Special Issue "Patient Satisfaction with Health Services"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: closed (31 August 2019).

Special Issue Editor

Prof. José Joaquín Mira
E-Mail Website
Guest Editor
Departamento de Psicología de la Salud, Universidad Miguel Hernández, Elche, Spain; Alicante-Sant Joan Health District. Alicante, Spain
Interests: patient satisfaction; patient-centered care; patient participation

Special Issue Information

Dear Colleagues,

Koos, in the 1950s, and Donabedian, in the 1960s, incorporated the patient’s perspective as a measure of the outcome of healthcare. In the 1970s, the measures of patient satisfaction experienced further growth, and we paid attention to what patients had to say. Today, in the 21st century, it has become evident that the role assigned to patients in their relationship with health professionals and healthcare organizations needs to be reoriented.

This issue of IJERPH focuses on research and experiences related to patient satisfaction measures and how patients are involved in the outcome assessment. This may include a description of new challenges, approaches or instruments to assess patient satisfaction in hospitalization, inpatient and outpatient surgery, mental health, primary care, telemedicine, the results of implementing a patient-centered approach, the impact of new interventions to increase patient satisfaction, the experiences of patients with chronic conditions, or the assessment of the support received to overcome the burdens that caregivers of these patients suffer.

In this special issue, we invite researchers in public health, management, quality assurance, epidemiology, health economics, and other social sciences to submit high quality empirical papers or systematical reviews related to the issues in this research area.

Prof. José Joaquín Mira
Guest Editor

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Keywords

  • Patient Satisfaction
  • Patient Acceptance of Health Care
  • Patient-Centered Care
  • Patient Preference
  • Consumer Satisfaction
  • Patient participation
  • Patient Outcome Assessment
  • Patient Reported Outcome Measures
  • Physician-Patient Relations
  • Nurse-Patient Relations

Published Papers (22 papers)

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Open AccessArticle
Patient Satisfaction with Rural Medical Services: A Cross-Sectional Survey in 11 Western Provinces in China
Int. J. Environ. Res. Public Health 2019, 16(20), 3968; https://doi.org/10.3390/ijerph16203968 - 17 Oct 2019
Abstract
Rural medical services play an important role in protecting and promoting the health of the rural population; however, patient satisfaction with rural medical services has been understudied in China. A better understanding of the actual situation and the determinants involved will provide evidence [...] Read more.
Rural medical services play an important role in protecting and promoting the health of the rural population; however, patient satisfaction with rural medical services has been understudied in China. A better understanding of the actual situation and the determinants involved will provide evidence for health-related policy makers and hospital managers to further improve rural medical services. A total of 9811 patients (5208 outpatients and 4603 inpatients) were included in this study from a cross-sectional survey conducted in rural hospitals from 11 western provinces in China. Three in five patients (including outpatients and inpatients) were satisfied with rural medical services. The mean overall satisfaction scores were 3.61 ± 0.857 and 3.80 ± 0.829 (out of a maximum of 5) for rural outpatients and inpatients, respectively. The most satisfying domains for outpatients and inpatients were medical service attitude and illness explanation, and waiting time and medical expenses were the domains that outpatients and inpatients were least satisfied with. Satisfaction with medical technology (OR: 1.73; 95% CI: 1.57–1.92) and satisfaction with trust in physicians (OR: 2.05; 95% CI: 1.85–2.28) were identified as the strongest predictors of outpatients’ and inpatients’ overall satisfaction with rural medical services, respectively. This study might shed light on rural medical services management in China. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
Patient Input in Regional Healthcare Planning—A Meaningful Contribution
Int. J. Environ. Res. Public Health 2019, 16(19), 3754; https://doi.org/10.3390/ijerph16193754 - 05 Oct 2019
Abstract
Background: There are well-known methodological and analytical challenges in planning regional healthcare services (HCS). Increasingly, the need for data-derived planning, including user-perspectives, is discussed. This study aims to better understand the possible contribution of citizen experience in the assessment of regional HCS needs [...] Read more.
Background: There are well-known methodological and analytical challenges in planning regional healthcare services (HCS). Increasingly, the need for data-derived planning, including user-perspectives, is discussed. This study aims to better understand the possible contribution of citizen experience in the assessment of regional HCS needs in two regions of Germany. Methods: We conducted a written survey in two regions of differing size—a community (3653 inhabitants) and a county (165,211 inhabitants). Multinomial logistic regression was used to assess the impact of sociodemographic and regional factors on the assessment of HCS provided by general practitioners (GPs) and specialists. Results: Except for age and financial resources available for one’s own health, populations did not differ significantly between the regions. However, citizens’ perception of HCS (measured by satisfaction with 1 = very good to 5 = very poor) differed clearly between different services (e.g., specialists: 3.8–4.3 and pharmacies: 1.7–2.5) as well as between regions (GPs: 1.7–3.1; therapists: 2.9–4). In the multivariate model, region (next to income and age) was a consistent predictor of the perception of GP- and specialist-provided care. Discussion: Citizens’ perceptions of HCS correspond to regional provider density (the greater the density, the better the perception) and add insights into citizens’ needs. Therefore, they can provide valuable information on regional HCS strengths and weaknesses and are a valid resource to support decision makers in shaping regional care structures. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
Promoting OPD Patient Satisfaction through Different Healthcare Determinants: A Study of Public Sector Hospitals
Int. J. Environ. Res. Public Health 2019, 16(19), 3719; https://doi.org/10.3390/ijerph16193719 - 02 Oct 2019
Cited by 3
Abstract
Patient satisfaction is a core tool for measuring the performance of the hospitals as well as the service provider and the services that they are providing to the patients. The aim of this research is to evaluate how information received, medical equipment, distance [...] Read more.
Patient satisfaction is a core tool for measuring the performance of the hospitals as well as the service provider and the services that they are providing to the patients. The aim of this research is to evaluate how information received, medical equipment, distance from the hospital, and physical infrastructure influenced patient satisfaction at public hospitals in Southern Punjab, Pakistan. An exploratory research technique was used. We distributed 700 questionnaires through a random method, and 579 provided proper responses. A confirmatory factor analysis (CFA) and a regression analysis were used for the data analysis. The study results illustrated that medical equipment, information received, distance from the hospital, and physical infrastructure had significantly positive impacts (p = 0.001) on patient satisfaction. To promote higher level of satisfaction, there is a need to take appropriate steps for improvement. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
Outpatient Satisfaction with Tertiary Hospitals in China: The Role of Sociodemographic Characteristics
Int. J. Environ. Res. Public Health 2019, 16(19), 3518; https://doi.org/10.3390/ijerph16193518 - 20 Sep 2019
Abstract
China’s increasing attention to patient satisfaction evaluation is part of an international trend of patient-centered healthcare. Patient sociodemographic characteristics are important intrinsic factors that will influence satisfaction. This paper aims to better understand how sociodemographic factors affect Chinese patient satisfaction with tertiary outpatient [...] Read more.
China’s increasing attention to patient satisfaction evaluation is part of an international trend of patient-centered healthcare. Patient sociodemographic characteristics are important intrinsic factors that will influence satisfaction. This paper aims to better understand how sociodemographic factors affect Chinese patient satisfaction with tertiary outpatient services using data from the 2017 China National Patient Survey. A total of 28,760 outpatient survey responses were analyzed, spanning 136 tertiary hospitals across 31 provinces. Multilevel logistic regression with fixed hospital effects was used to examine the association of patient satisfaction across multiple healthcare domains with sociodemographic factors. Results show that patients who were of a migrant population, of highest income, most educated, and who had medical aid insurance reported the lowest levels of overall satisfaction. Specifically, increasing age was correlated with decreased satisfaction in process management and affordability domains, while high-income and high-education outpatients reported lower satisfaction scores in the hospital environment domain. Furthermore, migrant patients experienced lower satisfaction across several domains. These intricate findings suggest that hospitals should tailor their services and evaluation metrics to specific patient demographics, and that the government should adopt policies that reduce disparities in healthcare access and affordability to ultimately improve the satisfaction of vulnerable groups. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
Open AccessArticle
Patient Satisfaction with Health Care Services; An Application of Physician’s Behavior as a Moderator
Int. J. Environ. Res. Public Health 2019, 16(18), 3318; https://doi.org/10.3390/ijerph16183318 - 09 Sep 2019
Cited by 2
Abstract
Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is one of the most important factors to determine the success of a health care facility. [...] Read more.
Patient satisfaction is a measure of the extent to which a patient is content with the health care they received from their health care provider. Patient satisfaction is one of the most important factors to determine the success of a health care facility. The purpose of this study was to determine patient satisfaction with healthcare services and encompass the physician’s behavior as moderation between patient satisfaction and healthcare services. The study seeks to measure the health care services, like a laboratory and diagnostic care, preventive healthcare and prenatal care, to patient satisfaction in the public health sectors of Pakistan. A descriptive survey research design was used for this study. The target population was patients from the out-patient department (OPD) of three public hospitals from Pakistan. By using the convenient sampling technique, 290 sample participants were selected from the target population. The reliability scales were tallied by using Cronbach’s Alpha. The findings of the study are gleaned by using regression to explore patient satisfaction with the health care services, and whether or not the physician’s behavior moderates the link of patient satisfaction and healthcare services. SPSS Hayes process was used for the moderation effect of the physician’s behavior. The main results of the regression analysis validate that health care services, such as laboratory and diagnostic care, preventive healthcare, and prenatal care, have a significant and positive effect on patient satisfaction. Specifically, the study suggests that the physician’s behavior significantly moderates the effect of health care services on the satisfaction of patients. The overall opinions about the satisfaction level of patients for the availability of health services in the hospitals were good. The degree of satisfaction was satisfactory with respect to laboratory and diagnostic care, preventive healthcare, and prenatal care services. Based on the outcomes, the study confirms that the proposed hypotheses are statistically significant. Furthermore, the directions for future research of the study are offered. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
Can Leadership Enhance Patient Satisfaction? Assessing the Role of Administrative and Medical Quality
Int. J. Environ. Res. Public Health 2019, 16(17), 3212; https://doi.org/10.3390/ijerph16173212 - 03 Sep 2019
Cited by 4
Abstract
This paper aimed to investigate the relationships between participative leadership (PL), administrative quality (AQ), medical quality (MQ), and patient satisfaction (PS) using the Malcolm Baldrige National Quality Award Healthcare Criteria (MBNQA) criteria. The study further examined the intervening influence of administrative quality and [...] Read more.
This paper aimed to investigate the relationships between participative leadership (PL), administrative quality (AQ), medical quality (MQ), and patient satisfaction (PS) using the Malcolm Baldrige National Quality Award Healthcare Criteria (MBNQA) criteria. The study further examined the intervening influence of administrative quality and medical quality on the relationship between participative leadership and patient satisfaction. The data was obtained from 123 public sector hospitals in Pakistan. We employed confirmatory factor analysis (CFA) and structural equation modeling (SEM) techniques to test the structural model. From the study results, we found significant and positive relationships between participative, administrative quality, medical quality, and patient satisfaction. In addition, our research found administrative quality and medical quality as potential mediators on PL-PS relation. Adopting participative leadership as an exogenous factor, and both administrative and medical quality as potential mediators of patient satisfaction, provided new insights into MBNQA criteria. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
A Measurement Scale to Assess Children’s Satisfaction with Hospitalization in the Andalusian Population
Int. J. Environ. Res. Public Health 2019, 16(17), 3110; https://doi.org/10.3390/ijerph16173110 - 27 Aug 2019
Abstract
Background: Patient satisfaction is a principal indicator in the evaluation of the stay of pediatric patients in hospitals, since its consequences can emotionally interfere with health treatment. The aim of this study was to obtain a valid scale to assess children’s satisfaction [...] Read more.
Background: Patient satisfaction is a principal indicator in the evaluation of the stay of pediatric patients in hospitals, since its consequences can emotionally interfere with health treatment. The aim of this study was to obtain a valid scale to assess children’s satisfaction with their time spent as a patient in an Andalusian hospital. Method: The Children’s Satisfaction with Hospitalization Questionnaire (CSHQ) was applied to 623 pediatric patients hospitalized in Andalusia. An exploratory factor analysis (EFA) showed one dimension underlying the children’s satisfaction with their hospitalization. After that, we developed a depuration analysis process to achieve a valid and unidimensional scale to assess children’s satisfaction. Results: The eleven-item one-dimension solution showed suitable consistency and goodness-of-fit indices. The final scale addresses hosting aspects as the main dimension of a minor’s satisfaction in Andalusian hospitals. Conclusion: A unidimensional scale has been determined for the assessment of children’s satisfaction with their stay in Andalusian hospitals based on hosting aspects. Nonetheless, other dimensions underlying the satisfaction of patients should also be considered. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
Linking Transformational Leadership with Nurse-Assessed Adverse Patient Outcomes and the Quality of Care: Assessing the Role of Job Satisfaction and Structural Empowerment
Int. J. Environ. Res. Public Health 2019, 16(13), 2381; https://doi.org/10.3390/ijerph16132381 - 04 Jul 2019
Cited by 7
Abstract
The purpose of this study was to examine the relationships between transformational leadership (TL), structural empowerment (SE), job satisfaction (JS), nurse-assessed adverse patient outcomes (APO), and the quality of care (QOC). The study further investigates the mediating effects of SE and JS on [...] Read more.
The purpose of this study was to examine the relationships between transformational leadership (TL), structural empowerment (SE), job satisfaction (JS), nurse-assessed adverse patient outcomes (APO), and the quality of care (QOC). The study further investigates the mediating effects of SE and JS on TL-APO and TL-QOC relationships. A total of 600 nurses working at 17 government hospitals in Pakistan completed the survey. The hypothesized model was tested using a confirmatory factor analysis and structural equation modeling. We found a positive relationship between TL, SE, JS, and QOC but negative relationships between TL and APO, SE and APO, and JS and APO. Our study further suggests that SE and JS strongly mediate both TL-APO and TL-QOC relationships. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
Measuring OPD Patient Satisfaction with Different Service Delivery Aspects at Public Hospitals in Pakistan
Int. J. Environ. Res. Public Health 2019, 16(13), 2340; https://doi.org/10.3390/ijerph16132340 - 02 Jul 2019
Cited by 4
Abstract
The satisfaction of the patient is believed to be one of the preferred results of healthcare, and it is directly connected with the usage of health services. This study aimed to assess how doctor services, nurses’ services, and waiting time predict patient satisfaction [...] Read more.
The satisfaction of the patient is believed to be one of the preferred results of healthcare, and it is directly connected with the usage of health services. This study aimed to assess how doctor services, nurses’ services, and waiting time predict patient satisfaction (PS) with the service delivery of healthcare in Southern Punjab, Pakistan. The study used an exploratory research method, in which 1000 participants were selected, and used a random technique, in which 850 responses were received. Multiple regression analysis and a confirmatory factor were employed to analyze the collected data. The findings showed that doctor services (β = 0.232; p = 0.01), nurses services (β = 0.256; p = 0.01), and waiting time (β = 0.091; p = 0.03) had positive significant impacts on PS, while registration services (β = 0.028; p = 0.390) had an insignificant association with PS. Hence, a significant gap existed in the registration services that were totally ignored in hospitals of Pakistan which needed proper considerations for improvements. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
Prevalence of Burnout among Primary Health Care Staff and Its Predictors: A Study in Iran
Int. J. Environ. Res. Public Health 2019, 16(12), 2249; https://doi.org/10.3390/ijerph16122249 - 25 Jun 2019
Cited by 1
Abstract
Burnout, which is an emerging challenge in health systems, is very common among primary health care (PHC) workers. The aim of this study was to investigate the level of burnout among PHC workers, and its predictive factors, in a region in the west [...] Read more.
Burnout, which is an emerging challenge in health systems, is very common among primary health care (PHC) workers. The aim of this study was to investigate the level of burnout among PHC workers, and its predictive factors, in a region in the west of Iran. In this cross-sectional study, all the health network staff (n = 539) were enrolled. The data collection instrument was the Maslach Burnout Inventory (MBI), which consists of 22 items and the three subscales of emotional exhaustion (EE), depersonalization (DP), and personal achievement (PA). High scores in EE and DP and low scores in PA are indicative of high burnout. Logistic regression was used to determine the predictors of high burnout. The data were analyzed using SPSS version 16. The findings showed that 90.5% of the staff had high DP, 55.3% had high EE, and 98.9% had low PA scores. Also, 52.9% (277 people) of the staff suffered from high burnout. Single people (OR = 3.33), less experienced employees (OR = 9.09), people aged over 35 years (OR = 2.35), physicians (OR = 1.72), and staff with permanent employment (OR = 5.0) were more likely to suffer high levels of burnout. We conclude that burnout is a common problem in PHC workers. Less experienced, younger, single employees and physicians were more at risk of suffering from high burnout. Preventive measures, such as strengthening social skills, communication competencies, and coping strategies, and reduction of risk factors such as job stress, are suggested for reducing employees’ risk of burnout. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
Open AccessArticle
Effect of Patient Participation on Nurse and Patient Outcomes in Inpatient Healthcare
Int. J. Environ. Res. Public Health 2019, 16(8), 1344; https://doi.org/10.3390/ijerph16081344 - 15 Apr 2019
Abstract
Using service-dominant logic as a theoretical lens, this study investigated the co-production of healthcare service and service value co-creation between nurses and patients. The main objective of this study was to: (1) examine the effect of patient participation on patient satisfaction and nurses’ [...] Read more.
Using service-dominant logic as a theoretical lens, this study investigated the co-production of healthcare service and service value co-creation between nurses and patients. The main objective of this study was to: (1) examine the effect of patient participation on patient satisfaction and nurses’ attitudes and behaviors; (2) examine boundary conditions of the effect of patient participation on patients and nurses. We proposed that patient participation positively impacted patient satisfaction and nurse job satisfaction, work engagement, and helping behaviors. We further proposed that first inpatient stay and length of stay moderated the effect of patient participation on patient satisfaction, and nurses’ sociodemographic characteristics moderated the effect of patient participation on nurse job satisfaction, work engagement, and helping behaviors. Using survey data from 282 nurses and 522 inpatients from a public hospital in China, we found that the effect of patient participation on patient satisfaction was contingent upon first inpatient stay and length of stay. We also found that patient participation improved nurse job satisfaction, work engagement, and helping behaviors. Furthermore, nurses’ sociodemographic characteristics, namely age and organizational tenure, moderated the effect of patient participation on nurse job satisfaction, but not on work engagement and helping behaviors. Theoretical and practical implications of our findings were discussed. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
What Factors Affect Patient Satisfaction in Public Sector Hospitals: Evidence from an Emerging Economy
Int. J. Environ. Res. Public Health 2019, 16(6), 994; https://doi.org/10.3390/ijerph16060994 - 19 Mar 2019
Cited by 3
Abstract
Patient satisfaction can identify specific areas of improvement in public sector hospitals. However, the Pakistani healthcare system, and quality of service delivery is rarely assessed through the perspective of patient satisfaction. Our study demonstrated the performance of public healthcare systems in Pakistan by [...] Read more.
Patient satisfaction can identify specific areas of improvement in public sector hospitals. However, the Pakistani healthcare system, and quality of service delivery is rarely assessed through the perspective of patient satisfaction. Our study demonstrated the performance of public healthcare systems in Pakistan by interacting with physical services (tangible and environmental), doctor–patient communication, and pharmacy and laboratory services based on patient satisfaction. Primary data were collected from the patients by using a random sampling method. Patients who participated in the study were visitors of public hospitals’ outpatient departments. A total of 554 questionnaires were circulated, and 445 were received. The confirmatory factor and multiple regression analyses were employed to analyze the collected data. The results revealed that laboratory, as well pharmacy services, had positive significant effects (p = 0.000) on patient satisfaction, while doctor–patient communication (p = 0.189) and physical facilities (p = 0.85) had an insignificant relationship with patient satisfaction. Therefore, it is suggested that a significant communication gap exists in the doctor–patient setting, and that Pakistan’s healthcare system is deprived of physical facilities. Consequently, such services need further improvements. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
The Colonoscopy Satisfaction and Safety Questionnaire (CSSQP) for Colorectal Cancer Screening: A Development and Validation Study
Int. J. Environ. Res. Public Health 2019, 16(3), 392; https://doi.org/10.3390/ijerph16030392 - 30 Jan 2019
Abstract
Colonoscopy services working in colorectal cancer screening programs must perform periodic controls to improve the quality based on patients’ experiences. However, there are no validated instruments in this setting that include the two core dimensions for optimal care: satisfaction and safety. The aim [...] Read more.
Colonoscopy services working in colorectal cancer screening programs must perform periodic controls to improve the quality based on patients’ experiences. However, there are no validated instruments in this setting that include the two core dimensions for optimal care: satisfaction and safety. The aim of this study was to design and validate a specific questionnaire for patients undergoing screening colonoscopy after a positive fecal occult blood test, the Colonoscopy Satisfaction and Safety Questionnaire based on patients’ experience (CSSQP). The design included a review of available evidence and used focus groups to identify the relevant dimensions to produce the instrument (content validity). Face validity was analyzed involving 15 patients. Reliability and construct and empirical validity were calculated. Validation involved patients from the colorectal cancer screening program at two referral hospitals in Spain. The CSSQP version 1 consisted of 15 items. The principal components analysis of the satisfaction items isolated three factors with saturation of elements above 0.52 and with high internal consistency and split-half readability: Information, Care, and Service and Facilities features. The analysis of the safety items isolated two factors with element saturations above 0.58: Information Gaps and Safety Incidents. The CSSQP is a new valid and reliable tool for measuring patient’ experiences, including satisfaction and safety perception, after a colorectal cancer screening colonoscopy. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
Patient Satisfaction with Community Pharmacies Services: A Cross-Sectional Survey from Punjab; Pakistan
Int. J. Environ. Res. Public Health 2018, 15(12), 2914; https://doi.org/10.3390/ijerph15122914 - 19 Dec 2018
Cited by 2
Abstract
Purpose: Patient satisfaction can identify specific areas of improvement in community pharmacy services. Currently in Pakistan, no evidence exists in this regard. This study was conducted to determine the needs of patients and the current standards of pharmacies. Methods: A cross-sectional [...] Read more.
Purpose: Patient satisfaction can identify specific areas of improvement in community pharmacy services. Currently in Pakistan, no evidence exists in this regard. This study was conducted to determine the needs of patients and the current standards of pharmacies. Methods: A cross-sectional study was conducted between October 2016 and June 2017. A pilot tested questionnaire was used to collected the data from 1088 patients of 544 community pharmacies. Likert scale and one way ANOVA was used to analyze the data. Results: The response rate of community pharmacies was 80% and that of purchasers was 68.1%. The mean age of participants was 35.2 years. The mean overall satisfaction score of participants was 2.78/5.00. Many patients were dissatisfied (1.65/5.00) with parking facilities provided by pharmacies. Pharmacy service time fulfilled the requirements of most patients (4.16/5.00). The counseling person’s good attitude (3.99/5.00) was credited by purchasers. Level of patient satisfaction with the availability of medicines (3.19/5.00), safe storage of medicines in pharmacy stores (3.66/5.00), and quality of medicines (3.41/5.00) were almost moderate. Many patients were very satisfied (4.35/5.00) with readable instructions for their medications. Approximately half of the patients were dissatisfied with the waiting time. Many patients were also dissatisfied (2.28/5.00) with the knowledge of the counseling person. Patients perceived that staff interest in patient recovery (2.24/5.00) was low. No significant difference in level of satisfaction with regard to participant’s characteristics was found. Conclusions: The current study demonstrated a low level of patient satisfaction with regard to community pharmacy services in Pakistan. These services need improvement. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
Open AccessArticle
Do Individuals in Old Age Prepare for the Risk of Long-Term Care? Results of A Population-Based Survey in Germany
Int. J. Environ. Res. Public Health 2018, 15(10), 2189; https://doi.org/10.3390/ijerph15102189 - 08 Oct 2018
Cited by 1
Abstract
The aim of the present study was to identify specific actions and financial precautions undertaken by individuals in preparation for their long-term care needs, as well as to determine the correlates of these actions. A population-based survey of the German population aged 65 [...] Read more.
The aim of the present study was to identify specific actions and financial precautions undertaken by individuals in preparation for their long-term care needs, as well as to determine the correlates of these actions. A population-based survey of the German population aged 65 years and above (n = 1006) was used. Individuals were asked whether they have undertaken financial preparations for their long-term care needs (no; yes). With respect to specific actions, individuals were asked whether they (no; yes): (i) Had obtained information (e.g., from doctor, internet, care support center, care facility), (ii) had modified their home (e.g., installed a stair lift), and (iii) had moved (e.g., old-age housing, care in relatives’ homes). In total, 30.4% had undertaken financial preparations for their long-term care needs. With respect to the specific actions undertaken, 6.5% had obtained information, 4.8% modified their home, and 7.3% had moved. The outcome measure, ‘had modified home’, was positively associated with lower age, West Germany, and lower self-rated health. The outcome measure, ‘had moved’, was positively associated with being female, and higher education. The outcome measure, ‘financial preparations for long-term care needs‘, was positively associated with lower age, West Germany, higher education, being born in Germany, and private health insurance. It is alarming that only around one in three individuals aged 65 and older had undertaken financial preparations for long-term care needs, and that far fewer individuals had undertaken other actions to prepare for their long-term care needs. The provision of timely information regarding the risk of long-term care, as well as its associated costs, may assist in sustaining the satisfaction of long-term care recipients. It may also help to reduce the risk of long-term care for individuals in old age. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
Open AccessFeature PaperArticle
The Measure of the Family Caregivers’ Experience
Int. J. Environ. Res. Public Health 2018, 15(9), 2040; https://doi.org/10.3390/ijerph15092040 - 18 Sep 2018
Abstract
Objective: Design and validate a measure of the experience of family caregivers with the integrated care that receive the persons they care for. Methods: The new instrument for measuring the experience of caregivers is based on the Instrument to Evaluate the [...] Read more.
Objective: Design and validate a measure of the experience of family caregivers with the integrated care that receive the persons they care for. Methods: The new instrument for measuring the experience of caregivers is based on the Instrument to Evaluate the EXperience of PAtients with Chronic Diseases (acronym in Spanish: IEXPAC) scale instrument. With the qualitative technique of the discussion group, nine professionals and eight caregivers assessed the face validity of the instrument and they advised on issues to explore and the measuring scale to use. The instrument’s items were analyzed individually, as well as its consistency, reliability, and construct and empirical validity. Results: 235 caregivers responded, of which 186 (79%) were women. The average age of the persons under their care was 83.9 years (SD 9.7). The scale’s score when eliminating its items one by one ranged between 38.6 and 41.1. The factorial saturations of the items ranged between 0.53 and 0.82. Cronbach’s alpha (12 elements) was 0.88 and the Kuder-Richardson coefficient was 0.91. The factorial solution explained 64.3% of the total variance and allowed isolating two factors (with 11 items with saturations greater than 0.65): care for the patient, and care for the caregiver. The internal consistency of both factors was greater than 0.80. The scale’s score was 41.1 (SD 9.7). Conclusions: The Caregivers Experience Instrument combines acceptability, ease of comprehension, and perceived usefulness for the caregivers. It has adequate internal consistency, reliability, and construct and empirical validity. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
Open AccessArticle
Dental-Dam for Infection Control and Patient Safety during Clinical Endodontic Treatment: Preferences of Dental Patients
Int. J. Environ. Res. Public Health 2018, 15(9), 2012; https://doi.org/10.3390/ijerph15092012 - 14 Sep 2018
Cited by 1
Abstract
Background: A number of factors (first experience, treating clinician and time to place dental-dam) may influence patients’ preferences regarding dental-dams. In general, patients accept placing it and that it must be used for teeth isolation during endodontic procures for the sake of patient [...] Read more.
Background: A number of factors (first experience, treating clinician and time to place dental-dam) may influence patients’ preferences regarding dental-dams. In general, patients accept placing it and that it must be used for teeth isolation during endodontic procures for the sake of patient safety and infection control. Objectives: The aim of this study is to investigate preferences and experiences of patients using dental-dam (DD) isolation during root canal treatment (RCT) and to explore influencing factors among the residents of Madinah Munnawara, Saudi Arabia. Methods: Following an ethical approval and a pilot study, a self-administrated questionnaire was distributed to 305 patients attending endodontic clinics at the Taibah University College of Dentistry (TUCOD) over six months. Patients voluntarily participated in the study after understanding the methodologies and signing a consent form. They were asked to fill out a questionnaire on their experiences and preferences in placing the DD during RCT. Data were analyzed using the Chi-square test at p = 0.05. Results: The response rate was 91%. There was no significant correlation between patients’ preferences and their race, age and gender (p > 0.05). The majority of participants (74.3%) would prefer to use a DD in their next session (p < 0.001). This preference negatively correlated with the time required to place a DD and the duration of the current visit (p < 0.001). While most of those who would prefer to use a DD in their next visit were pleased with how it was placed in the current session (76.6%), most of those who would not do so (66.7%) were uncomfortable. Overall, the highest proportion of participants (40.2%) reported that prevention of instrument swallowing was the most important advantage of DD isolation (p < 0.001). Conclusions: Overall, DD isolation for RCT is generally well accepted by patients regardless of their country of origin, gender, education and awareness of its advantages. Patients’ safety was the most attractive advantage for patients to the application of the DD. The time required to place the dental dam and first visit experience in placing the DD affect patients’ future preference. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
Open AccessArticle
Innovating New Rural Cooperative Medical Scheme (NCMS) for Better Patient Satisfaction in Rural China
Int. J. Environ. Res. Public Health 2018, 15(9), 2007; https://doi.org/10.3390/ijerph15092007 - 14 Sep 2018
Cited by 3
Abstract
With the broadening application of the New Rural Cooperative Medical Scheme (NCMS), its role in patient satisfaction in rural China has shifted to be the focus of academic research. Based on a technology acceptance model, this study will investigate the factors and mechanisms [...] Read more.
With the broadening application of the New Rural Cooperative Medical Scheme (NCMS), its role in patient satisfaction in rural China has shifted to be the focus of academic research. Based on a technology acceptance model, this study will investigate the factors and mechanisms influencing patient satisfaction on NCMSS in rural places in China. In this study, based on a technology acceptance model, we developed a model that is associated with the influencing factors, patients’ continued participation and patient satisfaction, and conducted an empirical analysis based on data collected from rural areas of China’s Anhui Province. A NCMS′s reputed reliability, value, and convenience played a key role in positively influencing patient satisfaction. However, long-term patient participation was not significantly influenced by other social factors. In order to increase patient satisfaction, NCMS policy and implementation procedure needs further government modification and innovation with the goal of improving the reimbursement ratio, reducing the financial burden, and improving patient convenience. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessArticle
Understanding the Role of Mobile Internet-Based Health Services on Patient Satisfaction and Word-of-Mouth
Int. J. Environ. Res. Public Health 2018, 15(9), 1972; https://doi.org/10.3390/ijerph15091972 - 10 Sep 2018
Cited by 1
Abstract
With the rapid advancement of Web 2.0 technologies, Internet medicine, and mobile healthcare, the influence of the use of patient-oriented Mobile Internet-based Health Services (MIHS) on patient satisfaction and the electronic word-of-mouth (WOM) of health service agencies is becoming the focus of the [...] Read more.
With the rapid advancement of Web 2.0 technologies, Internet medicine, and mobile healthcare, the influence of the use of patient-oriented Mobile Internet-based Health Services (MIHS) on patient satisfaction and the electronic word-of-mouth (WOM) of health service agencies is becoming the focus of the academic research community. Many large hospitals, including some Internet hospitals, have provided various online healthcare service platforms that enable patients to expediently consult with physicians and obtain healthcare services in an online to offline format. The purpose of this study is to analyze the main mechanisms of how the features and users’ experiences of MIHS influenced patient satisfaction and continuous use behaviors of the system to generate additional WOM dissemination behaviors. Based on post-adoption behavior and Expectation Confirmation Model of Information Technology Continuance (ECM-IT), this study conducted an empirical study through data collection from users (patients) from a large hospital providing online healthcare services. A total of 494 pieces of data were collected and analyzed using SmartPLS2.0(SmartPLS GmbH, Hamburg, Gernmany). The results show that: (1) patient satisfaction with MIHS and their intentions to continue use of MIHS have significantly positive influences on WOM; (2) patient satisfaction with MIHS is positively influenced by perceived usefulness and confirmation of MIHS performance expectations; (3) and patient intentions to continue use of MIHS are also affected by some technology factors, such as facilitating conditions and perceived risk, as well as some subjective feelings, such as perceived usefulness and perceived interactivity. The results of this study provide important implications for both research and practice of public health. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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Open AccessFeature PaperArticle
Clients’ Experience and Satisfaction of Utilizing Healthcare Services in a Community Based Health Insurance Program in Bangladesh
Int. J. Environ. Res. Public Health 2018, 15(8), 1637; https://doi.org/10.3390/ijerph15081637 - 02 Aug 2018
Abstract
Background: Community-based health insurance is recognized as a promising tool for health system improvement for low-income people that improves the health status of enrolees and enhances productivity and labor supply. The experience and opinion of the clients who utilized health services through [...] Read more.
Background: Community-based health insurance is recognized as a promising tool for health system improvement for low-income people that improves the health status of enrolees and enhances productivity and labor supply. The experience and opinion of the clients who utilized health services through the insurance scheme are important for improving healthcare services, shaping health policies and providing feedback on the quality, availability, and responsiveness of healthcare services. However, studies focusing on clients’ satisfaction provided by the health insurance scheme are still limited globally. Objective: To address this knowledge gap, this current study attempted to measure the degree of clients’ satisfaction towards healthcare services and insurance scheme, based on their experience of health care which will serve the future reference point to implement potential quality improvement initiatives of community-based health insurance program. Methods: A cross-sectional household survey was conducted within the catchment area of a community-based health insurance pilot program named Labor Association for Social Protection (LASP) during April–June 2014 to compare the evaluation of healthcare services provided by LASP scheme. In the descriptive analyses, the characteristics of the study participants were presented regarding frequency and the percentages with 95% confidence interval. Spearman correlation analysis was conducted between the satisfaction score of each indicator and overall satisfaction score; multivariate linear regression analysis was used to identify the factors associated with overall health scheme satisfaction. Results: The overall satisfaction mean score was 4.17 ± 0.04 (95% CI: 4.08–4.26) out of 5.00. The most satisfied domains were related to the diagnostic services (4.46 ± 0.98), explanation about the prescribed medicine (4.23 ± 0.81), the surrounding environment of healthcare facility (4.21 ± 0.70) and the behavior of health personnel toward clients (4.18 ± 0.73). Conclusions: Our study observed that the overall satisfaction level towards health services is quite favorable, but satisfaction scores can still be improved. These findings could contribute towards developing and designing the healthcare services packages of community-based health scheme which is in line with the health care financing strategy of Bangladesh as well as the recommendation of the World Health Organization for developing social health insurance as part of path to Universal Health Coverage. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
Open AccessArticle
Development of a Strategic Tool for Shared Decision-Making in the Use of Antidepressants among Patients with Major Depressive Disorder: A Focus Group Study
Int. J. Environ. Res. Public Health 2018, 15(7), 1402; https://doi.org/10.3390/ijerph15071402 - 03 Jul 2018
Abstract
Shared decision-making (SDM) has been recognized as an important tool in the mental health field and considered as a crucial component of patient-centered care. Therefore, the purpose of this study was to develop a strategic tool towards the promotion and implementation of SDM [...] Read more.
Shared decision-making (SDM) has been recognized as an important tool in the mental health field and considered as a crucial component of patient-centered care. Therefore, the purpose of this study was to develop a strategic tool towards the promotion and implementation of SDM in the use of antidepressants among patients with major depressive disorder. Nineteen doctors and 11 major depressive disorder patients who are involved in psychiatric outpatient clinic appointments were purposively selected and recruited to participate in one of six focus groups in a large teaching hospital in Malaysia. Focus groups were transcribed verbatim and analyzed using a thematic approach to identify current views on providing information needed for SDM practice towards its implementation in near future. Patients’ and doctors’ views were organized into six major themes, which are; summary of treatment options, correct ways of taking medication, potential side effects of treatments related to patients, sharing of case study related to the treatment options, cost of treatment options, and input from pharmacist. The information may be included in the SDM tool which can be useful to inform further research efforts and developments that contribute towards the successful implementation of SDM into clinical practice. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)

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Open AccessBenchmark
Experience of Good Practice in an Occupational Accident Mutual Insurance Society, Based on the Voice of Patients and Professionals
Int. J. Environ. Res. Public Health 2019, 16(20), 3856; https://doi.org/10.3390/ijerph16203856 - 12 Oct 2019
Abstract
In Spain, the protection of workers’ health is organized through what are known as occupational accident mutual insurance societies. While health protection is a fundamental issue within a mutual society, dimensions, such as patient quality and safety, are measured in the same way [...] Read more.
In Spain, the protection of workers’ health is organized through what are known as occupational accident mutual insurance societies. While health protection is a fundamental issue within a mutual society, dimensions, such as patient quality and safety, are measured in the same way as in the conventional healthcare sector. However, in mutual societies, it is traditionally acknowledged that experiences of medical evaluation systems of healthcare provision and quality improvement are less frequent. The following is an example of how a Quality Plan has been structured within an organization with these characteristics, and instruments and measures have been developed to capture information in decision making from the perspective of patients and professionals. The Quality Plan represents the ongoing commitment of this organization to achieve patient-centered care. These changes revolve around these measures and, therefore, it is defined as a good practice. Full article
(This article belongs to the Special Issue Patient Satisfaction with Health Services)
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