Quality of care assessment of public and private outpatient clinics in Metro Cebu, the Philippines

Background: Aiming to tackle the rise of non-communicable diseases and an ageing population, Albania is engaged in boosting primary healthcare services and quality of care. The patients’ perspectives on their experience with public and private providers are, however, missing, although their viewpoints are critical while shaping the developing services. Consequently, we analyze perceptions of users of primary healthcare as it relates to non-clinical quality of care and the association to sociodemographic characteristics of patients and the type of provider. Methods: A facility-based survey was conducted in 2018 using the World Health Organization responsiveness questionnaire which is based on a 4-point scale along with 8 non-clinical domains of quality of care. The data of 954 patients were analyzed through descriptive statistics and linear mixed regression models. Results: Similar mean values were reported on total scale of the quality of care for private and public providers, also after sociodemographic adjustments. The highest mean score was reported for the domain “communication” (3.75) followed by “dignity” (3.65), while the lowest mean scores were given for “choice” (2.89) and “prompt attention” (3.00). Urban governmental PHC services were rated significantly better than private outpatient clinics in “coordination of care” (2.90 vs 2.12, P < .001). In contrast, private outpatient clinics were judged significantly better than urban PHC clinics in “confidentiality” (3.77 vs 3.38, P = .04) and “quality of basic amenities” (3.70 vs 3.02, P < .001). “Autonomy” was reported as least important attribute of quality. Conclusion: While the perception of non-clinical care quality was found to be high and similar for public and private providers, promptness and coordination of care require attention to meet patient’s expectations on good quality of care. There is a need to raise the awareness on autonomy and the involvement of patients’ aspects concerning their health.

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Users' perspectives on non-clinical quality of care in public and private primary healthcare in Albania

10.21203/rs.2.24536/v2 ◽

2020 ◽

Author(s):

Jonila Gabrani ◽

Christian Schindler ◽

Kaspar Wyss

Keyword(s):

Quality Of Care ◽

Primary Healthcare ◽

Outpatient Clinics ◽

Ageing Population ◽

Coordination Of Care ◽

Public And Private ◽

Clinical Quality ◽

Private Providers ◽

Better Than

Abstract Background: Aiming to tackle the rise of non-communicable diseases and an ageing population, Albania is engaged in boosting primary healthcare services and quality of care. The patients’ perspectives on their experience with public and private providers are, however, missing, although their viewpoints are critical while shaping the developing services. Consequently, we analyse perceptions of users of primary healthcare as it relates to non-clinical quality of care and the association to sociodemographic characteristics of patients and the type of provider. Methods: A facility-based survey was conducted in 2018 using the World Health Organization responsiveness questionnaire which is based on a 4-point scale along eight non-clinical domains of quality of care. The data of 954 patients were analysed through descriptive statistics and linear mixed regression models.Results: Similar mean values were reported on total scale of the quality of care for private and public providers, also after sociodemographic adjustments. The highest mean score was reported for the domain ‘communication’ (3.75) followed by ‘dignity’ (3.65), while the lowest mean scores were given for ‘choice’ (2.89) and ‘prompt attention’ (3.00). Urban governmental PHC services were rated significantly better than private outpatient clinics in ‘coordination of care’ (2.90 vs 2.12, p < 0.001). In contrast, private outpatient clinics were judged significantly better than urban PHC clinics in ‘confidentiality’ (3.77 vs 3.38, p = 0.04) and ‘quality of basic amenities’ (3.70 vs 3.02, p < 0.001). For the other domains, no statistically significant differences were observed. ‘Autonomy’ was reported as least important attribute of quality. Enrolment in health insurance was a predictor of higher quality ratings (coefficient = 0.06, p = 0.02).Conclusion: While the perception of non-clinical care quality was found to be high and similar for public and private providers, promptness and coordination of care require attention to meet patient’s expectations on good quality of care. There is a need to shift from a ‘paternalistic’ model to a ‘co-managing the illness’, raising awareness on autonomy.

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Users' perspectives on non-clinical quality of care in public and private primary healthcare in Albania

10.21203/rs.2.24536/v1 ◽

2020 ◽

Author(s):

Jonila Gabrani ◽

Christian Schindler ◽

Kaspar Wyss

Keyword(s):

Quality Of Care ◽

Primary Healthcare ◽

World Health ◽

Outpatient Clinics ◽

Ageing Population ◽

Coordination Of Care ◽

Public And Private ◽

Clinical Quality ◽

Private Providers

Abstract Background: Aiming to tackle the rise of non-communicable diseases and an ageing population, Albania is engaged in boosting primary healthcare services and quality of care. The patients’ perspectives on their experience with public and private providers are, however, missing, although their viewpoints are critical while shaping the developing services. Consequently, we analyse perceptions of users of PHC services as it relates to non-clinical quality of care and the association to sociodemographic characteristics of patients and the type of provider. Methods: A facility-based survey was conducted in 2018 using the World Health Organization responsiveness questionnaire which is based on a 4-point scale along eight non-clinical domains of quality of care. The data of 954 patients were analysed through descriptive statistics and linear mixed regression models. Results: Similar mean values were reported on total scale of the quality of care for private and public providers, also after sociodemographic adjustments. The highest mean scores was reported for the domain ‘communication’ (3.75) followed by ‘dignity’ (3.65), while the lowest mean scores were given for ‘choice’ (2.89) and ‘prompt attention’ (3.00). Urban governmental PHC services were rated significantly better than private outpatient clinics in ‘coordination of care’ (2.90 vs 2.12, p < 0.001). In contrast, private outpatient clinics were rated significantly higher than urban PHC clinics in ‘confidentiality’ (3.77 vs 3.38, p = 0.04) and ‘quality of basic amenities’ (3.70 vs 3.02, p < 0.001). For the other domains, no statistically significant differences were observed. ‘Autonomy’ was reported as least important attribute of quality. Enrolment in health insurance was a predictor of higher quality ratings (coefficient = 0.06, p = 0.02). Conclusion: While the perception of non-clinical care quality was found to be high and similar for public and private providers, promptness and coordination of care require attention to meet patient’s expectations on good quality of care. There is a need to shift from a ‘paternalistic’ model to a ‘co-managing the illness’, raising awareness on autonomy.

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Gender discrimination as a barrier to high-quality maternal and newborn health care in Nigeria: findings from a cross-sectional quality of care assessment

BMC Health Services Research ◽

10.1186/s12913-021-06204-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Chioma Oduenyi ◽

Joya Banerjee ◽

Oniyire Adetiloye ◽

Barbara Rawlins ◽

Ugo Okoli ◽

...

Keyword(s):

Quality Of Care ◽

Family Planning ◽

Health Services ◽

Gender Discrimination ◽

Newborn Health ◽

Maternal And Newborn Health ◽

Gender Based Violence ◽

Cross Sectional ◽

Care Assessment

Abstract Background Poor reproductive, maternal, newborn, child, and adolescent health outcomes in Nigeria can be attributed to several factors, not limited to low health service coverage, a lack of quality care, and gender inequity. Providers’ gender-discriminatory attitudes, and men’s limited positive involvement correlate with poor utilization and quality of services. We conducted a study at the beginning of a large family planning (FP) and maternal, newborn, child, and adolescent health program in Kogi and Ebonyi States of Nigeria to assess whether or not gender plays a role in access to, use of, and delivery of health services. Methods We conducted a cross-sectional, observational, baseline quality of care assessment from April–July 2016 to inform a maternal and newborn health project in health facilities in Ebonyi and Kogi States. We observed 435 antenatal care consultations and 47 births, and interviewed 138 providers about their knowledge, training, experiences, working conditions, gender-sensitive and respectful care, and workplace gender dynamics. The United States Agency for International Development’s Gender Analysis Framework was used to analyze findings. Results Sixty percent of providers disagreed that a woman could choose a family planning method without a male partner’s involvement, and 23.2% of providers disagreed that unmarried clients should use family planning. Ninety-eight percent believed men should participate in health services, yet only 10% encouraged women to bring their partners. Harmful practices were observed in 59.6% of deliveries and disrespectful or abusive practices were observed in 34.0%. No providers offered clients information, services, or referrals for gender-based violence. Sixty-seven percent reported observing or hearing of an incident of violence against clients, and 7.9% of providers experienced violence in the workplace themselves. Over 78% of providers received no training on gender, gender-based violence, or human rights in the past 3 years. Conclusion Addressing gender inequalities that limit women’s access, choice, agency, and autonomy in health services as a quality of care issue is critical to reducing poor health outcomes in Nigeria. Inherent gender discrimination in health service delivery reinforces the critical need for gender analysis, gender responsive approaches, values clarification, and capacity building for service providers.

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Baseline Quality-of-Care Data From a Quality-Improvement Program Implemented by a Network of Diabetes Outpatient Clinics

Diabetes Care ◽

10.2337/dc08-0469 ◽

2008 ◽

Vol 31 (11) ◽

pp. 2166-2168 ◽

Cited By ~ 43

Author(s):

M. C.E. Rossi ◽

A. Nicolucci ◽

A. Arcangeli ◽

A. Cimino ◽

G. De Bigontina ◽

...

Keyword(s):

Quality Improvement ◽

Quality Of Care ◽

Quality Improvement Program ◽

Outpatient Clinics ◽

Improvement Program

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Development and Validation of a Cross-Country Hospital Patient Quality of Care Assessment Tool in Europe

The Patient: Patient-Centered Outcomes Research ◽

10.1007/s40271-017-0246-8 ◽

2017 ◽

Author(s):

Amanda Villiers-Tuthill ◽

Karolina Doulougeri ◽

Hannah McGee ◽

Anthony Montgomery ◽

Efharis Panagopoulou ◽

...

Keyword(s):

Quality Of Care ◽

Assessment Tool ◽

Hospital Patient ◽

Care Assessment ◽

Cross Country ◽

Development And Validation

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Quality of care assessment in acute cardiac care

The ESC Textbook of Intensive and Acute Cardiovascular Care ◽

10.1093/med/9780198849346.003.0007 ◽

2021 ◽

pp. 54-62

Author(s):

Fiona Ecarnot ◽

François Schiele

Keyword(s):

Cardiovascular Disease ◽

Quality Of Care ◽

Performance Measures ◽

Quality Measures ◽

Cardiac Care ◽

Composite Measures ◽

Care Assessment ◽

Measuring Outcomes ◽

Acute Cardiac Care

This chapter will describe the use of performance measures and quality measures in the assessment of the quality of care delivered to patients with acute cardiovascular disease. It gives a brief recap of the major landmarks in the development of the use of performance measures, and goes on to explain the different approaches to measuring processes of care and to measuring outcomes. The utility and construction of composite measures is also described.

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