RESEARCH PAPER
Determinants of primary healthcare patients’ dissatisfaction with the quality of provided medical services
1
Collegium Medicum, Institute of Health Sciences, Jan Kochanowski University, Kielce, Poland
2
Department of Economics and Finance, Faculty of Law and Social Sciences, Jan Kochanowski University, Kielce, Poland
3
College of Rehabilitation, Warsaw, Poland
4
Institute of Rural Health, Lublin, Poland
Corresponding author
Magdalena Florek-Łuszczki
Instytut Medycyny Wsi w Lublinie, ul. Jaczewskiego 2, 20-090, Lublin, Poland
Instytut Medycyny Wsi w Lublinie, ul. Jaczewskiego 2, 20-090, Lublin, Poland
Ann Agric Environ Med. 2021;28(1):142–148
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The quality of medical services and health care are complex problems with a number of various definitions, conceptual approaches, measurement tools and techniques. The most important influence on quality in primary health care has the (immaterial) human factor, the relationship between patient and doctor, medical personnel and the primary health care institution, and the skill to use new technologies to improve quality in health care.
Objective:
The aim of the study is to discover the determinants of primary health care patients’ dissatisfaction with the quality of medical services.
Material and methods:
Patients with medical appointments on the day of the survey and gave their consent to participate were included in the study. A total of 901 patients of primary health care institutions [591 (65.59%) women and 310 (34.41%) men] in the Świętokrzyskie Province took part. The diagnostic poll method based on a questionnaire examining the patients’ satisfaction with the quality of health services was used. Logistic regression identified the determinants of dissatisfaction of the patients.
Results:
The determinants that mostly affected the patients’ dissatisfaction with medical services were: rudeness of the doctor (p=0.0001), rudeness of the rest of medical staff (p=0.0001), non-comprehensibility of information about health by the patient (p=0.004), no clear identification of the patient in the health care system (p=0.01), and difficult access to information regarding the health condition (medical documentation) (p=0.018).
Conclusions:
Primary health care patients who participated in the study pointed to the attitude of the doctor towards a patient during a visit, and the attitude of the remaining medical personnel among the determinants of dissatisfaction with medical services.
The quality of medical services and health care are complex problems with a number of various definitions, conceptual approaches, measurement tools and techniques. The most important influence on quality in primary health care has the (immaterial) human factor, the relationship between patient and doctor, medical personnel and the primary health care institution, and the skill to use new technologies to improve quality in health care.
Objective:
The aim of the study is to discover the determinants of primary health care patients’ dissatisfaction with the quality of medical services.
Material and methods:
Patients with medical appointments on the day of the survey and gave their consent to participate were included in the study. A total of 901 patients of primary health care institutions [591 (65.59%) women and 310 (34.41%) men] in the Świętokrzyskie Province took part. The diagnostic poll method based on a questionnaire examining the patients’ satisfaction with the quality of health services was used. Logistic regression identified the determinants of dissatisfaction of the patients.
Results:
The determinants that mostly affected the patients’ dissatisfaction with medical services were: rudeness of the doctor (p=0.0001), rudeness of the rest of medical staff (p=0.0001), non-comprehensibility of information about health by the patient (p=0.004), no clear identification of the patient in the health care system (p=0.01), and difficult access to information regarding the health condition (medical documentation) (p=0.018).
Conclusions:
Primary health care patients who participated in the study pointed to the attitude of the doctor towards a patient during a visit, and the attitude of the remaining medical personnel among the determinants of dissatisfaction with medical services.
ACKNOWLEDGEMENTS
The project was financed in 2019–2022 in the amount of
11,999,000,00 zł under the programme ‘Regional Initiative of
Excellence’ of the Minister of Science and Higher Education
(Project No. 024/RID/2018/19).
REFERENCES (46)
1.
Shizheng Du, Yuling Cao, Tong Zhou, Agus Setiawan, Myat Thandar, Virya Koy, Mohd Said Bin Nurumal, Hong Anh, Wipada Kunaviktikul, Yan Hu. The knowledge, ability, and skills of primary health care providers in SEANERN countries a multi-national cross-sectional study. BMC Health Services Res. 2019; 19: 602.
2.
Kalra S, Akanov ZA, Pleshkova AY. Thoughts, Words, Action: The Alma-Ata Declaration to Diabetes Care Transformation. Diabetes Ther. 2018; 9(3): 873–876.
3.
White F. Primary health care and public health: foundations of universal health systems. Med Princ Pract. 2015; 24(2): 103–116.
4.
Sanders D, Nandi S, Labonté R, Vance C, Van Damme W. From primary health care to universal health coverage—one step forward and two steps back. The Lancet 2019; 394(10199): 619–21.
5.
Jamoulle M, Resnick M, Vander Stichele, Ittoo A, Cardillo E, Vanmeerbeek M. Analysis of definitions of general practice, family medicine, and primary health care: a terminological analysis. BJGP Open 2017; 1(3): bjgpopen17X101049.
6.
Belén Espinosa-González A, Delaney BC, Marti J, Darzi A. The impact of governance in primary health care delivery: a systems thinking approach with a European panel. Health Res Policy Syst. 2019; 17: 65.
7.
Rifkin SB. Alma Ata after 40 years: Primary Health Care and Health for All—from consensus to complexity. BMJ Global Health 2018; 3: e001188.
8.
Kruk ME, Gage AD, Arsenault C, Jordan K, Leslie HH, Roder-DeWan S, et al. High-quality health systems in the Sustainable Development Goals era: time for a revolution. Lancet Glob HealTH 2018; 6(11): e1196–252.
9.
Behzadifar M, Taheri Mirghaed M, Aryankhesal A. Primary Health Care: An Important Approach for Health Sector, Missed in Iran’s Health System Evolution Plan. Iran J Public Health 2017; 46(9): 1307–1308.
10.
Kruk ME, Nigenda G, Knaul FM. Redesigning Primary Care to Tackle the Global Epidemic of Noncommunicable Disease. Am J Public Health 2015; 105(3): 431–7.
11.
Gauld R, Blank R, Burgers J, et al. The World Health Report 2008 – Primary Healthcare: How Wide Is the Gap between Its Agenda and Implementation in 12 High-Income Health Systems? Health Policy 2012; 7(3): 38–58.
12.
Nylenna M, Bjertnaes Oyvind A, Saunes IS, Lindahl AK. What is Good Quality of Health Care? Professions and Professionalism 2015; 5(1): 1–16.
13.
Mohammad Ali Abbasi-Moghaddam, Ehsan Zarei, Rafat Bagherzadeh, Hossein Dargahi, Pouria Farrokhi. Evaluation of service quality from patients’ view point. BMC Health Services Res. 2019; 19: 170.
14.
Ali Mohammad Mosadeghrad. Healthcare service quality: Towards a broad definition. Int J Health Care Quality Assurance 2013; 26(3): 203–19.
15.
Allen-Duck A, Robinson JC, Stewart MW. Healthcare Quality: A Concept Analysis. Forum Nurs. 2017; 52 (4): 377–386.
16.
Ssemugabo Ch, Nalinya S, Ali Halage A, Mubeezi Neebye R, Musoke D, Jors E. Doctors experiences on the quality of care for pesticide poisoning patients in hospitals in Kampala, Uganda: a qualitative exploration using donabedian’s model. Health Services Res. 2020; 20: 30.
17.
Alhassan RK, Duku SO, Janssens W, Nketiah-Amponsah E, Spieker N, van Ostenberg P, et al. Comparison of perceived and technical healthcare quality in primary health facilities: implications for a sustainable. National Health Insurance Scheme in Ghana. PLoS One 2015; 10(10): e0140109.
18.
Chang Eun Kim, Joon-Shik Shin, Jinho Lee, Yoon Jae Lee, Me-riong Kim, Areum Choi, Ki Byung Park, Ho-Joo Lee, In-Hyuk Ha. Quality of medical service, patient satisfaction and loyalty with a focus on interpersonal-based medical service encounters and treatment effectiveness: a cross-sectional multicenter study of complementary and alternative medicine (CAM) hospitals. BMC Complement Altern Med. 2017; 17: 174.
19.
Aggarwal A, Aeran A, Rathee M. Quality management in healthcare: The pivotal desideratum. J Oral Biol Craniofac Res. 2019; 9(2): 180–182.
20.
Mandeep, Chitkara N, Goel S. Study to evaluate change of attitude toward acceptance of NABH guidelines: an intra-institutional experience. J Nat Accred Board Hosp Healthcare Providers. 2014; 1: 52–55.
21.
Ustawa o Podstawowej Opiece Zdrowotnej z dnia 27 października 2017 r. DzU 2019 poz. 357.
22.
Rolbina ES, Novikova EN, Sharafutdinova NS, Martynova OV, Akhmetshin RM. Analysis and Assessment of Quality of Medical Services in Conditions of Digital Transformation. In: Ashmarina S, Mesquita A, Vochozka M, editors. Digital Transformation of the Economy: Challenges, Trends and New Opportunities. Advances in Intelligent Systems and Computing, vol 908. Springer, Cham, 2020.
23.
Ossebaard HC. eHealth and quality in health care: implementation time. Int J Quality Health Care 2016; 28(3): 415–419.
24.
Melchiorre MG, Papa R, Rijken M, Ginneken E, Hujala A, Barbabella F. eHealth in integrated care programs for people with multi morbidity in Europe: Insights from the ICARE4EUproject. Health Policy 2018; 122(1): 53–63.
25.
Reiners F, Sturm J, Bouw LJW, Wouters EJM. Sociodemographic Factors Influencing the Use of e-Health in People with Chronic Disease. Int J Environ Res Public Health 2019; 16(4): 645.
26.
Apolinário-Hagen J, Menzel M, Hennemann S, Salewski CH. Acceptance of Mobile Health Apps for Disease Management Among People With Multiple Sclerosis: Web-Based Survey Study JMIR Formativ Res. 2018; 2(2): e11977.
27.
Duplaga M. A cross-sectional study assessing determinants of the attitude to the introduction of eHealth services among patients suffering from chronic conditions. BMC Med Inform Decis Mak. 2015; 19: 15–33.
28.
Bitton A, Ratcliffe HL, Veillard JH, Kress DH, Barkley S, Kimball M, et al. Primary health care as a foundation for strengthening health systems in low- and middle-income countries. J Gen Intern Med. 2017; 32(5): 566–71. doi: 10.1007/s11606-016-3898-5.
29.
Van der Zwart J, van der Voordt T. Pre-Occupancy Evaluation of Patient Satisfaction in Hospitals. Health Environ Res Design J. 2015; 9(1): 110–124.
30.
Astuti HJ, Nagase K. Patient loyalty to healthcare organization: relationship marketing and satisfaction. Int J Manage Marketing Res. 2014; 7(2): 39–56.
31.
Khan MM, Khan AH. Impact of service quality on patient’s trust; A case of health-care in Pakistan. J Quality Technol Manage. 2014; 10(1): 35–57.
32.
Zielińska-Więczkowska H. Empatia wśród przedstawicieli zawodów medycznych – korzyści a ryzyko wypalenia zawodowego. Med Rodz. 2016; 4: 255–260.
33.
Hernan AL, Giles SJ, Fuller J, et al. Patient and carer identified factors which contribute to safety incidents in primary care: a qualitative study. BMJ Qual Saf. 2015; 24: 583–93.
34.
Ricci-Cabello I, Marsden KS, Avery AJ, et al. Patients’ evaluations of patient safety in English general practices: a cross-sectional study. Br J Gen Pract. 2017; 67: e474–82.
35.
Błachnio A, Buliński L. Wellbeing and older adults in primary health care in Poland. Ann Agric Environ Med. 2019; 26(1): 55–61.
36.
Makara-Studzińska M, Wontorczyk A, Izydorczyk B. Stress and occupational burnout in a population of Polish doctors – Organizational-professional and non-professional-social predictors. Ann Agric Environ Med. doi: 10.26444/aaem/110846.
37.
Jha D, Frye AK, Schlimgen J. Evaluating variables of patient experience and the correlation with design. Patient Experience J. 2017; 4(1): 33–45.
38.
Mehta SJ. Patient satisfaction reporting and its implications for patient care. AMA J Ethics 2015; 17(7): 616–621.
39.
Report Health at a Glance: Europe 2018: State of Health in the EU Cycle, OECD Publishing, Paris. https://doi.org/10.1787/health....
40.
Al Shammari M, Al Habib S, Al Shubrami D, Al Rashidi M. Impact of hospital’ accreditation on patient safety in Hail city, Saudi Arabia: nurses’ perspective. J Nurs Health Sci. 2015; 4(1): 51–55.
41.
Yildiz A, Kaya S. Perception of nurses on the impact of the accreditation on quality of healthcare. Clinical Governance: An International J. 2014; 19 (2): 69–82.
42.
Smoleń E, Ksykiewicz-Dorota A. Profesjonalizm pielęgniarek jako element oceny satysfakcji rodziców/opiekunów dzieci z opieki pielęgniarskiej. Med Pr. 2015; 66(4): 549–556.
43.
Grochowska A, Kubik B, Romanowska U, Lebica M. Burnout among nurses. Medical Studies/Studia Medyczne. 2018; 34(3): 189–195. doi: 10.5114/ms.2018.78681.
44.
Ratcliffe HL, Schwarz D, Hirschhorn LR, Cejas C, Diallo A, Elorrio EG, Fifield J, Gashumba D, Hartshorn L, Leydon N, Mohamed M, Nakamura Y, Ndiaye Y, Novignon J, Ofosu A, Roder-DeWan S, Rwiyereka A, Secci F, Veillard JH, Bitton A. PHC Progression Model: a novel mixed-methods tool for measuring primary health care system capacity. BMJ Glob Health. 2019; 4(5): e001822. doi: 10.1136/bmjgh-2019-001822.
45.
Ware P, Bartlett SJ, Pare G, et al. Using eHealth technologies: interests, preferences, and concerns of older adults. Interact J Med Res. 2017;6:e3.
46.
Strzelecka A, Stachura M, Wójcik T, Pacian AB, Kulik T, Pacian J, Kaczoruk M, Galińska EM, Kawiak-Jawor E, Nowak-Starz G. Using affinity analysis in diagnosing the needs of patients as regards e-Health. Ann Agric Environ Med. doi: 10.26444/aaem/123872.
Share
RELATED ARTICLE
Improvement of visual identification of the journal - task financed under the agreement No. 618/P-DUN/2019 by the Minister of Science and Higher Education allocated to the activities of disseminating science.
Generation of the DOI (Digital Object Identifier) - task financed under the agreement No. 618/P-DUN/2019 by the Minister of Science and Higher
We process personal data collected when visiting the website. The function of obtaining information about users and their behavior is carried out by voluntarily entered information in forms and saving cookies in end devices. Data, including cookies, are used to provide services, improve the user experience and to analyze the traffic in accordance with the Privacy policy. Data are also collected and processed by Google Analytics tool (more).
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.
You can change cookies settings in your browser. Restricted use of cookies in the browser configuration may affect some functionalities of the website.