Perceived health-care quality in China: a comparison of second- and third-tier hospitals

2021 ◽  
Vol 33 (1) ◽  
Author(s):  
Hongmei Shi ◽  
Ming Fan ◽  
Hao Zhang ◽  
Shaoying Ma ◽  
Wenxin Wang ◽  
...  

Abstract Objectives To evaluate disparity in service quality between second- and third-tier hospitals and explore factors that affect patients' perception of service quality in China. Design Cross sectional study. Setting Twelve hospitals in China. Participants 5714 patients. Intervention None. Main Outcome Measure Total score of the SERVQUAL scale and each of its five dimensions. Results Patients from third-tier hospitals rated significantly higher scores overall and in all the five dimensions of the SERVQUAL scale. Those with lower education, urban residents and those who had higher degree of life satisfaction and attention paid to health perceived higher service quality. Inpatients perceived higher service quality compared with outpatients. Conclusion We found a significant gap in patient's perceived service quality between second- and third-tier hospitals in China. A variety of demographic and personality factors were found to significantly influence patient's perceived service quality.

Author(s):  
Verónica Aranaz Ostáriz ◽  
María Teresa Gea Velázquez de Castro ◽  
Francisco López Rodríguez-Arias ◽  
José Lorenzo Valencia Martín ◽  
Carlos Aibar Remón ◽  
...  

(1) Background: Identifying and measuring adverse events (AE) is a priority for patient safety, which allows us to define and prioritise areas for improvement and evaluate and develop solutions to improve health care quality. The aim of this work was to determine the prevalence of AEs in surgical and medical-surgical departments and to know the health impact of these AEs. (2) Methods: A cross-sectional study determining the prevalence of AEs in surgical and medical-surgical departments was conducted and a comparison was made among both clinical areas. A total of 5228 patients were admitted in 58 hospitals in Argentina, Colombia, Costa Rica, Mexico, and Peru, within the Latin American Study of Adverse Events (IBEAS), led by the Spanish Ministry of Health, the Pan American Health Organization, and the WHO Patient Safety programme. (3) Results: The global prevalence of AEs was 10.7%. However, the prevalence of AEs in surgical departments was 11.9%, while in medical-surgical departments it was 8.9%. The causes of these AEs were associated with surgical procedures (38.6%) and nosocomial infections (35.4%). About 60.6% of the AEs extended hospital stays by 30.7 days on average and 25.8% led to readmission with an average hospitalisation of 15 days. About 22.4% resulted in death, disability, or surgical reintervention. (4) Conclusions: Surgical departments were associated with a higher risk of experiencing AEs.


2020 ◽  
Vol 6 (2) ◽  
pp. 117-124
Author(s):  
Haniyeh Nazem ◽  
◽  
Hadi Raeis Abdollahi ◽  
Abasat Mirzaei ◽  
◽  
...  

Background: Health care services are costly and complex and provide facilities that significantly affect the economy and quality of life of individuals. In this study, we determined the gap between patients’ expectations and perceptions of hospital service quality to provide reference data for creating strategies to improve health care quality. Methods: In this descriptive cross-sectional study, five private hospitals in Tehran were selected. Using a simple random sampling method, 110 patients were recruited and voluntarily responded to the standard service quality (SERVQUAL) model questionnaire. Data were analyzed by the K-S test, t-test, and paired t-test using SPSS V. 23. Results: The results showed that among the quality of health care components, the highest mean was related to the responsiveness (M=3.89) and the least was related to the tangible dimension (M=3.11). The lowest average quality gap (perceived service and expected service) was seen in the responsiveness dimension (2.96 and 3.28) and followed by reliability (2.66 and 3.90), tangible (2.53 and 3.91), empathy (1.36, 3.19), and assurance dimensions (2.39 and 4.75). Conclusion: The findings revealed a significant difference between the patients’ perceived and expected services, which indicates that the quality of services as perceived by patients was lower than their expectations. According to the findings, the assurance dimension had the greatest gap. To reduce or eliminate the existing gap, it is suggested that hospitals consider strategic and operational planning to improve hospitalization experience‏, quality of medical services, and hospital resources.


2016 ◽  
Vol 8 (9) ◽  
pp. 294 ◽  
Author(s):  
Ali Mohammad Varzi ◽  
Koroush Saki ◽  
Khalil Momeni ◽  
Ghasem Rajabi Vasokolaei ◽  
Zahra Khodakaramifard ◽  
...  

<p><strong>INTRODUCTION:</strong> Patient satisfaction with provided services is used as an indicator of health care quality. Patient satisfaction is defined as patient perception of provided care compared to expected care. This study was administered to evaluate the health tourists' satisfaction of provided services in Lorestan University of Medical Sciences affiliated hospitals in 2015. </p><p><strong>METHOD:</strong> In this descriptive case study, 1800 (696 (54.4 %) men and 812 (45.6 % ) women, 74.5 province native) patients were selected by random sampling from among the patients of Lorestan University of Medical Sciences affiliated hospitals in 2015 spring. The data collection instrument is a semi-structured questionnaire in this study. The questionnaire has 62 general and specific items. Each of the specific items is scaled on four points; satisfied, fairly satisfied, dissatisfied and O.K.. In order to analyze the data both descriptive and inferential statistics were used.</p><p><strong>RESULTS:</strong> Poldokhtar Imam Khomeini Hospital had the highest Level of satisfaction of 68 percent in all aspects (hoteling, discharge, paramedical, nurses, medical and admission) among the studied hospitals. Kuhdasht Imam Khomeini hospital had the lowest level of satisfaction of 53 percent. The overall satisfaction level in all hospitals was 61%.<strong> </strong><strong></strong></p><p><strong>DISCUSSION &amp; CONCLUSION:</strong> Despite the shortcomings observed in different areas, the results of the present study are in an intermediate status compared to other studies. While treating patients, patient-centered issue and patients ‘need and preferences should be focused on to enhance health care quality. Considering Patients preferences not only are morally good but also lead to improved care and access to sustainable care practices. Therefore it is needed to drive organizational management approach toward the customer preferences management and needs.</p>


Author(s):  
Mohammad Ali Sahraian ◽  
Abdorreza Naser Moghadas ◽  
Sharareh Eskandarieh

Background: After intensified economic sanctions against Iran, decreased welfare of patients were more recognizable. The present study was aimed at identifying the challenges and stress level experienced by patients with multiple sclerosis (MS) regarding treatment and health care services in 2018-2019 after strengthening of economic sanctions against Iran. Methods: A cross-sectional study was conducted on MS patients in Tehran, Iran. A structured questionnaire was designed to measure the main variables addressing the challenges and stress level of MS patients with respect to receiving care and treatment services. Results: In total, 1039 MS patients were enrolled into the study. Among the patients who answered yes to the questions, 873 (85.8%) and 837 (86%) were concerned about medicine unavailability and supply and purchase of internationally branded medicine, respectively. Moreover, 671 (70.3%) subjects were concerned about replacing their medicines with cheaper alternatives due to financial problems and 427 (41.4%) were unwilling to continue their treatment due to the economic burden of MS. In total, 795 (82%) were concerned about the effectiveness of Iranian drugs in comparison with internationally branded drugs. Generally, 970 (93.53%) subjects had experienced increased current living costs and 711 had experienced (68.82%) reduced nutrition quality, which (OR: 2.68; 95% CI: 1.99, 3.60) was significantly higher among subjects who had an income of less than or equal to 250 US$ per month. Conclusion: The sanctions can impose greater stress and hardship on patients due to the unavailability and costs of medicines. Iran should manage health care quality and provide services to prevent the adverse effects of sanctions on MS patients and guarantee patients’ right to receive well-established medication and health services.  


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042853
Author(s):  
Desalegn Gebrehaweria Kassa ◽  
Cheng Xiang ◽  
Shuchen Hu ◽  
Khezar Hayat ◽  
Amanuel Kidane Andegiorgish ◽  
...  

ObjectiveTo ensure the availability of quality pharmaceutical products and effective pharmaceutical services, a package of interventions named auditable pharmaceutical transactions and services (APTS), was implemented in the tertiary and secondary hospitals across Ethiopia since 2014. This study aimed to evaluate outpatients’ perception of pharmaceutical service quality in hospitals with APTS in Ethiopia.DesignCross-sectional study.SettingSeven hospitals of Tigray, Ethiopia.Participants794 patients coming for pharmaceutical services.Main outcome measuresSERVQUAL instrument was employed to collect the patient’s perception of pharmaceutical services. The mean perception score of pharmaceutical service quality was the main outcome measurement.ResultsOut of 810 patients approached, 794 participated in the study (response rate of 98.02%). Overall, the mean perception score of the service quality was 3.1 of 5. Among the five dimensions of SERVQUAL, dimension of empathy achieved the highest result with a mean score of 3.71, and tangibility was the second (3.19), followed by responsiveness (3.08), assurance (2.87) and reliability (2.81). The perception of patients in tertiary hospitals of service quality was more positive compared with patients in secondary hospitals (3.265>3.011, p=0.04). However, the difference was only significant in the dimension of assurance when considering the five dimensions separately. Respondents who were older, widowed, illiterate, farmer, retired or Orthodox were found to have better quality service experience compared with others (p=0.001).ConclusionGenerally, outpatients’ perception of pharmaceutical service quality was positive. However, two dimensions of the service quality (assurance and reliability) were negatively perceived. To improve the service quality, we recommended the following: (1) managers should provide more training for pharmacists to strengthen their professional knowledge and encourage them to cooperate with other professionals; (2) the government needs to develop guidelines on information provided to patients and train the pharmacists to follow them; (3) hospitals can apply various procurement methods and efficient inventory management methods.


Author(s):  
Vitriana Biben ◽  
Dian Marta Sari ◽  
Farida Arisanti ◽  
Sunaryo B Sastradimadja

Background: A high demand of physiatrist should be supported by quality assurance in education system of Physical Medicine & Rehabilitation (PMR) residency program, that could be done by evaluating satisfaction of its service users. This study was conducted to find the dimensions of service quality that influences the students satisfaction.Methods: A cross-sectional study with fifty subjects using total sampling technique was conducted. Service quality was evaluated using ServQual questionnaire consisted of five dimensions: ‘tangible’, ‘reliability’, ‘responsiveness’, ‘assurance’ and ‘empathy’. Statistical analysis consisted of bivariate analysis followed by a multivariate analysis was performed to determine the most significant dimension associated with student satisfaction which was measured using Likert scale.Results: Bivariate analysis revealed that all dimensions had significant association with satisfaction (p value < 0,05) except for ‘tangible’(p value = 0,060). Further multivariate analysis resulted in ‘reliability’ dimension as the most significant dimension associated with satisfaction (p value = 0,005; Adjusted OR = 142,67; CI 95% = 15,460-1316,587).Conclusion: Reliability is the most significant dimension associated with student satisfaction. Improvement of this dimension, followed by other significant dimensions would lead to satisfaction of the students.


2016 ◽  
Vol 29 (8) ◽  
pp. 820-834 ◽  
Author(s):  
Canan Cengiz ◽  
Yusuf Celik ◽  
Neset Hikmet

Purpose The purpose of this paper is to evaluate the utilisation of patient wristbands (PWs) and patient identification (PI) process in a training hospital in Ankara, Turkey. Design/methodology/approach This descriptive and cross-sectional study was conducted in a training hospital with 640 beds, accreditied by Joint Commission International. The views of 348 patients and 419 hospital personnel on the implementation of patient wristbands and identification process were evaluated. Findings The results indicated that lack of information among patients about the importance of PWs and the misknowledge among staff participants on when, where, and by whom PWs should be put on and verified were the weakest points in this hospital. Research limitations/implications PI process must be strictly implemented according to the standard procedures of patient safety. Both patients and hospital personnel should be trained continuously, and training sessions must be held to increase their awareness about the importance of PWs and identification process. Practical implications Finding new ways and using new methods for increasing knowledge about PI and PWs are necessary. Hospital management should prepare a written PI and PW policy and procedure documents by taking the views of patients and hospital personnel and share these with them. Originality/value This study incorporates the views and attitudes of patients and health care personnel in improving health care quality by increasing awareness about PI and wristbands.


2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Mulugeta Hayelom Kalayou ◽  
Berhanu Fikadie Endehabtu ◽  
Habtamu Alganeh Guadie ◽  
Zeleke Abebaw ◽  
Kassahun Dessie ◽  
...  

Background. Electronic medical record (EMR) systems offer the potential to improve health care quality by allowing physicians real-time access to patient healthcare information. The endorsement and usage of EMRs by physicians have a significant influence on other user groups in the healthcare system. As a result, the purpose of this study was to examine physicians’ attitudes regarding EMRs and identify the elements that may influence their attitudes. Method. An institutional-based cross-sectional study design supplemented with a qualitative study was conducted from March 1 to April 30, 2018, among a total of 403 physicians. A self-administered questionnaire was used to collect quantitative data. The validity of the prediction bounds for the dependent variable and the validity of the confidence intervals and P values for the parameters were measured with a value of less than 0.05 and 95 percent of confidence interval. For the supplementary qualitative study, data were collected using semistructured in-depth interviews from 11 key informants, and the data were analyzed using thematic analysis. Result. Physicians’ computer literacy (CI: 0.264, 0.713; P : 0001) and computer access at work (CI: 0.141, 0.533, P : 0.001) were shown to be favorable predictors of their attitude towards EMR system adoption. Another conclusion from this study was the inverse relationship between physicians’ prior EMR experience and their attitude about the system (CI: -0.517, -0.121; P : 0.002). Conclusion. According to the findings of this study, physicians’ attitudes regarding EMR were found moderate in the studied region. There was a favorable relationship between computer ownership, computer literacy, lack of EMR experience, participation in EMR training, and attitude towards EMR. Improving the aforementioned elements is critical to improving physicians’ attitudes regarding EMR.


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