SATISFACTION OF PATIENTS WITH FIRST MEDICAL CARE: CROSS-SECTION STUDY (ON THE EXAMPLE OF CITY KYIV)
Abstract
After reorganization of ambulatory-polyclinic net of medical institutions in city Kyiv in 2013 and creation of centers of first medical care (FMC), the necessity in monitoring of patients’ satisfaction with received first medical care appeared.
Aim. To estimate satisfaction of patients of FMC Centers of city Kyiv with received first medical care, to compare it with patients’ satisfaction in rural area of Ukraine and in European Union countries.
Materials and methods. The cross-section study was realized in FMC centers of city Kyiv during 6 months of 2017 year. In total 397 persons, 18 years old and more, who addressed to doctors of the first link during no less than one year, were selected for the study. The used EUROPEP instrument, the questionnaire, consists of 23 questions with their possible assessment by Likert five-point scale and includes the following aspects: doctor-patient-relationship, assessment of direct medical care, information and support of a patient by a doctor, organization aspects of care, its accessibility. The internal succession of the questionnaire Cronbach's alpha was estimated, and its reliability was checked. Main indices of research results were mean EUROPEP indices (minimum 1, maximum 5).
Results. The study has established, that satisfaction of Ukrainian patients with FMC (index - 75,5 %) is statistically reliably lower than indices of European Union countries. In average, only 37,16 % of respondents estimated the level of received FMC as “perfect” and correspondingly 38,35 % of patients as “good”. There were revealed problems with an access to medical care, namely: “Time of waiting for a consultation near a cabinet” received the least mark (3,29 and 45,59 % respectively), “Possibility of registration for consultation by phone” is also low (3,47 and 59,95 % respectively). Problems in communications, the low level of trust and doctor’s authority were revealed in the decreased index “Doctor’s help in fighting against negative emotions, connected with your health status” (3,72 and 56,17 % respectively). There was studied, that in Ukraine satisfaction of patients, who live in rural area, is statistically reliably lower than Kyiv indices.
Conclusion. The study of satisfaction of patients with received FMC revealed imperfection of the existing system of first medical care. The research results may be used at elaborating new functional-organizational model of activity of first medical care, including patients’ satisfaction as an important component in the integrative dimension of the medical help quality.
Downloads
References
Coruh, M. (1996). Total quality management in primary care practice. Ankara: Haberal EgitimVakfi.
Van Royen, P., Rees, C. E., Groenewegen, P. (2014). Patient-centred interprofessional collaboration in primary care: challenges for clinical, educational and health services research. An EGPRN keynote paper. European Journal of General Practice, 20 (4), 327–332. doi: 10.3109/13814788.2014.908462
Kinnersley, P., Stott, N., Peters, T., Harvey, I., Hackett, P. (1996). A comparison of methods for measuring patient satisfaction with consultations in primary care. Family Practice, 13 (1), 41–51. doi: 10.1093/fampra/13.1.41
Baker, R. (1996). Characteristics of practices, general practitioners and patients related to levels of patients’ satisfaction with consultations. British Journal of General Practice, 46 (411), 601–605.
Roque, H., Veloso, A., Ferreira, P. L. (2016). Portuguese version of the EUROPEP questionnaire: contributions to the psychometric validation. Revista de Saude Publica, 50, 61. doi: 10.1590/s1518-8787.2016050006259
Grol, R., Wensing, M., Mainz, J. et. al. (2000). Patients in Europe evaluate general practice care: an international comparison. British Journal of General Practice, 50 (460), 882–887.
Wensing, M., Mainz, J., Grol, R. (2000). A standardised instrument for patient evaluations of general practice care in Europe. European Journal of General Practice, 6 (3), 82–87. doi: 10.3109/13814780009069953
Dimova, R., Stoyanova, R., Keskinova, D. (2017). The EUROPEP questionnaire for patient’s evaluation of general practice care: Bulgarian experience. Croatian Medical Journal, 58 (1), 63–74. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5346897/ doi: 10.3325/cmj.2017.58.63
Mortsiefer, A., Altiner, A., Ernst, A., Kadusziewicz, H., Krahe, A., Mellert, C. et. al. (2017). Satisfaction with general practice care in German patients with multimorbidity: a cross-sectional study. Family Practice, 34 (4), 452–458. doi: 10.1093/fampra/cmw141
Akturk, Z., Atesoglu, D., Ciftci, E. (2015). Patient satisfaction with family practice in Turkey: Three-year trend from 2010 to 2012. European Journal of General Practice, 21 (4), 238–245. doi: 10.3109/13814788.2015.1048681
Williams, S. J., Calnan, M. (1991). Key Determinants of Consumer Satisfaction With General Practice. Family Practice, 8 (3), 237–242. doi: 10.1093/fampra/8.3.237
Odrynskyi, V. A. (2015). Medyko-socialne obg'runtuvannia modeli pervynnoi medyko-sanitarnoi dopomogy silskomu naselenniu na rivni administratyvnogo raionu. Nacionalna medychna akademiia pisliadyplomnoi osvity imeni P. L. Shupyka. Kyiv, 197.
Tavakyn, E. P. (2009). Osnovy metodyky sociologicheskogo issledovaniia. Moscow: YNFRA-M, 239.
Wensing, M., Mainz, J., Grol, R. (2000). A standardised instrument for patient evaluations of general practice care in Europe. European Journal of General Practice, 6 (3), 82–87. doi: 10.3109/13814780009069953
EUROPEP (2006). Revised Europep instrument and user manual. Center for Quality of Care Research, Michel Weinsing (co-ordinator). Available at: http://www.equip.ch/files/25/europep_2006rapport.pdf
Szecsenyi, J., Goetz, K., Campbell, S., Broge, B., Reuschenbach, B., Wensing, M. (2011). Is the job satisfaction of primary care team members associated with patient satisfaction? BMJ Quality & Safety, 20 (6), 508–514. Available at: http://qualitysafety.bmj.com/content/20/6/508 doi: 10.1136/bmjqs.2009.038166
Vedsted, P., Sokolowski, I., Heje, H. N. (2008). Data quality and confirmatory factor analysis of the Danish EUROPEP questionnaire on patient evaluation of general practice. Scandinavian Journal of Primary Health Care, 26 (3), 174–180. doi: 10.1080/02813430802294803
Bjertnaes, O. A., Lyngstad, I., Malterud, K., Garratt, A. (2010). The Norwegian EUROPEP questionnaire for patient evaluation of general practice: data quality, reliability and construct validity. Family Practice, 28 (3), 342–349. Available at: http://fampra.oxfordjournals.org/content/early/2010/11/15/fampra.cmq098.full doi: 10.1093/fampra/cmq098
King, A., Hoppe, R. B. (2013). “Best Practice” for Patient-Centered Communication: A Narrative Review. Journal of Graduate Medical Education, 5 (3), 385–393. doi: 10.4300/jgme-d-13-00072.1
Petek, D., Kunzi, B., Kersnik, J., Szecsenyi, J., Wensing, M. (2011). Patients’ evaluations of European general practice–revisited after 11 years. International Journal for Quality in Health Care, 23 (6), 621–628.
Copyright (c) 2017 Valentin Pariy, Oleksandr Korotkyi
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.