地域医療と健康教育

抽象的な

Predictors of Patient Satisfaction in Three Tiers of Health Care Facilities of North India

Sonu Goel, Deepak Sharma, Pankaj Bahuguna, Sonika Raj and Amrjeet Singh

Background: Satisfaction with quality of health care provision can be conceptualized as a degree of congruency between patient expectation and his perception of services and care received. Aims and objectives: This paper examines the level of satisfaction among patients attending OPD (Outpatient Department) in public health facilities in a city in Northern part of India. Methodology: The study used a cross-sectional sample survey design, wherein a total of 942 study subjects were exit interviewed. An eighty item scale was developed and validated using Delphi technique which covers six major domains of patient satisfaction. It was pilot tested in twenty subjects for development of final tool. Each item was dichotomized as “not satisfied” and “satisfied”. The composite score of each item was later computed and coded as “below average satisfaction” if it was below 0.5 and “above average satisfaction” if it was above 0.5. Binary logistic regression was performed to identify potential predictors of patient satisfaction. Results: Out of 942 study subjects, 728 (77.3%) were satisfied with the various dimensions of service provision at the health care facilities. Logistic regression model revealed that the predictors of patient satisfaction were accessibility to health facility (Odds ratio=6.6), physician care (Odds ratio=4.2), management (Odds ratio=2.9) and physical environment (Odds ratio=2.1). Display of signage’s and staff behaviour did not predict patient satisfaction. Patients attending higher level health care facilities like district hospital were more satisfied (Odds ratio=123.3) as compared to those attending community health centres (Odds ratio=26.0), polyclinic (Odds ratio=12.5) and dispensaries. The respondents in younger age group (10-19 years) were more satisfied as compared to those in age group 19-60 years (Odds ratio=0.79) and 60 years and above (Odds ratio=0.64). Similarly, literate individuals were less satisfied (Odds ratio=0.2) as compared to their counterparts. Conclusion: To conclude, there was an overall good level of satisfaction with OPD. The policy makers should focus on correlates of satisfaction namely, accessibility to health facility, physician care, physical environment and management of health care facility.