1
|
Aljarallah NA, Almuqbil M, Alshehri S, Khormi AMS, AlReshaidan RM, Alomran FH, Fawzan Alomar N, Alshahrani FF, Alshammari MS, Alsanie WF, Alhomrani M, Alamri AS, Asdaq SMB. Satisfaction of patients with health care services in tertiary care facilities of Riyadh, Saudi Arabia: A cross-sectional approach. Front Public Health 2023; 10:1077147. [PMID: 36711344 PMCID: PMC9880422 DOI: 10.3389/fpubh.2022.1077147] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023] Open
Abstract
As part of Saudi Vision 2030, the country's healthcare system is undergoing a significant makeover, with accessibility and effectiveness serving as the benchmarks for measuring patient care quality. This study's goal was to ascertain the degree of patient satisfaction with the medical care and services received in Riyadh's tertiary care facilities. The PSQ-18 (Patient Satisfaction Questionnaire-18), a standardized validated questionnaire including areas of "overall satisfaction," "technical quality," "interpersonal aspect," "communication," "financial aspect," "time spent with the doctor," and "accessibility and convenience," was used in this cross-sectional study on 384 patients of two tertiary care facilities in Riyadh, Saudi Arabia, over a 6-month period. The degree to which sociodemographic characteristics and components of patient satisfaction are correlated was assessed using binary and multiple regression analysis. When the P-value was < 0.05, the results were considered significant and were presented as adjusted odds ratios (AOR). To ascertain how each PSQ-18 subscale affected other subscales, a Pearson Correlation analysis was conducted. The overall degree of satisfaction with all 18 items was 73.77%. The financial component received a rating of 81% compared to 77% for general satisfaction. Technical quality (75%) was followed by accessibility and convenience (73.5%), communication (73%), and interpersonal elements (72%). At 68%, the time spent in the doctor's domain received the lowest rating. The odds of satisfaction were increased by 3.87 times, 3.45 times, and 3.36 times among those who are employed, qualified by university education, and married compared to unemployed (P-value = 0.018), less qualified (P-value = 0.015) and singles (P-value = 0.026), respectively. The younger age group also made 1.78 times more of a difference in higher satisfaction ratings. The general satisfaction domain showed a positive association with other areas. Participants who were satisfied with the communication and accessibility and convenience domains of healthcare providers were the only ones who were typically satisfied with the domain of doctor time spent. The study's findings could act as a benchmark for Saudi Arabia's healthcare services as well as a starting point for quality assurance procedures.
Collapse
Affiliation(s)
- Nasser Ali Aljarallah
- Department of Computer Science and Information Systems, College of Applied Sciences, AlMaarefa University, Ad Diriyah, Riyadh, Saudi Arabia,Department of Business Administration, College of Business Administration, Majmaah University, Al Majma'ah, Saudi Arabia
| | - Mansour Almuqbil
- Department of Clinical Pharmacy, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | - Sultan Alshehri
- Department of Pharmaceutics, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia
| | | | | | - Fayez Hadi Alomran
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh, Saudi Arabia
| | | | - Fayez Faleh Alshahrani
- Department of Family Medicine, King Abdulaziz Medical City in Riyadh, Ministry of National Guard, Riyadh, Saudi Arabia
| | | | - Walaa F. Alsanie
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia,Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia
| | - Majid Alhomrani
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia,Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia
| | - Abdulhakeem S. Alamri
- Department of Clinical Laboratory Sciences, The Faculty of Applied Medical Sciences, Taif University, Taif, Saudi Arabia,Centre of Biomedical Sciences Research (CBSR), Deanship of Scientific Research, Taif University, Taif, Saudi Arabia
| | - Syed Mohammed Basheeruddin Asdaq
- Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Dariyah, Riyadh, Saudi Arabia,*Correspondence: Syed Mohammed Basheeruddin Asdaq ✉ ; ✉
| |
Collapse
|
2
|
Sanıl M, Eminer F. An integrative model of patients' perceived value of healthcare service quality in North Cyprus. Arch Public Health 2021; 79:227. [PMID: 34930446 PMCID: PMC8685307 DOI: 10.1186/s13690-021-00738-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 11/14/2021] [Indexed: 11/10/2022] Open
Abstract
Background Improving healthcare quality has become an essential objective for all health institutions worldwide to address the need to improve services, manage costs and satisfy patient expectations about the quality of care. As health is one of the leading service sectors of the North Cyprus economy, analysing patients’ perceived value of healthcare service quality is crucial. In this research, a comparative analysis of existing models revealed affordability, acceptability and accessibility as the leading modern service quality indicators affecting patients’ perceived value of healthcare service quality. The quality of services is a leading factor impacting business competition and retention dictated by the current market. This study aimed to investigate the factors that influence patient perceptions of healthcare service quality in North Cyprus. Methods A self-administered questionnaire was carried out among 388 patients of public and private hospitals in North Cyprus, and the data were analysed using partial least squares-structural equation modelling. Results Empirical results highlight that the acceptability of healthcare services is a prerequisite for perceiving a high value of service quality. The affordability and accessibility of services, respectively, were less effective. Results concerning mediating effects confirm that acceptability could fully mediate the relationship between affordability and perceived value and could partially mediate the impact of accessibility on the perceived quality of healthcare services. Conclusion This study contributes to healthcare theory and practice by developing a conceptual framework to provide policymakers and managers with a practical understanding of factors that affect healthcare service quality.
Collapse
Affiliation(s)
- Mert Sanıl
- Faculty of Health Sciences, European University of Lefke, Gemikonagı-Lefke, North Cyprus, TR-10, Mersin, Turkey.
| | - Fehiman Eminer
- Faculty of Economics and Administrative Sciences, European University of Lefke, Gemikonagı-Lefke, North Cyprus, TR-10, Mersin, Turkey
| |
Collapse
|
3
|
Wardhani V, van Dijk JP, Utarini A. Hospitals accreditation status in Indonesia: associated with hospital characteristics, market competition intensity, and hospital performance? BMC Health Serv Res 2019; 19:372. [PMID: 31185984 PMCID: PMC6560753 DOI: 10.1186/s12913-019-4187-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 05/28/2019] [Indexed: 11/17/2022] Open
Abstract
Background Hospital accreditation is widely adopted as a visible measure of an organisation’s quality and safety management standards compliance. There is still inconsistent evidence regarding the influence of hospital accreditation on hospital performance, with limited studies in developing countries. This study aims to explore the association of hospital characteristics and market competition with hospital accreditation status and to investigate whether accreditation status differentiate hospital performance. Methods East Java Province, with a total 346 hospitals was selected for this study. Hospital characteristics (size, specialty, ownership) and performance indicator (bed occupancy rate, turnover interval, average length of stay, gross mortality rate, and net mortality rate) were retrieved from national hospital database while hospital accreditation status were recorded based on hospital accreditation report. Market density, Herfindahl-Hirschman index (HHI), and hospitals relative size as competition indicators were calculated based on the provincial statistical report data. Logistic regression, Mann-Whitney U-test, and one sample t-test were used to analyse the data. Results A total of 217 (62.7%) hospitals were accredited. Hospital size and ownership were significantly associated with of accreditation status. When compared to government-owned, hospital managed by ministry of defense (B = 1.705, p = 0.012) has higher probability to be accredited. Though not statistically significant, accredited hospitals had higher utility and efficiency indicators, as well as higher mortality. Conclusions Hospital with higher size and managed by government have higher probability to be accredited independent to its specialty and the intensity of market competition. Higher utility and mortality in accredited hospitals needs further investigation. Electronic supplementary material The online version of this article (10.1186/s12913-019-4187-x) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Viera Wardhani
- Post Graduate Program in Hospital Management, Faculty of Medicine, Universitas Brawijaya, East Java, Jalan Veteran No 1, Malang, 65145, Indonesia. .,Doctoral Program in Medicine and Health, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Jalan Farmako Sekip Utara, Yogyakarta, 55281, Indonesia.
| | - Jitse Pieter van Dijk
- Department of Community and Occupational Medicine, University Medisch Centrum, University of Groningen, Antonius Deusinglaan 1, 9713, AV, Groningen, The Netherlands.,Department of Social Medicine and Public Health, Faculty of Medicine and Dentistry, Palacký University, Hněvotínská 3, 775 15, Olomouc, Czech Republic
| | - Adi Utarini
- Department of Health Policy and Management, Faculty of Medicine, Public health and Nursing, Universitas Gadjah Mada, Jalan Farmako Sekip Utara, Yogyakarta, 55281, Indonesia
| |
Collapse
|
4
|
Lee S, Wang W, Washburn DJ, Shi H, Yu Y, Du Y, Zhang H, Maddock JE. Effect of the treatment-before-deposit policy on trust in physicians and perceived service quality among patients in 12 hospitals in China. Int J Health Plann Manage 2018; 33:1110-1120. [PMID: 30074645 DOI: 10.1002/hpm.2592] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/24/2018] [Accepted: 06/29/2018] [Indexed: 11/10/2022] Open
Abstract
This study examined effects of the treatment-before-deposit policy on Chinese patients' trust in physicians and perceived service quality. This study included 3313 patients recruited from 12 hospitals in China. The research team used cross-sectional survey to examine Chinese patients' experience with the treatment-before-deposit policy, perceived service quality, and trust in their physicians. Using mediation analysis, we estimated direct and indirect effects of the treatment-before-deposit policy on patients' perceived service quality and trust in their physicians. Patients who benefitted from the treatment-before-deposit policy reported greater service quality and higher trust in their physicians. The impacts of whether patients benefitted from the policy on trust in physicians were fully mediated by perceived service quality with statistically significant indirect effect. The results support the hypothesis that the treatment-before-deposit policy improves patients' perceived service quality and trust in physicians.
Collapse
Affiliation(s)
- Shinduk Lee
- Center for Population Health and Aging, School of Public Health, Texeas A&M University, College Station, TX, USA.,Department of Health Promotion and Community Health Sciences, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Wenxin Wang
- School of Management, Jiangsu University, Zhen Jiang, China
| | - David J Washburn
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Hongmei Shi
- School of Management, Jiangsu University, Zhen Jiang, China
| | - Yue Yu
- School of Management, Jiangsu University, Zhen Jiang, China
| | - Yuxian Du
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Hao Zhang
- Department of Health Policy and Management, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Jay E Maddock
- Office of the Dean, School of Public Health, Texas A&M University, College Station, TX, USA
| |
Collapse
|
5
|
Suriyawongpaisal P, Aekplakorn W, Srithamrongsawat S, Srithongchai C, Prasitsiriphon O, Tansirisithikul R. Copayment and recommended strategies to mitigate its impacts on access to emergency medical services under universal health coverage: a case study from Thailand. BMC Health Serv Res 2016; 16:606. [PMID: 27769256 PMCID: PMC5073698 DOI: 10.1186/s12913-016-1847-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 10/12/2016] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND Although bodies of evidence on copayment effects on access to care and quality of care in general have not been conclusive, allowing copayment in the case of emergency medical conditions might pose a high risk of delayed treatment leading to avoidable disability or death. METHODS Using mixed-methods approach to draw evidence from multiple sources (over 40,000 records of administrative dataset of Thai emergency medical services, in-depth interviews, telephone survey of users and documentary review), we are were able to shed light on the existence of copayment and its related factors in the Thai healthcare system despite the presence of universal health coverage since 2001. RESULTS The copayment poses a barrier of access to emergency care delivered by private hospitals despite the policy proclaiming free access and payment. The copayment differentially affects beneficiaries of the major 3 public-health insurance schemes hence inducing inequity of access. CONCLUSIONS We have identified 6 drivers of the copayment i.e., 1) perceived under payment, 2) unclear operational definitions of emergency conditions or 3) lack of criteria to justify inter-hospital transfer after the first 72 h of admission, 4) limited understanding by the service users of the policy-directed benefits, 5) weak regulatory mechanism as indicated by lack of information systems to trace private provider's practices, and 6) ineffective arrangements for inter-hospital transfer. With demand-side perspectives, we addressed the reasons for bypassing gatekeepers or assigned local hospitals. These are the perception of inferior quality of care and age-related tendency to use emergency department, which indicate a deficit in the current healthcare systems under universal health coverage. Finally, we have discussed strategies to address these potential drivers of copayment and needs for further studies.
Collapse
Affiliation(s)
- Paibul Suriyawongpaisal
- Department of Community Medicine, Faculty of Medicine Ramathibodi hospital, Mahidol University, Bangkok, Thailand
| | - Wichai Aekplakorn
- Department of Community Medicine, Faculty of Medicine Ramathibodi hospital, Mahidol University, Bangkok, Thailand
| | - Samrit Srithamrongsawat
- Department of Community Medicine, Faculty of Medicine Ramathibodi hospital, Mahidol University, Bangkok, Thailand
| | - Chaisit Srithongchai
- Department of Community Medicine, Faculty of Medicine Ramathibodi hospital, Mahidol University, Bangkok, Thailand
| | - Orawan Prasitsiriphon
- Department of Community Medicine, Faculty of Medicine Ramathibodi hospital, Mahidol University, Bangkok, Thailand
| | - Rassamee Tansirisithikul
- Department of Community Medicine, Faculty of Medicine Ramathibodi hospital, Mahidol University, Bangkok, Thailand.
| |
Collapse
|
6
|
Xesfingi S, Vozikis A. Patient satisfaction with the healthcare system: Assessing the impact of socio-economic and healthcare provision factors. BMC Health Serv Res 2016; 16:94. [PMID: 26979458 PMCID: PMC4793546 DOI: 10.1186/s12913-016-1327-4] [Citation(s) in RCA: 84] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2015] [Accepted: 03/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Patient satisfaction is an important measure of healthcare quality as it offers information on the provider's success at meeting clients' expectations and is a key determinant of patients' perspective behavioral intention. The aim of this paper is first to assess the degree of patient satisfaction, and second, to study the relationship between patient satisfaction of healthcare system and a set of socio-economic and healthcare provision indicators. METHODS This empirical analysis covers 31 countries for the years 2007, 2008, 2009 and 2012. The dependent variable, the satisfaction index, is defined as the patient satisfaction of their country's health system. We first construct an index of patient satisfaction and then, at a second stage, this index is related to socio-economic and healthcare provision variables. RESULTS Our findings support that there is a strong positive association between patient satisfaction level and healthcare provision indicators, such as nurses and physicians per 100,000 habitants, with the latter being the most important contributor, and a negative association between patient satisfaction level and number of hospital beds. Among the socio-economic variables, public health expenditures greatly shape and positive relate to patient satisfaction, while private spending on health relates negatively. Finally, the elder a patient is, the more satisfied with a country's healthcare system appears to be. CONCLUSIONS We conclude that there is a strong positive association between patient satisfaction and public health expenditures, number of physicians and nurses, and the age of the patient, while there is a negative evidence for private health spending and number of hospital beds.
Collapse
Affiliation(s)
- Sofia Xesfingi
- Department of Economics, University of Piraeus, 18534, Piraeus, Greece
| | | |
Collapse
|
7
|
Chang YK, Hsu CC, Chen PC, Chen YS, Hwang SJ, Li TC, Huang CC, Li CY, Sung FC. Trends of cost and mortality of patients on haemodialysis with end stage renal disease. Nephrology (Carlton) 2015; 20:243-9. [DOI: 10.1111/nep.12380] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Yu-Kang Chang
- Division of Geriatrics and Gerontology, Institute of Population Health Sciences; National Health Research Institutes; Chunan Taiwan
| | - Chih-Cheng Hsu
- Division of Geriatrics and Gerontology, Institute of Population Health Sciences; National Health Research Institutes; Chunan Taiwan
- Department of Health Administration; China Medical University; Taichung Taiwan
| | - Pei-Chun Chen
- Clinical Informatics & Medical Statistics Research, Center; Chang Gung University; Taoyuan Taiwan
| | - Yi-Shan Chen
- Department of Health Administration; China Medical University; Taichung Taiwan
| | - Shang-Jyh Hwang
- Division of Nephrology; Kaohsiung Medical University Hospital; Kaohsiung Taiwan
| | - Tsai-Chung Li
- Institute of Biostatistics; China Medical University; Taichung Taiwan
| | - Chiu-Ching Huang
- Division of Nephrology; China Medical University Hospital; Taichung Taiwan
| | - Chung-Yi Li
- Institute of Public Health; National Cheng Kung University; Tainan Taiwan
| | - Fung-Chang Sung
- Institute of Clinical Medical Science; China Medical University College of Medicine; Taichung Taiwan
| |
Collapse
|
8
|
Hsiao YY, Cheng SH. Is there a disparity in the hospital care received under a universal health insurance program in Taiwan? Int J Qual Health Care 2013; 25:232-8. [PMID: 23548442 DOI: 10.1093/intqhc/mzt029] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Yu-Yu Hsiao
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | |
Collapse
|
9
|
Chen CC, Cheng SH. Hospital competition and patient-perceived quality of care: Evidence from a single-payer system in Taiwan. Health Policy 2010; 98:65-73. [PMID: 20650538 DOI: 10.1016/j.healthpol.2010.06.022] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2009] [Revised: 06/22/2010] [Accepted: 06/27/2010] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To examine the effects of market competition on patient-perceived quality of care under a single-payer system in Taiwan. METHODS Data came from two nationwide surveys conducted on discharged patients and National Health Insurance (NHI) hospital claim datasets in 2002 and 2004. Competition was measured by the Herfindahl-Hirschman Index (HHI). Quality of care was measured by patient-rated hospital performance including interpersonal skills and clinical competence domains. We used the instrumental variable approach to address the endogeneity between competition and patient-perceived quality of care. RESULTS The results showed that HHI was significantly associated with a decrease in the perceived interpersonal skills (coefficient of -0.460; p<0.001), indicating that the interpersonal skill level increases in competition. A similar association was found for the perceived clinical competence (coefficient of -0.457; p=0.001). CONCLUSION Quality of care from the patients' perspective is sensitive to the degree of competition. By using patient-reported data, this study provides new evidence concerning competition and quality of care.
Collapse
Affiliation(s)
- Chi-Chen Chen
- Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan
| | | |
Collapse
|
10
|
Abstract
Background and Purpose—
As healthcare costs keep rising, cuts in reimbursement such as the Balanced Budget Act in the United States or global budgeting have become the key to healthcare reform efforts. Limited information is available, however, concerning whether reimbursement cuts are associated with changes in stroke outcomes. The objective of this study is to determine whether 30-day mortality rates for patients with ischemic stroke changed under increased financial strain from global budgeting in Taiwan.
Methods—
We analyzed all 258 167 patients with ischemic stroke admitted to general acute care hospitals in Taiwan over the period 1998 to 2007 through Taiwan’s National Health Insurance Research Database. Multilevel logistic regression analysis was used to examine whether 30-day stroke mortality rates varied after the implementation of hospital global budgeting since July 2002 adjusted for patient, physician, and hospital characteristics.
Results—
The magnitude of payment reduction on overall hospital net revenues was between 4.3% and 10.0%. The 30-day mortality rates for patients with ischemic stroke in Taiwan increased after the implementation of hospital global budgeting after adjustment for patient gender and age, comorbidities, surgery, physician age and volume, specialty, hospital volume, ownership, accreditation level, bed size, geographic location, competition, and trend.
Conclusions—
The mortality rate of patients with stroke rose under increased financial strain from cuts in reimbursement. Therefore, stroke outcomes are more likely to be affected by hospital financial pressures. It is imperative to monitor stroke outcomes and develop strategies to maintain levels of stroke care as cuts in reimbursement are adopted.
Collapse
Affiliation(s)
- Yu-Chi Tung
- From the Department of Healthcare Information and Management (Y.-C.T.), Ming Chuan University, Taoyuan County, Taiwan; and the Department of Family Medicine (G.-M.C.), Cardinal Tien Hospital, Taipei County, Taiwan
| | - Guann-Ming Chang
- From the Department of Healthcare Information and Management (Y.-C.T.), Ming Chuan University, Taoyuan County, Taiwan; and the Department of Family Medicine (G.-M.C.), Cardinal Tien Hospital, Taipei County, Taiwan
| |
Collapse
|
11
|
Hsu C, Cheng SH. Practice guideline adherence and health care outcomes--use of prophylactic antibiotics during surgery in Taiwan. J Eval Clin Pract 2009; 15:1091-6. [PMID: 20367710 DOI: 10.1111/j.1365-2753.2009.01182.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
RATIONALE, AIMS AND OBJECTIVES To evaluate adherence to guidelines for prophylactic antibiotic use in total knee replacement (TKR) and total hip replacement (THR) procedures and to examine the associations between guideline adherence and health care outcomes. METHODS Using nationwide health insurance claims data, all adult inpatients undergoing TKR or THR procedures at teaching hospitals from 2002 to 2006, were included. Guideline adherence rates were assessed every year according to the national guidelines introduced in 2004. Multiple regression analyses with generalized estimating equations models were used to examine the relationships between the deliberate variables. RESULTS The guideline adherence rates stably increased from 14.07% in 2002 to 28.34% in 2006. The 2006 dataset included 12 863 observations. The results revealed that guideline adherence was negatively associated with length of stay and health care expenses with beta = -0.0207 and -0.0087, respectively (P < 0.0001). The 30-day readmission rate was 1.54% among the patients seen in 2006, and it was significantly different between the two groups, with 0.90% of the adherence group and 1.82% of the non-adherence group being readmitted (P = 0.0002). CONCLUSIONS The guideline adherence for prophylactic use of antibiotics is improving in Taiwan and is associated with a shorter length of stay, fewer medical expenses and lower 30-day readmission rates. Promoting evidence-based practice guidelines may be beneficial to patients and health care providers.
Collapse
Affiliation(s)
- Chentong Hsu
- Institute of Health Policy & Management, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | |
Collapse
|
12
|
Tung YC, Chang GM. Patient satisfaction with and recommendation of a primary care provider: associations of perceived quality and patient education. Int J Qual Health Care 2009; 21:206-13. [PMID: 19258342 DOI: 10.1093/intqhc/mzp006] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To identify whether attributes of perceived clinic quality and patient education are associated with patient satisfaction and recommendation of a primary care provider. DESIGN Data used in this study were obtained through a national telephone survey by random sampling. SETTING Clinics throughout Taiwan. PARTICIPANTS A total of 1910 patients. MAIN OUTCOME MEASURES Overall patient satisfaction and recommendation were measured by single item questions. Attributes of clinic quality were measured using 11 items: doctor's technical skill (four items), doctor's interpersonal skill (three items), staff care and access (four items). Patient education was measured on the basis of education provided on disease prevention and control during the visit. RESULTS With regard to clinic quality, doctor's technical skill was most related to overall satisfaction and recommendation, followed by doctor's interpersonal skill. Staff care and access were associated with overall satisfaction but were not associated with recommendation. Patient education was related to both overall satisfaction and recommendation. CONCLUSION Doctor's technical skill is the most critical attribute of primary care quality for both overall satisfaction and recommendation, followed by doctor's interpersonal skill. Staff care and access are associated with improved overall satisfaction but not related to increasing the likelihood of recommending a clinic to relatives and friends. Doctor's technical and interpersonal skills rather than staff care and access can be the essence of quality competition in the primary care market. Providing patient education during the visit on how to prevent or control diseases may also relate to improved patient satisfaction and recommendation.
Collapse
Affiliation(s)
- Yu-Chi Tung
- Department of Healthcare Information and Management, Ming-Chuan University, Room AA611, No.5, De-Ming Road, Gui-Shan Township, Taoyuan County, Taiwan, 333.
| | | |
Collapse
|