Perceived quality of care for severe acute malnutrition management among caregivers of under-five children with severe acute malnutrition in Addis Ababa, Ethiopia, 2022: a mixed-method study

Introduction

All the factors at the institutional, provider, and client levels have an impact on the quality of care. In low- and middle-income countries, poor quality of severe acute malnutrition (SAM) management at health institutions is a major contributor to child morbidity and mortality. This study aimed to determine the perceived quality of care for SAM management among caregivers of under-five children.

Methods

This study was conducted in public health facilities that provide inpatient SAM management in Addis Ababa, Ethiopia. An institution-based convergent mixed-method study design was implemented. Quantitative data were analyzed by using a logistic regression model, while thematic analysis was used to analyze the qualitative data.

Results

A total of 181 caregivers and 15 healthcare providers were recruited. The overall perceived quality of care for SAM management was 55.80% (CI: 48.5-63.10). Urban residence (AOR = 0.32, 95% CI: 0.16-0.66), college and above level education (AOR = 4.42, 95% CI: 1.41-13.86), working as a government employee (AOR = 2.72, 95% CI: 1.05-7.05), readmitted to the hospital (AOR = 0.47, 95% CI: 0.23-0.94), and length of hospital stays >7 days (AOR = 2.1, 95% CI: 1.01-4.27) were found to be significantly associated factors with perceived low-quality care for SAM management. Additionally, lack of support and attention from higher levels of management, and lack of supplements, separate units, and laboratory facilities were among the factors that impede the provision of quality care.

Discussion

Perceived quality of SAM management services was low against the national goal of quality improvement to meet the expectations of both internal and external clients. Rural residents, those with more educational qualifications, government employees, newly admitted patients, and patients who stayed longer in hospitals were the most unsatisfied groups. Improving support and logistic supply to health facilities, providing client-centered care, and responding to caregivers' demands may help to improve quality and satisfaction.

Quality of Pediatric Healthcare Services and Associated Factors in Felege-Hiwot Comprehensive Specialized Hospital, North-West Ethiopia: Parental Perception

BACKGROUND

Poor quality of pediatric healthcare services at health facilities is a major contributing factor to child morbidity and mortality in low- and middle-income countries, including Ethiopia, and it brings parental dissatisfaction. Eliciting parents' perception is an important method used to assess functionality or quality of pediatric healthcare services. Thus, the objective of this study was to assess the perceived quality of pediatric healthcare services and to identify factors for it in Felege-Hiwot Comprehensive Specialized Hospital, Northwest Ethiopia.

METHODS

A facility-based cross-sectional study was conducted among parents of childhood patients from September 15, 2019 to October 15, 2019; 407 participants were recruited. Stratified random sampling was used to select respondents and data were collected using face-to-face interviews. Frequencies, percentages, and means with standard deviations were used to describe profiles of respondents. Both bi-variable and multivariable logistic regressions were used to model the odds of perceived quality of pediatric healthcare services.

RESULTS

The proportion of perceived quality of pediatric healthcare services was 57.6% (95% CI:52.6-62.3%). College and above parental education status (AOR=5.22, 95% CI:2.39-11.38), urban residency (AOR=3.35, 95% CI:1.97-5.72), outpatient services (AOR=2.52, 95% CI:1.35-4.71), and surgical illnesses (AOR=2.18, 95% CI:1.28-3.73) were independent determinants for increased parental lower perceived level of quality. The odd of parental lower perceived level of quality was 2.42-times greater in those parents who did not prefer the hospital for revisiting (AOR=2.42, 95% CI:1.36-4.30).

CONCLUSION

Perceived quality of healthcare services in the hospital was low compared to the national plan which reflected that childhood patients did not receive optimal care. Educational status, place of residence, service delivering unit, illness type, and intention of hospital preference were independent determinants for parental perceived quality of pediatric healthcare service delivery. Continuous and periodic parental feedback should be considered in order to assess their satisfaction which in turn is an insight for quality improvement to be taken by the facility managers.

Improving Patient behavioral Consent through Different Service Quality Dimensions: Assessing the Mediating Role of Patient Satisfaction

This study aimed to examine the impact of the five-dimensional health care service quality (SQ) on patient behavioral consent (PBC). This study further explored the mediating role of patient satisfaction (PS) on the SQ–PBC relationship. A survey questionnaire was used to collect the data from public sector hospitals situated in Bahawalpur division, Punjab, Pakistan. We used confirmatory factor analysis (CFA) and structural equation modeling (SEM) to test the hypotheses. This study found positive and significant relationships between SQ and PBC, SQ and PS, and PS and PBC. Our results further revealed that PS partially mediates the relationship between SQ and PBC. Our study offers a comprehensive theoretical framework of several service quality attributes (SQs) affecting patient behavioral consent (PBC) and patient satisfaction (PS) in health care institutions. Testing these above relationships via a mediation approach is novel and contributed to the current study on service quality.

Perceived service quality's effect on patient satisfaction and behavioural compliance

PURPOSE

The purpose of this paper is to advance healthcare service quality research using hierarchical component models.

DESIGN/METHODOLOGY/APPROACH

This study used a quantitative approach with cross-sectional design as a survey method, combining cluster and convenience sampling and partial least square structural equation modelling (PLS-SEM) to validate the research model and test the hypotheses.

FINDINGS

The study extends health service quality literature by showing that: patient satisfaction (PS) is dominant, significant and indirect determinant of behavioural compliance (BC); perceived service quality has the strongest effect on BC via PS.

RESEARCH LIMITATIONS/IMPLICATIONS

Only one hospital was evaluated.

PRACTICAL IMPLICATIONS

The study provides managers with a service quality model for conducting integrated service delivery systems analysis and design.

ORIGINALITY/VALUE

Overall, the study makes a significant contribution to healthcare organizations, better health outcomes for patients and better quality of life for the community.

Interrelations of service quality and service loyalty dimensions in medical tourism

Purpose

– The purpose of this paper is to identify the dimensions of service quality as well as of service loyalty in the context of medical tourism. It seeks to demonstrate the conceptualization of medical tourism service loyalty (MTSL) construct. This research also attempts to examine the effect of service quality dimensions on service loyalty dimensions of medical tourism.

Design/methodology/approach

– The dimensions of service quality as well as of service loyalty are identified using an exploratory factor analysis. Next, the reliability and validity of the quality factors and loyalty factors are established through confirmatory factor analysis using AMOS 18.0 version. The related hypotheses are tested using structural equation modeling (SEM).

Findings

– The paper identifies eight-factor construct for medical tourism service quality and three-factor construct for MTSL. It is found that the treatment satisfaction dimension of service quality has positive and significant impact on MTSL. It is also observed that, overall, medical tourism service quality has positive impact on MTSL.

Practical implications

– These dimensions of service quality should be viewed as the levers of improving perceived service quality with respect to medical tourism. Examining the service quality dimensions’ impact on customer loyalty for medical tourism sector can offer the industry valuable insights regarding which aspects of the service to focus on in order to improve medical tourist’s satisfaction and loyalty toward the firms.

Originality/value

– This paper introduces the concept of service quality and service loyalty in medical tourism sector. In conceptualizing MTSL, the authors propose an integration of behavioral measures, attitudinal measures and cognitive measures. The interrelationship between the service quality construct and medical loyalty construct was established using SEM. This is useful for the healthcare manager to measure the medical tourist’s perceptions of service quality on these dimensions as related to medical tourism performance.

Service quality and perceived value of technology-based service encounters: evaluation of clinical staff satisfaction in Taiwan

Previous research has evaluated technology-based service encounters (TBSEs) in the delivery of health care by assessing patient satisfaction. This study examined service quality and perceived value of TBSEs used in health organisations from the perspective of clinical staff, with staff technology readiness as a moderator. A quantitative survey was conducted in Taiwan, across private and public healthcare organisations. Results showed that TBSEs had a direct effect on service quality and perceived value, which in turn had a direct effect on staff satisfaction in using TBSEs. However, service quality had no effect on perceived value when moderated by technology readiness. Theoretical and managerial implications of these findings are discussed.