified the most important factors affecting the patient satisfaction in the public sector hospitals. Surveys and interview were conducted from the 100 patients in order to come out with primary data. Further an appropriate structure questionnaire was excerpted from the available literature and expert opinion relating to the patients satisfaction from healthcare professionals. The questionnaire data was then interpreted through SPSS-20.

Conclusion:

The study ascertained the 30 most important factors resulting in poor level of patient satisfaction. Results identified that majority of the factors out of 30 factors lie in Medium and high Severity zone (with a rating between 3.4 to 4.2 out of total 5). These factors also require foremost attention by the Government. After pointing out the 30factors and their severity level, the study revealed the top 12 most important factors on the basis of Impact Factor and Relative Importance Index.

Limitations:

The study is bordered to Lahore, Punjab Public sector Hospitals, Pakistan.

Importance and Contribution:

The quality of health care services is directly linked with the satisfaction level of the patients, as the quality increase the level of patient satisfaction becomes higher. The foremost objective and purpose of this study is to facilitate the Govt., people, especially patients and healthcare service provider with plentiful information to find out the fundamentals standards of quality improvement, and to deliver a starting point for the developments in quality level that has better influence on the patient satisfaction.

KEY WORDS: Patient satisfaction and Health care institutions.

1. Introduction

Level of healthcare resources mention the healthcare quality. The foremost concern of healthcare institutions is to deliver the high quality medical facilities to all patients equally. Healthcare quality is defined as the best care received for disease; the all-inclusive it also covers the complete experience of given healthcare facilities except of errors or mistakes. Quality procedures facilitate us to differentiate the level of actual performance against benchmark. Quality shows satisfaction of patients, while satisfaction of patient’s level rely on numerous factors like, food, staff behavior, techniques, strikes, diagnostic facilities, and admission procedure.

In the Eastern Mediterranean region of World Health Organization (WHO), Islamic republic of Pakistan lies it is the sixth largest nation of the world on the population basis. Within Pakistan, provision of clothing, shelter, education and Health facilities is a primary responsibility as Pakistan is a welfare state. As per Alma Ata declaration (AAD) in 1978, govt. of Pakistan was founded an wide-ranging network of basic health facilities to enhanced the convenience of the population’s primary healthcare services with a main objective of delivering operative, rightfully, and available .

Healthcare services at a reasonable cost. Various reasons are impacting the patient satisfaction level and causing disappointment from the govt. provided healthcare facilities such as non-availability of staff, shortage of indispensable medicine and other equipments are major factors resulting in low satisfaction level. Although, due to various significant reasons of underutilization of health facilities provided by the Govt. hospitals, the most important aspect of patient satisfaction has not been explored to better extent in Pakistan. Patient satisfaction is not a new conception but there is no such disposition of incorporation of the patient’s satisfaction delivery services as per the expectancy of patients. Hence there is no appropriate literature accessible that shows the decreased patient satisfaction with respect to govt. provided healthcare facilities across all income quintiles (from low to high socioeconomic status). Numerous studies are conducted in Pakistan regarding outpatients, indoor-patients and emergency healthcare services to determine the patient satisfaction. Various studies have been conducted in the country to explore variable level regarding patient satisfaction with the healthcare service providers.

Pakistan is a signatory of the Millennium Declaration which obligates it to achieve the Millennium Development Goals (MDGs). MDGs basically signifies a convention of the world leaders to effort in order to resolve the starvation, sickness (disease) and degradation of the environment. Health sector is one of the most significant development goal of the MDGs and three are directly related with the health sector. Numerous conducted studies shows that most of the countries will not get closer to the MDG targets without sound policy creativities. In Pakistan, primary health issues are associate with other problems. Progress of Pakistan has been impeded by the current political and economic scenario towards the MDGs that relates to health sector. Sluggish growth of economy, energy crises, humanitarian disasters, flooding, terrorism and military operations harshly blocked the efforts made by Govt. to come out with the MDGs and it is also becoming hard to fulfill them.

The Punjab government has allocated an estimated Rs. 121.80 billion for the health budget along with an additional Rs. 2 billion so as to achieve the MDG’s. Moreover, Rs 600 million have been earmarked to grant the for dialysis related facilities, Rs 8.25 billion to offer the treatment without any cost for the poor patients in public sector hospitals across the province and Rs.47.44 billion will be budgeted to be spent for the provision of advanced facilities to patients and up-gradation of healthcare institutions during current financial year. After understanding the whole scenario, Punjab govt. has taken the inventiveness to initiate the Health Sector Reforms Program (HSRP). This inventiveness will be a stepping stone towards achieving the Millennium Development Goals by 2015.

2. Review of Literature

In 2014, Mosadeghrad concluded the undeviating consequences for the providers of healthcare facilities. They are fortified to administer healthcare quality on regular basis and to also get started uninterrupted quality development programs to sustain patient satisfaction level. Conclusions are of great significance for policy makers.

Dhyana (2015) argued enlighten the significance of healthcare service provider’s quality extents, the study concludes with the results that“ physical services” is of the foremost significance within health sector, followed by behavior of staff and admission process from patient view point. The level of understanding on healthcare quality by the experienced staff differs with most educated and highly experienced staff having “more knowledge” on healthcare quality. Quality development creativities i.e, organizational mission statement in respect of quality promise, re-engineering and reforming (redesigning) in health sector regularly, fixation and implementation of bench marking within the health institution and monitoring of management to identify foremost issues relating to quality enable the healthcare authorities to provide the better quality.

Choi et al. (2005) determined with the findings that healthcare service quality is linked with patient satisfaction level, loyalty (Boshoff and Gray, 2004) and profitability and productivity of organization (Alexander et al. 2006).

Quality healthcare is itself a complex, subjective and multi-dimensional concept. Mosadeghrad (2013) concluded that healthcare quality is “providing the right healthcare services in a right way in the right place at the right time by the right provider to the right individual for the right price to get the right results”. He ascertained a totality of 182 healthcare quality attributes comprising of 700 healthcare professionals and stakeholders including patients, executives, health providers by using the pluralistic assessment and grouped them comprising of 5 (five) categories: environment, efficacy, effectiveness, efficiency and empathy. Quality healthcare attributes includes such as appropriateness, competency, timeliness, reliability, privacy, affordability, continuity, equity, availability, accuracy, accessibility, acceptability, confidentiality, attentiveness, caring, responsiveness, accountability, reliability, completeness and facilities (Mosadeghrad, 2012).

As reported by Ahmad et al. (2011) Patient satisfaction is a severe issue for the providers of healthcare services. Larsson (2010) explored the basic relationship of patient satisfaction and healthcare quality awareness.

According to Chassin (2010) national accountability clearinghouse is a common place to quantity quality of health care and by using said measurements to boost the enhancement of raise transparency and health services.

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