Shaikh, Babar T

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eCommons@AKUCommunity Health Sciences Department of Community Health SciencesNovember 2005Quality of health care: an absolute necessity forpatient satisfactionBabar T. ShaikhAga Khan UniversityFollow this and additional works at: https://ecommons.aku.edu/pakistan_fhs_mc_chs_chsRecommended CitationShaikh, B. T. (2005). Quality of health care: an absolute necessity for patient satisfaction. Journal of Pakistan Medical Association,55(11), 515-516.Available at: https://ecommons.aku.edu/pakistan_fhs_mc_chs_chs/556Vol. 55, No. 11, November 2005 515View PointQuality of health care: an absolute necessity for patient satisfactionBabar T. ShaikhDepartment of Community Health Sciences, Aga Khan University Hospital, Karachi, Pakistan.The context Pledging quality in health care services ought to be apriority for any health care system. The notion of qualityhas emerged more strongly because of the rising costs oftreatments, constrained resources in health services and evi-dence of variations in clinical practice.1 A quality healthcare system is one which guarantees the continuum of care,not merely for curative services, but for health promotion aswell as prevention. Assessment of quality usually focuseson technical concerns as well as the process through whichcare is delivered. This assessment becomes more authenticand legitimate if based on the application of professionalstandards integrating the patients' views, experiences andperceptions.2,3 However, an effective system can only func-tion properly, if it operates on a regular assessment of peo-ple's perceptions and monitors itself based on their feed-back. Researchers have shown that for measuring healthcare system's performance, the assessment of patient satis-faction is a more sensitive indicator than the traditionalmeasures such as morbidity and mortality patterns and morereliable than other methods such as physician peer review.4The patient assessment of the health services and the healthstaff in view of improving the level of quality, is in factrespecting the consumer sovereignty.5 Increasing practice ofconducting patients' satisfaction surveys, may be an evi-dence of the shift from traditional doctor-patient relation-ship to provider-client attitude. Dimensions of quality serviceWorld Health Organization in world health report2000 defined quality of health care through benchmarks ofefficiency, cost effectiveness and social acceptability. If theterm social acceptability is unpacked, patients' perspective isclearly highlighted. This is not even very different from thecorporate sector where consumers are given the primeimportance. Reliability, responsiveness, assurance andempathy and tangibles are those attributes which we seebeing used in all sectors dealing with public goods and serv-ices. Health services are also public goods, where there is adefinite potential to improve the level of patient satisfactionwith the service by tracking these dimensions. Reliability ofthe service would mean that the patient is seen according tohis/her expectations and received the required treatment. Aresponsive service would be where all patients regardless oftheir origin, status and background receive prompt attentionby the hospital staff with courtesy and cooperation. Waitingtime is appropriate and not bothersome. The factor of assur-ance is reflected from the reliance of the patients on doctorand hospital staff, and the confidence on their qualificationand competence. The dimension of empathy could be seen asthe individual attention given to the patients, calling by nameand showing caring attitude towards them. Tangiblesaccount for the cleanliness in the health facility, use of cleaninstruments and standard procedures in the facility and last-ly the prescription, which should be easy to understand forthe patients.This philosophy of quality of health services, hitherto,may help us finding the answer to the enigma of underutiliza-tion of public sector health services in many developingcountries and the flourishing private sector. Let's focus onPakistan for instance. In spite of huge health infrastructure atthe primary care level, it is most likely the dearth of qualitythat only 21% of the patients go to a public health centre forseeking care and 77% per capita health expenditures isincurred in the private sector.6 No doubt, the quality of healthservice in private sector can also be questioned. Still a higherpattern of utilization of private sector allopathic health facili-ties is attributed mostly to issues of acceptability such as min-imal waiting time, longer and flexible opening hours, all timeavailability of staff and drugs in the health facilities, betterattitude and more confidentiality in socially stigmatized dis-eases. The attitude of the health provider and patient satisfac-tion with the treatment play a role in health seeking behav-iour. The dissatisfaction with public sector health providersactually make people to do the health care shopping. Alsopeople tend to go to secondary or tertiary level hospitals forminor ailments. This phenomenon has its own repercussionsin the form of considerable inefficiency and compromisedquality of services in these big hospitals. It is, thus, quiterational to assess patient satisfaction of these public and pri-vate health facilities to bring about an overall improvement inquality of services delivered. It is seldom seen thatresearchers have looked for evaluation of health care servic-es from a consumer perspective. However, satisfaction hasbeen an implicit element in a range of assessments of utiliza-tion pattern surveys.DiscussionQuality improvement is imperative to developmentand improvement in health care systems in Pakistan.Although latest national health policy has emphasized ongood governance to achieve quality health care, an authen-tic system of information has always been a flaw in theentire health care system and there is no mechanism onrecord to check the quality of these services. It is envisagedthat through regular tracking of the dimensions of quality ofcare cited above, health providers and hospitals couldreceive timely feedback on areas of deficiency and this willstimulate a mechanism to improve patient satisfaction. Theefficient delivery of primary health care through the exist-ing health system will lead to improved health conditions byreducing morbidity, reducing mortality-specifically mater-nal and infant mortality and reducing population growthrate. This will also promote the appropriate use of the healthservices which will be catering to the very needs and aspi-rations of the community. The providers must get the firsthand information from their clients which should help themto re-orient their services by adopting more client centredapproach, moulding their attitude and introducing convivialambiance at health service outlets based on the feedback oftheir clients. Gender sensitization of the doctors and thehealth facility staff is also a pre-condition to make the serv-ices more responsive for the women clientele.Understanding the health needs of the women and improv-ing one's interpersonal communication skills of womenclients especially would be enviable to bring about a changein the system. More health care is not always better healthcare. Providing good quality health care is of critical impor-tance for the future economic and overall social well-beingof this country. References1. Campbell SM, Roland MO, Buetow SA. Defining quality of care. Soc SciMed 2000;51:1611-25.2. Haddad S, Potvin L, Roberge D, Pineault R, Remondin M. Patient perceptionof quality following a visit to a doctor in a primary care unit. Fam Pract2000;17:21-9.3. Aharony L, Strasser S. Patient satisfaction: What we know about and what westill need to explore. Med Care Rev 1993;50:49-79.4. Fitzpatrick R. Surveys of patient satisfaction: important general considera-tions. BMJ 1991;302:887-9.5. Grol R. Improving the quality of medical care: Building bridges among pro-fessional pride, payer profit and patient satisfaction. JAMA 2001;286:2578-85.6. Pakistan Medical Research Council. Pattern of health care utilization.National Health Survey of Pakistan. Islamabad: 1998.516 J Pak Med Assoc

Quality of health care: an absolute necessity for patient satisfaction

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Quality of health care: an absolute necessity for patient satisfaction

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