Title

Assessment of patient satisfaction with primary health care at the Family Medicine Centre of Aga Khan University Hospital, Nairobi

Date of Award

8-26-2018

Document Type

Dissertation

Degree Name

Master of Medicine (MMed)

First Supervisor/Advisor

Dr. Jacob Shabani

Second Supervisor/Advisor

Mr. James Orwa

Third Supervisor/Advisor

Dr. Fleur de Meijer

Department

Family Medicine (East Africa)

Abstract

Background: Patient satisfaction is one of the key indicators by which the quality of healthcare service is evaluated. The World Conference of Family Doctors African Chapter's (WONCA-Africa) encourages Family Medicine practices to regularly assess their patients' satisfaction as one of the criteria for benchmarking and auditing the quality of primary care in Africa. The Kenyan government, in a quest to improve primary care provision, has formulated policy to make family physicians essential players in coordinating and enhancing standards of primary care.

Objective: This study aimed to assess patient satisfaction with the quality of primary health care services provided by family physicians at the Family Medicine Clinic Aga Khan University Hospital Nairobi.

Methods: A cross-sectional, descriptive, quantitative study using a modified version of the post-consultation General Practice Assessment Questionnaire (GPAQ-R) was conducted. A total of 317 patients were selected through systematic random sampling. Level of satisfaction was calculated by averaging summing the total scores of different domains in the questionnaire. The cut off for the level of satisfaction was 82 points out of a possible 128 points. Exploratory Factor analysis derived factors affecting overall satisfaction. The correlation of the independent variables with overall satisfaction was analysed using the Chi-Square test.

Results: Of the 310 study respondents, 93% were satisfied with the care provided. The overall mean patient satisfaction score (standard deviation) was 103.14 (14.2). Factors that mostly contributed to overall patient satisfaction were effective communication (variance 31 %) and timeliness of care (variance 8 %). Patients with long-standing conditions were more satisfied than those with acute conditions. (99.01 % v 90 %, p=0.006).

Conclusion and recommendation: Patients were highly satisfied with the care provided at the Family Medicine Clinic. Communication and timeliness of care contributed to overall satisfaction. Patients' with chronic conditions were found to be satisfied with the care provided. Additional research that incorporates a care provider's perspective may be required to better elucidate enablement and empathy as factors that affect patient satisfaction. Furthermore, we recommend a study that addresses financial accessibility, infrastructure and clinical competencies of care providers in the assessment.

This document is available in the relevant AKU library

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