A study “Patients' satisfaction with services obtained from Aminu Kano Teaching Hospital,

Kano, Northern Nigeria (Z Iliyasu, IS Abubakar, S Abubakar, UM Lawan, AU Gajida -

Department of Community Medicine, Aminu Kano Teaching Hospital & Bayero University
Kano, Nigeria)” Periodic patient satisfaction surveys provide feedback to hospital management
and staff regarding the quality of services rendered. These surveys have become routine as part
of total quality management in developed countries. We assessed patient satisfaction with
services provided in a teaching hospital in northern Nigeria. Method : Structured questionnaires
were administered on a cross-section of 201 patients and two focus group discussions were held
with patient relatives at Aminu Kano Teaching Hospital. Results : Overall, 83% of the patients
were satisfied with the services received from Aminu Kano Teaching Hospital, while the
remaining 17% were dissatisfied. Specifically, 88%, 88%, 87% and 84% of the patients were
satisfied with patient provider relationship, in-patient services, hospital facilities and access to
care. High number of patients(85%) were also satisfied with the ease of access of the hospital.
However, 30% and 27% of the patients were dissatisfied with waiting time and cost of treatment
respectively. Patients and their relatives complained about delayed appointments, missing
folders, missing laboratory results and long appointments for ultrasound and other radiological
investigations. It has also been found out that patients come to the hospital long before
opening hours and waiting for long periods before being seen. This is a result of the
“appointment system” widely present in the western world not being available
there. Conclusion : The high patient satisfaction notwithstanding, health workers need to
consider patients as customers by being friendly and reducing waiting time for consultation and
investigations. Widespread implementation of the National Health Insurance Scheme will also
reduce the cost of services and drugs to patients.

A STUDY ON OUT PATIENT SATISFACTION AT A SUPER SPECIALTY HOSPITAL

IN INDIA [Dr. S. K. Jawahar MHA (AIIMS), DNB (Health Administration) Administrative
Medical Officer, Sree Chitra Tirunal Institute for Medical Sciences and Technology,
Thiruvananthapuram, Kerala, India]
Patients and staff satisfaction is an important component of the health care industry in this
competitive modern era. In the hospital, the Outpatient Department is often called “Shop
Window”. Patients’ satisfaction leads to drift in both new and old patients, which hinders the
sustainability of any hospital in long run. This study was conducted to know the satisfaction level
of patients and also get a feedback about the services provided in the outpatient departments. The
patients were randomly selected and a questionnaire was developed to evaluate patient
satisfaction about the outpatient department services, logistic arrangement in the outpatient
departments, waiting time, facilities, perception about the performance of staff, appointment
system, behavior of staff, support service and any other suggestions of patients. Out of 200
patients surveyed, 90-95% of patients were satisfied with the service offered in the hospital.
Some other results that were got through this study are that 57% of the patients felt that they had
to wait long hours to get an appointment. 35.5% who felt that doctors were well behaved but
could have been more patient. Friendliness component of the nursing service was rated to be
only average by 40% of the patients. study also showed that friendliness of the nursing staff
needs to be improved.
A study “PATIENT SATISFACTION AT THE MUHIMBILI NATIONAL HOSPITAL IN
DAR ES SALAAM, TANZANIA [E.P.Y. Muhondwa1, M.T. Leshabari1, M. Mwangu2, N.
Mbembati3, M. J. Ezekiel1]”

Objectives: Patients are the primary beneficiaries of the services and care that hospitals provide.
The Patient Satisfaction study examined the extent to which patients at the Muhimbili National
Hospital (MNH) were satisfied with the services and care they received at MNH.
This was part of a baseline study that sought to determine the level of performance of the
hospital before massive restructuring, reform, and renovations were undertaken.
Methodology: Exit interviews were the main research method used to determine patient
satisfaction. Patients were interviewed as they were leaving the OPD clinics, laboratory, X-ray,
pharmacy and inpatient wards.
Results: The study found that most patients were satisfied with the services and care they
received. This high level of satisfaction must be viewed within the context of a hierarchical
public health care delivery system, with MNH at the apex. The services and care MNH provides
can only be excellent compared to that provided by lower level health facilities. Indeed, patients
covered by this study perceived the services provided by MNH as superior, and this was
reflected in the high level of satisfaction they reported. Some patients expressed dissatisfaction
with specific aspects of the services that they received. They were particularly dissatisfied with
long waiting times before receiving services, the high costs of treatment and investigations
charged at MNH, poor levels of hygiene in the wards. patients complained about the use of
humiliating words while attending patients. Nurses were particularly singled
out as being rude, uncaring, and fond of using humiliating language and negative attitudes of
staff towards patients.
Conclusion: Although only a small proportion of patients expressed dissatisfaction with these
aspects of the services provided, they are significant in that they constitute a call for action by the
MNH management to encourage the health personnel to embrace a new staffpatient relationship
ethos, in which the patient is a viewed as a customer.

Measuring patient satisfaction: A case study to improve quality of care at public health
facilities

Prahlad Rai Sodani1, Rajeev K Kumar1, Jayati Srivastava2, Laxman Sharma1

1
Department of Research, Institute of Health Management Research, Jaipur, India
2
Directorate of Medical, Health and Family Welfare Services, Government of
Rajasthan, Jaipur, India

Objective: The main objective of the study is to measure the satisfaction of OPD
(Outpatient Department) patients in public health facilities of Madhya Pradesh in
India. Materials and Methods: Data were collected from OPD patients through
pre-structured questionnaires at public health facilities in the sampled eight districts
of Madhya Pradesh. The data were analyzed using SPSS. Settings: Outpatient
Departments of district hospital, civil hospital, community health centre, and
primary health centre of the eight selected districts of Madhya Pradesh. Results: A
total of 561 OPD patients were included in the study to know their perceptions
towards the public health facilities, choosing health facility, registration process,
basic amenities, perception towards doctors and other staff, perception towards
pharmacy and dressing room services. It was found that most of the respondents
were youth and having low level of education. The major reason of choosing the
public health facility was inexpensiveness, infrastructure, and proximity of health
facility. Most of the patients (64%) felt that the registration counter was
overcrowded.Measuring patient satisfaction were more satisfied with the basic
amenities at higher health facilities compared to lower level facilities. It was also
observed that the patients were more satisfied with the behavior of doctors and
staff at lower health facilities compared to higher level facilities. The study findings
suggest that following measures may be taken by the policy makers and hospital
administrators to increase the patient satisfaction at public health facilities: 1)
Efforts should be made to reduce the patient load at the higher level facilities so
that doctors and other staff can give more attention and time to the patients; 2)
Efforts are also needed to strengthen infrastructure and human resources at the
lower level health facilities. The findings of the present study can be utilized to
improve the services at public health facilities of the state resulting in the more
satisfaction of patients availing such public health facilities.

A Study on Compliance and Behavioral Responses of

Patients in an out-Patient Clinic
Author(s): Mrs. J.P. Acharya, I Acharya
Research question: What is the level of compliance, the reasons of compliance failure and
prevailing behaviour of OPD patients?
Objective: To assess the relationship between behavioural responses of out-patients and their
various levels of compliance.
Study design: Longitudinal follow-up of patients.
Setting: An out patient clinic with basic facilities like laboratory, X-ray, minor OT etc. in
Ahmedabad cantonment area.
Participants: 250 OPD patients who required follow-ups.
Study variables: Level of compliance to medical regimen, various reasons for partial and non-
compliance and behaviour ot patients in relation to prescribed drugs, treating doctor and OPD
environment.
Statistical analysis: Proportions.
Results: The overall compliance profile showed 59.8% to be fully compliant, 39.6% as partially
compliant and 0.6% as non-compliant. Compliance failure was mostly due to side effect of drugs
(28.3%), forgetting to take the doses (23.1 %), bad taste of drugs (15.2%) etc. Analysis showed
that the fully compliant patient had understood the prescription properly, was prescribed less
number of drugs, thought the treatment to be effective, could identify the drugs prescribed, had a
good impression of the treating doctor's acumen, behaviour, way of examination and explanation
ot the disease and found the waiting period in the OPD suitable, the staff skilled and helpful and
sitting arrangements comfortable. The non-compliant and partially compliant were not satisfied
with the drugs, doctor and OPD staff. Full compliance was high amongst cases who felt that the
approach of the doctor was personal (136 or 65.7%), patient was satisfied with the examination
carried out (143 or 61.4%), when doctor explained about the disease to patient (132 or 64.7%)
and where doctor's capability to judge illness was satisfactory (128 or 60.9%). The partial and
non-compliance was high when doctor's approach was impersonal (34 or 79.1%), patient was
dissatisfied by doctor's examination (15 or 88.2%), when he could not satisfactorily explain
about the disease etc. to the patient (33 or 71.7%) and where his capability to judge severity was
unsatisfactory (23 or 57.5%).

A study “Measuring patient satisfaction: A case study to improve quality of

care at public health facilities” by Prahlad Rai Sodani, Rajeev K Kumar, Laxman
Sharma from Department of Research, Institute of Health Management Research,
Jaipur, India & Jayati Srivastava from Directorate of Medical, Health and Family
Welfare Services, Government of Rajasthan, Jaipur, India, published in Indian journal
of community medicine Year : 2010 Volume : 35 Issue : 1 Page : 52-56.

Main objective of the study is to measure the satisfaction of OPD (Outpatient

Department) patients in public health facilities of Madhya Pradesh in India. Data
were collected from OPD patients through pre-structured questionnaires at public
health facilities in the sampled eight districts of Madhya Pradesh. Settings for the
above research were Outpatient Departments of district hospital, civil hospital,
community health centre, and primary health centre of the eight selected districts
of Madhya Pradesh.

A total of 561 OPD patients were included in the study to know their perceptions
towards the public health facilities, choosing health facility, registration process,
basic amenities, perception towards doctors and other staff, perception towards
pharmacy and dressing room services. It was found that most of the respondents
were youth and having low level of education. The major reason of choosing the
public health facility was inexpensiveness, infrastructure, and proximity of health
facility. Measuring patient satisfaction was more satisfied with the basic amenities
at higher health facilities compared to lower level facilities. It was also observed
that the patients were more satisfied with the behavior of doctors and staff at lower
health facilities compared to higher level facilities.

According to a study “A study of patient satisfaction with primary health care services in
Saudi Arabia-M. El Shabrawy Ali and M. Eisa Ali Mahmoud JOURNAL OF COMMUNITY
HEALTH Volume 18, Number 1, 49-54, DOI: 10.1007/BF01321520- M. El Shabrawy Ali, Ph.D
is Professor and Chairman, Department of Community and Family Medicine, College of
Medicine, King Saud University, Riyadh, Saudi Arabia; M. Elisa Ali Mahmoud, M.D. is
Consultant in Epidemiology and Statistics, Ministry of Health, Rivadh, Saudi Arabia.” patient
satisfaction is of value to primary health care providers where the main objective of the study
was to estimate patient satisfaction with respect to primary health care services in Riyadh City,
Saudi Arabia. Fourteen primary health care centers were chosen randomly to represent various
geographic areas of Riyadh. Information was collected through a pre-tested questionnaire used
by thirty well-trained final year medical students. Systematic sampling of family files was
conducted and the household head was interviewed. 900 respondents were interviewed
concerning their satisfaction with the services delivered. The findings were as follows: 40% were
dissatisfied. One third of the dissatisfied expressed the view that the center was too far; 19.4%
complained that the working hours of the center were not suitable; 38.9% complained of the
absence of specialty clinics; 19.4% had language barriers with the physicians; 63.9% complained
about delays at the center; 16.7% of the satisfied and 38.9% of the dissatisfied complained that
the physicians did not satisfactorily explain their health problems and treatments. In 22.7% of the
dissatisfied category, physicians' explanations were neither clear nor understandable. Among the
satisfied, 74.6% said that primary health care center was the first choice if they felt sick; 61.1%
of the non-satisfied category gave this response.

A study “Health literacy and the risk of hospital admission David W. Baker,
Ruth M. Parker, Mark V. Williams and W. Scott Clark Journal of General Internal
Medicine Volume 13, Number 12, 791-798, DOI: 10.1046/j.1525-1497.1998.00242”.
A prospective cohort study set in an Urban public hospital where a total of 979 emergency
department patients who participated in the Literacy in Health Care study and had completed an
intake interview and literacy testing with the Test of Functional Health Literacy in Adults were
eligible for this study. Hospital admissions to Grady Memorial Hospital during 1994 and 1995 were
determined by the hospital information system. We used multivariate logistic regression to
determine the independent association between inadequate functional health literacy and
hospital admission. Patients with inadequate literacy were twice as likely as patients with
adequate literacy to be hospitalized during 1994 and 1995 (31.5% vs 14.9%, p<.001). After
adjusting for age, gender, race, self-reported health, socioeconomic status, and health insurance,
patients with inadequate literacy were more likely to be hospitalized than patients with adequate
literacy (adjusted odds ratio [OR] 1.69; 95% confidence interval [CI] 1.13, 2.53). The association
between inadequate literacy and hospital admission was strongest among patients who had been
hospitalized in the year before study entry (OR 3.15; 95% CI 1.45, 6.85). Thus in this study
population, patients with inadequate functional health literacy had an increased risk of hospital
admission.

A study “Service quality perceptions and patient satisfaction: a study of hospitals in a developing
country -School of Business, The Pennsylvania State University at Erie, The Beheend College,
Station Road, Erie, PA 16563-1400, USA” showed patients’ perceptions about health
services seem to have been largely ignored by health care providers in developing
countries. That such perceptions, especially about service quality, might shape
confidence and subsequent behaviors with regard to choice and usage of the
available health care facilities is reflected in the fact that many patients avoid the
system or avail it only as a measure of last resort. Those who can afford it seek help
in other countries, while preventive care or early detection simply falls by the
wayside. Patients’ voice must begin to play a greater role in the design of health
care service delivery processes in the developing countries. This study is, therefore,
patient-centered and identifies the service quality factors that are important to
patients; it also examines their links to patient satisfaction in the context of
Bangladesh. A field survey was conducted. Evaluations were obtained from patients
on several dimensions of perceived service quality including responsiveness,
assurance, communication, discipline, and baksheesh. Using factor analysis and
multiple regression, significant associations were found between the five
dimensions and patient satisfaction. Implications and future research issues are
discussed.