The quality of patient care in oncology departments in Karachi, Pakistan: patients' perceptions

Health seeking behaviours and private sector delivery of care for non-communicable diseases in low- and middle-income countries: a systematic review

BACKGROUND

Globally, non-communicable diseases (NCDs) are the leading cause of mortality and morbidity placing a huge burden on individuals, families and health systems, especially in low- and middle-income countries (LMICs). This rising disease burden calls for policy responses that engage the entire health care system. This study aims to synthesize evidence on how people with NCDs choose their healthcare providers in LMICs, and the outcomes of these choices, with a focus on private sector delivery.

METHODS

A systematic search for literature following PRISMA guidelines was conducted. We extracted and synthesised data on the determinants and outcomes of private health care utilisation for NCDs in LMICs. A quality and risk of bias assessment was performed using the Mixed Methods Appraisal Tool (MMAT).

RESULTS

We identified 115 studies for inclusion. Findings on determinants and outcomes were heterogenous, often based on a particular country context, disease, and provider. The most reported determinants of seeking private NCD care were patients having a higher socioeconomic status; greater availability of services, staff and medicines; convenience including proximity and opening hours; shorter waiting times and perceived quality. Transitioning between public and private facilities is common. Costs to patients were usually far higher in the private sector for both inpatient and outpatient settings. The quality of NCD care seems mixed depending on the disease, facility size and location, as well as the aspect of quality assessed.

CONCLUSION

Given the limited, mixed and context specific evidence currently available, adapting health service delivery models to respond to NCDs remains a challenge in LMICs. More robust research on health seeking behaviours and outcomes, especially through large multi-country surveys, is needed to inform the effective design of mixed health care systems that effectively engage both public and private providers.

TRIAL REGISTRATION

PROSPERO registration number CRD42022340059 .

Quality of care in the oncological outpatient setting: Individual interviews with people receiving cancer treatment

PURPOSE

To describe how patients receiving cancer treatment perceive quality of care in the oncological outpatient settings.

METHOD

A strategic sample of 20 adult patients with cancer treated in four oncological outpatient settings in four hospitals in Sweden participated in the study. Participants were interviewed using a semi-structured interview guide with open-ended questions. The interviews were audio-recorded, and the transcripts were analysed using a phenomenographic approach.

RESULTS

Three descriptive categories emerged from the data: The patient's care is designed to meet individual needs, The patient's dignity is respected, and The patient feels safe and secure with the care. Overall, quality of care in the oncological outpatient setting is perceived as something positive and described in normative terms by the participants.

CONCLUSION

The results emphasises that in order to achieve quality of care it is important to the patients that they are able to meet with the same well-educated, professional, caring and sensible health care professionals every time.