31.8.4 To Evaluate the Level of Patient Satisfaction with OPD Services in Terms of Describing the Experiences of Patients About OPD Services in District Swat

Original Article

 

OPD Services in District Swat

To Evaluate the Level of Patient Satisfaction with OPD Services in Terms of Describing the Experiences of Patients About OPD Services in District Swat

Qaribullah1, Naeemullah2, Munib2 and M Ishaq2

ABSTRACT

Objective: To determine the level of patient satisfaction in OPD services in terms of describing the experience of patients about OPD services and accessibility to services among the patients who attended the OPD of public-sector of tehsil head quarter hospitals in district swat.

Study Design: Observational study

Place and Duration of Study: This study was conducted at the Department of Community Medicine, Swat Medical College, Swat from Jannuary 2020 to June 2020.

Materials and Methods: The patients from the six public-sectors, tehsil head quarter hospitals of district Swat were included in the study. The data was collected through questionnaire from all patients attending OPD’s of the 6 tehsil head quarter, public-sector hospital in district Swat

Results: Out of the 2000 subjects in the Sample, 57.5% to 91.4% were in view as they were satisfied from their doctor as procedures related to doctor are concerned and 1830 (91.5%) were in view that the doctor did not wash his hand before/after each patient’s examination and 1176(58.8%) were in view that the visiting/ examination times of the patient by the doctor was not suitable. The Space in waiting room was reported adequate by 507 (25.35%), Good by 485(24.25) and very good by 315(15.75%) of the viewers.

The OPD staff during the working hours consider adequate by 573(28.65%), good by 465(23.25%) and very good by 342(17.1%). In terms of overall satisfaction, 84.5% were satisfied from the cleanliness of waiting room and 92% were satisfied from the cleanliness of the doctor room. 58.6% were satisfied from bathroom facility, 86.6% were satisfied with the staff and 84.5% were satisfied with other associated services (e.g. pharmacy, radiology, community based Lab tests etc. of the hospitals.

Conclusion: The majority of the Patients were relatively satisfied with the staff and doctor but the patient examination time and doctor’s hand washing before /after each patient examination were a matter of concern for majority of the patients.

Key Words: Patient satisfaction, Public-sector hospital, associated services, Outpatient department.

Citation of article: Qaribullah, Naeemullah, Munib, Ishaq M. To Evaluate the Level of Patient Satisfaction with OPD Services in Terms of Describing the Experiences of Patients About OPD Services in District Swat. Med Forum 2020;31(8):15-19.

 

 

INTRODUCTION

Patient satisfaction has emerged as a critical outcome of medical care due to increasing emphasis on patients as consumers of services in medical place.1 The real benefit of Patient satisfaction survey is that it provides information about hospital performance.

 

 

1. Department of Radiology, Sialkot Medical College, Sialkot.

2. Department of Radiology, Lahore General Hospital Lahore.

 

 

Correspondence: Dr. Qaribullah, HoD Community Medicine Department, Swat Medical College, Swat.

Contact No: 03419033609

Email: qaribullahdrsmc@gmail.com

 

 

Received:    July, 2020

Accepted:    July, 2020

Printed:        August, 2020

 

 

 

 

 

 

It serves as an indicator, and if the indicator is below the average level, it is a signal as well as an opportunity to review.

Outpatient department (OPD) is the first point of contact of the hospital and the care in them is believed to indicate the quality of services of a hospital. Patient satisfaction embodies the patient’s perceived need, his expectations from the health system, and experience of health care. This multidimensional concept includes both medical and non-medical aspects of health care2. Satisfaction of patients is one of the desirable targets for clinical practice in order to achieve good results in terms of outcomes3. Some studies referred to overall quality of the hospital as the principal key for acquiring patient satisfaction4. Others reported nursing care and a few considered that organizational efforts play an integral part in ensuring satisfaction among patients5.  Nevertheless, literature has considered patient-physician communication as a successful key for adherence to treatment. The care in the OPD is reflected by patient’s satisfaction with the services being provided6. Better appreciation of the factors pertaining to patient satisfaction would result in implementation of custom-made programs according to the requirements of the patients, as perceived by patients and service providers.7

Patient satisfaction is an important issue both for evaluation and improvement of healthcare services.8 It reflects the gap between the expected service and the experience of the service from the patient’s point of view. Measuring patient satisfaction has become an integral part of hospital/clinic management strategy across the globe9.

Patient satisfaction is a reflection of patients’ perceptions of medical care processes, and it is considered an important index of medical quality.10

For most of the patients, a visit to a hospital is often a new and frightening experience. The attention, attitude, and the information the hospital staff provide are very important to the patients. Satisfaction is one of the core outcome measures for health care11.

There are quite a few studies from Pakistan about measuring the patient satisfaction. However, most of them were either conducted in a single center or worked on a single aspect with a small sample size covering a non-representative general population. This study was designed to get a pertinent insight about patient satisfaction towards different domains of quality services in Government’s hospitals of all tehsil headquarter (THQ) hospitals of district swat with the following objective.

MATERIALS AND METHODS

Medicine, Swat Medical College, Swat from
1st Jannuary 2020 to 30th June 2020.

The patients attending OPD’s of the 6 tehsil head quarter, public-sector hospital (Barikot, Kabal,Khwaza khela, Matta, Madian, Kalam) in district Swat were included in the study. A well informed consent from eligible participants was taken. 

The randamized sample size of 2000 patients was collected from the general OPD and OPDs  of gynea/ obs, surgical, medical and peadiatrict on working days, available in the OPD’s of these hospitals in such a way that the 1st patient was selected randomly and then every 10th patient was selected till the number of sample was completed.

The total patient was divided in two strata of male and female. A randomized sample of 2000 patient was selected from these two strata. The data was obtained on a pre tested questionnaire. All questionnaires were filled by trained volunteer underwent a two days training during which they were taught how to fill questionnaires from the patients.  The data was divided in two strata of male and female. From each type of 5  OPD’s, the required number of patient were selected as shown in the table No.1. The data was presented in the various tables as shown in table No.1,2,3,4. All the respondents were assured of complete anonymity and confidentiality.

RESULTS

We included 2000 patients in this study. 333 participants were included from each of Barikot, Kable, Khwazakhela and Kalam hospital and 334 participants were included from each of matta and Madian hospital. These numbers have nearly equally divided into General OPD and OPDs of Medicine, G. Surgery, Gynea/Obs and peadiatrics.

Our sample included 1232 (61.6%) of male and 768 (38.4%)of female Participants. Participants with No formal education were 477 (23.85%)   while the rest of the participant 1523(76.15%) having various level of education. The highest response (27.75%) came from age group 40-49 years followed by age group 30-39 year which is 27.25%

 

 

 

Table No.1: Distribution of Participants from OPDs of Various Specialty in Various Tehsil Head Quarter Hospitals of District Swat

Name of hospital

Total number

Medicine

G.Surgery

Peads

General OPD

Gynea/Obs

Barikot

333

67

67

66

67

66

Kabal

333

67

67

66

67

66

Khwaza khela

333

67

67

66

67

66

Matta

334

67

67

66

67

67

Madian

334

67

67

66

67

67

Kalam

333

67

67

66

67

66

Grand total

2000

402

402

396

402

398

 

 

 

 

 

 

 

 

 

Table No.2: Demographic characteristics of the participants

Characteristics

Number

   %

Gender

 

 

Male

1232

61.6 %

Female

  768

38.4 %

Age

 

 

Less than 20

210

10.5%

20–39

545

27.25%

40–49

555

27.75%

50-59

406

20.3%

60 and above

284

14.2%

Education

 

 

No formal education        

Primary

477

623         

23.85%

31.15%

Secondary/high school

452         

22.60%

undergraduate, and graduate

348         

17.40%

Postgraduate

100     

5.00%

Table No.3: Rate of Satisfaction from the Visit of the Concerned Doctor

Items/ services

Yes

No

I am confident about this doctor’s ability to provide care

1294

(64.7%)

706

(35.3(%)

Being polite

1360 (68.0%)

640

(32.0%)

Was the doctor washed his hand before/after each patient

examination?                  

170

(8.5%)

 

1830

(91.5%)

 

Was your condition managed/ treated in a sympathetic manner?

1487 (74.35%)

 

413

(20.65%)

 

Were visiting/ examination times suitable?

824

(41.2%)

1176

(58.8%)

Obtaining the appointment number for doctor visit was reasonable.     

1511

(75.55%)

 

489

(24.45%)

 

The services provided to me, met my needs related to my visit                           

1459

(72.95%)

 

541

(27.05%)

 

The waiting time to see my doctor was acceptable

1330

(66.5%)

670

(33.5%)

Involving you in decisions about your Treatment

1150

(57.5%)

750

(37.5%)

When prescribed medication, I was informed how the medication Worked and possible side effects in a manner that I understood

1282 (64.1%)

 

718

(35.9%)

 

I felt my concerns were heard, and I received

answers to my questions               

1562

(78.1%)

 

438

(21.9%)

 

I was cared for promptly in the place of test/investigation                                   

712

(35.6%)

1288

(64.4%)

I was treated with dignity and Respect in the place of test/ investigation.             

1828

(91.4%)

 

172

(8.6%)

 

 

The participants were satisfied from the visit of the doctor concerned in all respect with the exception that 1176(58.8%) answered that the visiting/examination times of the patient was not suitable (less), and 1830 (91.5%) answered that the doctor concerned did not washed his hands before/after each patient examination, and 1288(64.4%) were not satisfied from the time spent at the place of test/ investigation as showed in Table 3.

Most of the patients were satisfaction from various general and associated services of the hospital as shown in table 4.

Table No.4: Rate of Response and Level of Satisfaction of the Participants According to the General and Associated Services of the Hospitals

 

Poor

Adequate

Good

Very Good

How would you rate the Space of

waiting room?             

693

(34.65%)

 

507

(25.35%)

 

485

(24.25)

 

315

(15.75%)

 

How would you rate the required OPD staff during the working hours.

620

(31%)

 

573

(28.65%)

 

465

(23.25%)

342

(17.1%)

 

 

How would you rate the cleanliness of waiting room?

312

(15.6%)

 

688

(34.4%)

 

714

(35.7%)

 

286

(14.3%)

 

How would you rate the cleanliness of doctor’s room?      

160

(8.0%)

 

716

(35.8%)

 

924

(46.2%)

 

200

(10.0%)

 

How would you rate the bathroom facilities?                    

822

(41.4%)

 

678

(33.9%)

 

395

(19.75%)       105

(5.25%)

 

 

Were the staff courteous, polite,

friendly and helpful during your

stay in the waiting room?            

292

(14.6%)

 

508

(25.4%)

 

877

(43.85%)

 

323

(16.15%)

 

How would you rate the associated

services (e.g. pharmacy, radiology,

community based Lab tests etc.

310

(15.5%)

 

790

(39.5%)

 

567

(28.35%)

 

333

(16.65%)

 

 

DISCUSSION

The present study was an attempt to assess the level of satisfaction of the patients with the various aspects of health care in tehsil head quarter hospitals of district Swat. identification of the patients was kept confidential.

Total experiences of two thousand patients were computed to determine their experiences regarding different services provided by the OPDs of public-sector tehsil head quarter hospital. The patient with good experience showed high level of satisfaction as compared to those who had poor/low level of satisfaction. Patients had good experience from all the components of services provided by the hospitals but the services provided by the doctors, the patients had the highest level of good satisfaction. This is the same as for the other study12. 

While covering the aspect of all problems and issues suffered by public-sector hospitals in district Swat, this study is the first of its kind to cover multi-center and large sample population to measure satisfaction of the patients. Our study had a brilliant response rate of 100%. This was largely due to the tactic of using dedicated assistants who went and spoke directly with the patients. Our excellent response rate is more than the response rate (91.2%) of a study done by Joshi S    et al12.

Our study results showed that there was more presentation of male 1232 (61.6%) as compare to female 768 (38.4%) while in a study done by Mukhtar F, Anjum A et al3 the representation of males 127 (51%) and females 121 (49%). This difference is because of the culture of district swat that most of the participant to answer the questions on behalf of children and female were male.  110 (44%) of the respondents were in the age category of 15-30 years whereas, 18 (7%) were in the age category of 60-75 years in their study while in our study 555 (27.75%) of the respondents were in the age category of 40-49 and 284 (14.2%) were from 60 years and above.  The education of the patients was categorized into five categories in our study as: No formal education, primary, secondary, undergraduate/ graduate and postgraduate. Among them 477 (23.85%) were illiterate, 623 (31.15%) completed primary school, 452 (22.60%) completed secondary school, 348 (17.40%) undergraduate/ graduate, 100 (5.0%) were postgraduate.  In the study of Mukhtar F, Anjum A et al2 41 (17%) were illiterate, 40 (16%) completed primary school, 74 (30%) completed secondary school, 78 (31%) were undergraduates and 15 (6%) were graduates. These values are nearly equal to the values in our study with the exception that postgraduate values were higher in our study. This is because the higher level of education in swat was more as compare to other areas.

Our study showed that up to 91% of the patients who visited the OPD were satisfied with their doctor except “the act of hand washing before / after patient examination of the patient” as shown in table No.4. This level is a little low than the study3 in which 94% of the Patients’ views were ascertained. Majority of patients found the doctor to be courteous (98%), listened attentively to the patients (88%), gave patients an opportunity to talk about their illness (87%), provided instructions regarding dose and time of medication (82%), advised follow up to the patients (80%) and made the patient comfortable during examination (79%). This is similar to other international studies which reported that 88–92% of their patients believed that they were treated with respect and dignity10.

In our study, majority of patients found the doctor to be sympathetic (74.35%), polite (68%), Obtaining the appointment number for doctor visit (75.55%) was easy, the services provided to them, met their needs related to their visit (72.95%).  66.5% were in view that the waiting time to see their doctor was acceptable.  57.5% were in view that the doctor involved them in decisions about their treatment. 64.1% were in view that the doctor informed them about the use of medication and possible side effects in a manner that they understood, their concerns were heard, and they received answers to their questions (78.1%), treated them with dignity and Respect in the place of test/ investigation (91.4%). These values were low as compare to the study2. This is because of the fact that their study was done in OPD services in a Tertiary Care Hospital of Lahore which was large city. But these values in our study are more than the value of the study13. This is because of the fact that study was done in single OPD services in a Tertiary Care Hospital while our study was done in many OPDs of various specialties as well as (multi- centered). Therefore, our study is more reliable.

Patients were asked about rate of response and level of satisfaction of the participants according to the general and associated services of the hospitals (cleanliness, adequate ventilation, location of the registration desk and availability of seats and toilet facility in the waiting area). Majority of the patients were found satisfied with respect to these facilities. This satisfaction is in coherent with other studies3.

In a study of Joshi S, et al12, the satisfactory level was from 58% to 74% on various aspects of questions about doctors in OPD, which was from 41 % to 91 % in our study. The values in these two studies on important items were nearly the same. The value given in the study11 are also similar as given in our study for doctor satisfaction however, there value of experiences for general and associated services were low as compare to our study. This is because that study taken the values only for surgical OPD in tertiary hospital was single center while our study considered the 6 number of tehsil head quarter hospital OPDs of 5 specialties as a whole.

A major limitation of our study (like other studies) was use of self-reported intention/ wishes. These may have introduced bias and resulted in systematic under- or over- reporting. Thus, our data may have underestimated or overestimate the true condition.

CONCLUSION

The patients were satisfied from their visits to the hospital. However, the chance of further improvement can never be missed.

Author’s Contribution:

Concept & Design of Study:

Qaribullah

Drafting:

Qaribullah, Munib

Data Analysis:

Naeemullah, M Ishaq

Revisiting Critically:

Qaribullah, Naeemullah, Munib, M Ishaq

Final Approval of version:

Qaribullah

Conflict of Interest: The study has no conflict of interest to declare by any author.

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