A research of service quality perceptions and patient satisfaction: Case study of public hospitals in Romania

Historical origins of corruption in the Romanian public health system - path dependency and contagion effect

BACKGROUND

In this paper, we estimate the long-lasting influence of the former Habsburg Empire's border on the territory of Romania, specifically on the prevalence of corrupt behaviour and practices in health services.

METHODS

Employing microdata from the 2016 Life in Transition Survey and applying ordered probit regression, we explore the hypothesis that the geographical proximity of respondents' residences to the former imperial border-restricting the analysis within a bandwidth of 50 km, 75 km or even 100 km on either side - significantly influences current individual tendencies towards corrupt behaviour.

RESULTS

The results indicate that individuals in Transylvania living in the immediate vicinity of the former border of the Habsburg Empire (no more than 75 km away) show a higher propensity towards corrupt behaviours, similar to those from Moldova and Wallachia who reside in the same bandwidth but to the east of the former historical border. Interestingly, on one hand, after a series of tests with various relevant factors, the contagion effect is observed from right to left, meaning from those in Moldova and Wallachia towards those in Transylvania, and not the other way around as might be expected based on other previous studies. On the other hand, individuals living more than 75 kms west of the former historical border show clear reluctance to engage in informal payments and gift-giving when interacting with the public health system as patients.

CONCLUSION

By rigorously controlling for various variables that comprehensively show different legacies of the communist regime, our results confirm the persistence of these influences across different bandwidths, thereby corroborating the hypothesis of path dependence influenced by the former Habsburg Empire.

Effects of Hospital Decentralization Processes on Patients’ Satisfaction: Evidence from Two Public Romanian Hospitals across Two Decades

Patient satisfaction represents an essential indicator in assessing healthcare quality, as it is an extensive source of information regarding the healthcare provider’s ability to meet patients’ expectations and is a key predictor of patients’ behavioral approaches. The purpose of this study is to evaluate the degree of satisfaction of patients who have been admitted for inpatient hospitalization in two public hospitals located in the North-West of Romania, during two different periods of administration/management of healthcare services, in the context of an ongoing decentralization process of public healthcare services (initiated in 2010). An exploratory study was conducted in the period of April–December 2021, based on a patient satisfaction survey, through which the quality of in-hospital services was evaluated at present and up until 2010, by the hospitalized patients in both periods. In total, 208 survey responses were validated and analyzed. The chi-square test and t-test were used for statistical processing. The results of the survey revealed that the percentage of patients that evaluated the inpatient experience as excellent was significantly higher during the period when hospitals were administered by local authorities than during the period of centralized administration (68.27% vs. 28.37%; p < 0.001), both in medical care as well as in hospital hotel services (71.63 vs. 29.81%), respectively (56.25 vs. 27.40; p < 0.001). The results obtained from this survey indicate that the decentralization of hospital units has had a positive effect on the quality of inpatient medical services and highlight the need for formulating and finalizing a policy aimed at developing and enhancing medical services.