Supervisors info:
Δάφνη Καϊτελίδου, Αναπληρώτρια Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Αθηνά Καλοκαιρινού, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Μαριάννα Διομήδους, Αναπληρώτρια Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Background: In the recent years, accessible, continuous, coordinated, qualitative and people-centered care has been a challenge internationally, putting forward the primary health care sector (PHC) and the necessity to strengthen its role in the health system. Comprehending the quality of the provided services, as experienced by the patients, constitutes a major component of the assessment of the quality of care provided in PHC.
Aim: To assess PHC services’ responsiveness by evaluating users’ experiences.
Material - Methods: A cross-sectional study took place at the Outpatient Clinic (OC) of a public hospital of Thessaloniki from July to September 2018. The questionnaire used derived from a pilot study conducted for the development of a tool for evaluating of PHC patients’ experiences by Kaitelidou, Oikonomou, Galani et al (2018). Selection criteria included willingness to participate, ability to communicate in Greek and the age of 18 years or over.
Results: The study included 200 individuals, with a mean age of 42.1 years (SD=16.0). Males comprised 68% of the study sample, while 98.55 of the participants were of Greek nationality. Fifty two percent (52%) were university/college graduates and/or holders of a postgraduate and/or doctorate diploma. The number of uninsured patients amounted to 7.5%. Seventeen percent (17%) described their health as excellent, 41% as very good. A disability of >67% was found in 2.5% of the participants, while 41.5% suffered from at least one chronic disease. Ten percent (10%) of the participants were frequent users of the services, while the majority (62.5%) visited the hospital OC following the recommendation of a physician. Fifty eight percent (58%) of the participants scheduled their visit, mainly by phone (43.1%), and directly with the physician (39.7%). Thirty percent (30%) waited less than one week from scheduling the visit until the day of the visit, and 31.9% waited for more than a month. The administrative procedures took less than 15 minutes for 49.5%, while 47% waited for more than an hour, from the completion of the administrative procedures up to being seen by the doctor. Moreover, 20.5% were referred to another physician or health service, and the majority (68%) described the information given as adequate. On a scale of 0-10, the mean score for the recommendation of the physician was 8.22 (SD=1,9) and the mean score for the recommendation of the OC was 8.19 (SD=2,1). The overall patient experience score, on a scale of 1-5, was 3.92 (SD=0,57) The physician recommendation score was found to be positively correlated with age (p=0,011), accessibility (p=0,027) and the overall experience score (p<0,001), while there was a negative correlation with the user's insurance coverage (p=0,028). The OC recommendation score was found to be positively correlated with the overall experience score (p<0,001) and dimensions of health care related to accessibility (p=0,012), comprehensiveness of care (p=0,032) and quality of medical care (p=0,008), while there was a negative correlation with the educational level (p=0,016) and the examination waiting time (p=0,035). More specifically, an increase in the examination waiting time was associated with reduction in the score of all six dimensions of health care. In particular, the waiting time from the completion of the administrative procedures until the visit (p<0,001), as well as age (p=0,032), were found to have a negative correlation with the overall experience score.
Conclusions: The analysis of the results showed that users had negative experiences regarding the waiting time related to the scheduling of the appointment and the examination. On the contrary, they had negative experiences with the dimensions of care related to facility features and the quality of the medical care, within the scope of increasing patient involvement in decision making regarding care and treatment.
