Patient dissatisfaction with health services at basic health in district Quetta
Date of Award
Master of Science in Epidemiology & Biostatistics (MSc Epidemiology & Biostats)
Community Health Sciences
Patient satisfaction, assessed through "patient satisfaction surveys" is used as an important indicator of quality of medical care in many developed countries. However, in developing countries, little attention has been paid to such surveys. Information on relative satisfaction of service users with primary care facilities is of great value in understanding characteristics of patients and their pattern of health service utilization. The assessment of health care quality in Pakistan has been most of the times from the provider's perspective. There is a need to look how recipients of health services feel about services provided. A cross-sectional survey was conducted at Basic Health Units (BHU) in Quetta on 354 patients of age 15 years and above in order to estimate the proportion and factors associated with patient dissatisfaction with the curative care. The mean age of respondents was 34 years. Seventy-two percent (72%) were married, eighty nine percent (89%) women and seventy two percent (72%) were those who have not had the opportunity to attend a school. The median monthly income of respondents' household was found to be rupees 3000.A large proportion (76.6%) of respondents were frequent visitor to government health centers. The mean number of visits to a BHU for the sample in past two months was 3.05(SD ±2). Twenty percent (20%) of patients presented combination of symptoms. The duration of illness, before respondents visited the center was 3-7 days for about forty seven (47%) percent of patients. It was found that one fourth (24%) of patients were treated by paramedics. Only seven patients (2%) were referred to secondary or tertiary centers for further treatment. Only nine (2.5%) were advised investigations of which none were available in corresponding BHU. The majority of respondents (71.2%) were not given complete medication as prescribed by health care provider. About 30.8% (95% CI: 25% — 35%) were dissatisfied with the overall care theyreceived from the health center. Patients who were satisfied with health care providers' behavior were less likely to be dissatisfied (OR = 0.81, 95% CI: 0.73-0.85). Patients who did not receive or received an incomplete course of medicine were more likely to be dissatisfied as compared to those who a complete course of medication (OR = 5.2, 95% C.I. 1.1 — 25.2). Those patients who were living within one to two kilometers of distance from BHU were less likely to be dissatisfied as compared to those who lived within less than one kilometer distance (OR=0.34, 95% CI: 0.2-0.7). While it is important to emphasize on the need for compassionate providers of care, it is also necessary that further research focus on patients' satisfaction for the other intrinsic qualities of care such as perceived effectiveness.
Khan, M. I. (2002). Patient dissatisfaction with health services at basic health in district Quetta (Unpublished doctoral thesis). Aga Khan University, Karachi, Pakistan.