Factors that impede access to care and patient satisfaction are explored in three recent studies

2003 ◽  
Keyword(s):  
Patient Satisfaction ◽  
Access To Care

scholarly journals Evaluation of Patient Satisfaction with Tuberculosis Services in Southern Nigeria

2015 ◽  
Vol 8 ◽  
pp. HSI.S27177 ◽  
Author(s):  
Ugochukwu U. Onyeonoro ◽  
Joseph N. Chukwu ◽  
Charles C. Nwafor ◽  
Anthony O. Meka ◽  
Babatunde I. Omotowo ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Health System ◽  
Access To Care ◽  
Care Facility ◽  
Related Factors ◽  
Staff Attitude ◽  
Patients Satisfaction ◽  
Multilinear Regression Analysis ◽  
Southern Nigeria ◽  
Adherence Counseling

Objective Knowing tuberculosis (TB) patients’ satisfaction enables TB program managers to identify gaps in service delivery and institute measures to address them. This study is aimed at evaluating patients’ satisfaction with TB services in southern Nigeria. Materials and Methods A total of 378 patients accessing TB care were studied using a validated Patient Satisfaction (PS-38) questionnaire on various aspects of TB services. Factor analysis was used to identify eight factors related to TB patient satisfaction. Test of association was used to study the relation between patient satisfaction scores and patient and health facility characteristics, while multilinear regression analysis was used to identify predictors of patient satisfaction. Results Highest satisfaction was reported for adherence counseling and access to care. Patient characteristics were associated with overall satisfaction, registration, adherence counseling, access to care, amenities, and staff attitude, while health system factors were associated with staff attitude, amenities, and health education. Predictors of satisfaction with TB services included gender, educational status, if tested for HIV, distance, payment for TB services, and level and type of health-care facility. Conclusion Patient- and health system–related factors were found to influence patient satisfaction and, hence, should be taken into consideration in TB service programing.

scholarly journals SWK-10. TELEHEALTH IN OUTPATIENT PEDIATRIC NEURO-ONCOLOGY CARE

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii466-iii466
Author(s):  
Shannon Raber ◽  
Carly Hoffman ◽  
Carol Yarbrough ◽  
Linda Branagan ◽  
Neela Penumarthy ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Patient Satisfaction ◽  
Access To Care ◽  
San Francisco ◽  
Nurse Practitioners ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Patient Acceptance ◽  
Outpatient Services

Abstract BACKGROUND Telehealth is an emerging modality that can include patient evaluation, review of test results, and clinical decision-making. Access to care and quality of life are challenges for patients with pediatric brain tumors and their families. Herein we describe the introduction of video visits within our outpatient services led by nurse practitioners and nurse coordinators. METHODS The pediatric neuro-oncology program at University of California, San Francisco - Benioff Children’s Hospital (UCSF) established a robust telehealth practice to improve access to care for children and young adults with brain and spine tumors. Our nursing team identifies appropriate time points to offer video visits in lieu of in-person visits. Families are guided to connect through secure video conferencing. Data was collected retrospectively through electronic medical record schedules, billing records, and UCSF patient satisfaction surveys. RESULTS Since 2015 we have utilized telehealth for over 400 encounters. The service was limited to patients located in California. Introduction of telehealth resulted in savings of 2300 hours of travel by car, over $22,000 in gas, and over 127,000 miles traveled. Surveys indicate patient satisfaction is equal to or better than in-person experiences. Anecdotally, this service allows for face-to-face contact with patients who have significant barriers to travel. Challenges have included technology platforms, native language, provider and patient acceptance, and billing. CONCLUSION Overall, telehealth is feasible as a tool to deliver outpatient care in pediatric neuro-oncology. Implementation of video visits in clinical practice increases access to neuro-oncologic care and improves quality of life for patients and families.

scholarly journals Management of chronic headache with referral from primary care to direct access to MRI compared with Neurology services: an observational prospective study in London

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e036097
Author(s):  
Tiago Rua ◽  
Asif Mazumder ◽  
Yvonne Akande ◽  
Charikleia Margariti ◽  
Juliana Ochulor ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Access To Care ◽  
Secondary Care ◽  
Chronic Headache ◽  
Brain Mri ◽  
Secondary Outcome ◽  
Cost Difference ◽  
Brain Scan ◽  
Mean Cost

ObjectivesTo evaluate the cost, accessibility and patient satisfaction implications of two clinical pathways used in the management of chronic headache.InterventionManagement of chronic headache following referral from Primary Care that differed in the first appointment, either a Neurology appointment or an MRI brain scan.Design and settingA pragmatic, non-randomised, prospective, single-centre study at a Central Hospital in London.ParticipantsAdult patients with chronic headache referred from primary to secondary care.Primary and secondary outcome measuresParticipants’ use of healthcare services and costs were estimated using primary and secondary care databases and questionnaires quarterly up to 12 months postrecruitment. Cost analyses were compared using generalised linear models. Secondary outcomes assessed: access to care, patient satisfaction, headache burden and self-perceived quality of life using headache-specific (Migraine Disability Assessment Scale and Headache Impact Test) and a generic questionnaire (5-level EQ-5D).ResultsMean (SD) cost up to 6 months postrecruitment per participant was £578 (£420) for the Neurology group (n=128) and £245 (£172) for the MRI group (n=95), leading to an estimated mean cost difference of £333 (95% CI £253 to £413, p<0.001). The mean cost difference at 12 months increased to £518 (95% CI £401 to £637, p<0.001). When adjusted for baseline and follow-up imbalances between groups, this remained statistically significant. The utilisation of brain MRI improved access to care compared with the Neurology group (p<0.001). Participants in the Neurology group reported higher levels of satisfaction associated with the pathway and led to greater change in care management.ConclusionDirect referral to brain MRI from Primary Care led to cost-savings and quicker access to care but lower satisfaction levels when compared with referral to Neurology services. Further research into the use of brain MRI for a subset of patient population more likely to be reassured by a negative brain scan should be considered.Trial registration numberNCT02753933.

Telemedicine for neurosurgery consultations at a Pituitary Center of Excellence: Patient preference and willingness to proceed with surgery

2021 ◽  
Author(s):  
Alexander Craig McConnell Greven ◽  
James Miller Douglas ◽  
Jordan Couceyro ◽  
Anudeep Nakirikanti ◽  
Reem Dawoud ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Access To Care ◽  
Patient Preference ◽  
Pituitary Tumor ◽  
Pituitary Surgery ◽  
Chi Square ◽  
Tumor Patient ◽  
Patient Reported ◽  
Better Than

Objective The purpose of this study was to evaluate pituitary tumor patient satisfaction with telemedicine, patient preference for telemedicine, potential socioeconomic benefit of telemedicine, and patients’ willingness to proceed with surgery based on a telemedicine visit alone. Methods 134 patients who had pituitary surgery and a telemedicine visit during the COVID-19 pandemic (4/23/20-3/4/21) were called to participate in a 13-part questionnaire. Chi-square, ANOVA, and Wilcoxon Rank Sum were used to determine significance. Result Of 134 patients contacted, 90 responded (67%). 95% were “satisfied” or “very satisfied” with their telemedicine visit, with 62% stating their visit was “the same” or “better” than previous in-person appointments. 82% of patients rated their telemedicine visit as “easy” or “very easy.” On average, patients saved 150 minutes by using telemedicine compared to patient reported in-person visit times. 77% of patients reported the need to take off work for in-person visits, compared to just 12% when using telemedicine. 49% of patients preferred in-person visits, 34% preferred telemedicine, and 17% had no preference. 50% of patients said they would feel comfortable proceeding with surgery based on a telemedicine visit alone. Patients with both initial evaluation and follow-up conducted via telemedicine were more likely to feel comfortable proceeding with surgery based on a telemedicine visit alone compared to patients who had only follow-up telemedicine visits (p=0.051). Conclusion Many pituitary patients patients are satisfied with telemedicine visits and feel comfortable proceeding with surgery based on a telemedicine visit alone. Telemedicine is an important adjunct to increase access to care.

scholarly journals Use of Lean Six Sigma to Improve Access to Care in a Surgical Subspecialty Clinic

2020 ◽  
Vol 185 (5-6) ◽  
pp. e887-e893
Author(s):  
James T Flanary ◽  
Nicholas R Rocco ◽  
Timothy Dougherty ◽  
Matthew S Christman
Keyword(s):  
Patient Satisfaction ◽  
Access To Care ◽  
Six Sigma ◽  
Health Agency ◽  
Lean Six Sigma ◽  
Simulation Software ◽  
Software Analysis ◽  
Six Sigma Approach ◽  
Urology Clinic ◽  
Improve Access

Abstract Introduction At the Naval Medical Center San Diego urology clinic, patients reported waiting for greater than 1 month for an initial consult. A Lean Six Sigma approach was used to improve access to care (ATC) and decrease variation in access by improving scheduling. Methods A Define-Measure-Analyze-Improve-Control approach was used. Delay to new patient visits was identified as the focus of intervention. The scheduling template was changed from a fixed stream to a modified wave based on simulation software analysis of appointment cycle times. Appointment length was adjusted based on cycle time analysis, and two rooms per clinician were used instead of one. The ratio of initial consults relative to established follow-ups and procedures was adjusted upward to better balance with the historic demand. Results Statistically significant improvement was seen in ATC and compliance with the Defense Health Agency (DHA) standard that new consults be seen within 28 days. Average days for a new consult to be seen were reduced by 7.2 days in the pediatric urology clinic (P &lt; 0.0001) and 6.4 days in the adult urology clinic (P &lt; 0.0001). Compliance with the Defense Health Agency 28-day ATC standard increased from a baseline of 69.2% to 88.9% and 61.7% to 84.4%, respectively, in the pediatric and adult clinics (P &lt; 0.001 for both). Patient satisfaction was maintained at or above the goal threshold throughout the project. Conclusions An Lean Six Sigma model was used to improve timeliness of care for our patients, improving the overall quality of their healthcare experience. Simulation software can be used to model the clinic throughput and test alternative scheduling templates. ATC was significantly improved and patient satisfaction was maintained at or above goal thresholds.

scholarly journals Patient satisfaction with chronic HIV care provided through an innovative pharmacist/nurse-managed clinic and a multidisciplinary clinic

2017 ◽  
Vol 150 (6) ◽  
pp. 397-406 ◽  
Author(s):  
Jason Kielly ◽  
Deborah V. Kelly ◽  
Shabnam Asghari ◽  
Kim Burt ◽  
Jessica Biggin
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Access To Care ◽  
Treatment Plan ◽  
Patient Characteristics ◽  
Hiv Care ◽  
Satisfaction With Care ◽  
Care Clinic ◽  
Multidisciplinary Clinic

Background: Pharmacist/nurse-led clinics are an established model for many chronic diseases but not yet for HIV. At our centre, patients with HIV are seen by a multidisciplinary team (physician, nurse, pharmacist, social worker) at least yearly. Some attend an HIV-specialist pharmacist/nurse clinic (or “nonphysician clinic,” NPC) for alternate biannual visits. Our objective was to assess patient satisfaction with care received through both clinics. Methods: The Patient Satisfaction Survey for HIV Ambulatory Care (assesses satisfaction with access to care, clinic visits and quality of care) was administered by telephone to adults who attended either clinic between January and July 2014. Descriptive statistics described patient characteristics and satisfaction scores. Fisher’s exact test compared satisfaction scores between the NPC and multidisciplinary clinic (MDC). Multivariate logistic regression examined associations between overall satisfaction with care and clinic type and patient characteristics (e.g., age, disease duration). Results: Respondents were very satisfied with the overall quality of HIV care in both the NPC and MDC (89% vs 93%, respectively, p = 0.6). Patients from both clinics expressed satisfaction with access to care, treatment plan input, their provider’s knowledge of the newest developments in HIV care and explanation of medication side effects, with no significant differences noted. Significantly more MDC patients reported being asked about housing/finances, alcohol/drug use and whether they needed help disclosing their status. Patient characteristics were not significantly associated with satisfaction with overall quality of care. Conclusion: Patients are satisfied with both clinics, supporting NPC as an innovative model for chronic HIV care. Comparison of outcomes between clinics is needed to ensure high-quality care.

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