Psychiatric out Patients’ Health Service Satisfaction at Psychiatric out Patient Department in Amanuel Hospital, A.A, Ethiopia
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2017-12
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Abstract
Consumer satisfaction is playing an increasingly important role in quality of carereforms and health-care delivery more generally in United States of America and Europe.However, consumer satisfaction studies are challenged by the lack of a universally accepted definition or measure [1–6] and by a dual focus: while some researchers focus on patient satisfaction with the quality and type of health-care services received [7–10]. Others focus on people’s satisfaction with the health system more generally [11–14]. The importance of bothperspectives has been demonstrated in the literature. For example, satisfied patients are morelikely to complete treatment regimens and to be compliant and cooperative [14, 15]. Researchon health system satisfaction, which is largely comparative, has identified ways to improvehealth, reduce costs and implement reform. Even though it is difficult to find an agreed-upondefinition, patient satisfaction is “health care recipient’s reaction to salient aspects of his orher experience, expectation and preference of a service met by health care service andprovider [17] and is one desired outcome of mental health care service and core parameter forthe positive evaluation of a mental health care system [18-20]. For consumers of mentalhealth services, satisfaction has become a significant contributing outcome in the assessmentand improvement of quality of care, including adherence to treatment, intent to return for care and follow-up and continuity of outpatient care [21].The absence of a solid conceptual basis and consistent measurement tool forconsumer satisfaction has led, over the past 10 years, to a proliferation of surveys that focus exclusively on patient experience, i.e. aspects of the care experience such as waiting times,the quality of basic amenities, and communication with health-care providers, all of whichhelp identify tangible priorities for quality improvement.The increasing importance of patient experience and the sustained interest incomparing people’s satisfaction with the health system across different countries and time2periods suggests the need to characterize the relationship between them. Research relatingglobal satisfaction ratings with patient experience has revealed strong associations betweenthe two [23]. Yet to what extent patient experience explains satisfaction with the health-caresystem remains unclear. The literature suggests that much of the remaining variation in healthsystem satisfaction after adjusting for factors commonly used to measure the concept is areflection of patient experience [24, 25].Different studies showed that the global level of patient satisfaction to psychiatricservices ranges from 39.3% to 91.9%. A range of factors can affect patient satisfaction,including unpleasantly built environments, staff being too busy, failure to obtain prescribedmedications from the hospital pharmacies, the stigma of a psychiatric treatment service, longwaiting hours, results, and payment for psychiatric services. Consequently, a dissatisfiedpatient is not psychologically and socially well becoming evident of lack of goal attainmentby the service provider or the clinician.[31–33] Different studies also indicated that, otherthan the quality of service delivery, satisfaction is also affected by many factors such aspatients’ demographics [34,35] diagnosis and duration of disease, [36,37] treatment program,[38] and patients’ expectation of service [39] Studies on 21 European countries showed thatpatient experience accounts for only a small fraction of the unexplained variation in healthsystem satisfaction, even after adjustments for the demographic, health and institutionalfactors with which such satisfaction is commonly associated. [21–23, 26–30]. In this study,most of the variation in satisfaction with the health-care system was explained by factors above and beyond patient experience.Reliance on psychiatric symptoms alone as a measure of service satisfaction issomehow a narrow concept; it is rather important to see how satisfied the patients are by theservice they received [42]. Despite psychiatric outpatient service being given in most ofreferral hospitals in Ethiopia, there had been few evidences that examined patients’3satisfaction with the quality ofpsychiatric care based on sound theoretical frameworks andthis study also probably contributes pattern of satisfaction of psychiatric patients in Ethiopia.
However the scales used to measure satisfaction level was based on scales validated and usedin other countries. Hence a need to understand more patients experience based on a mentalhealth service scale (MHSSS) scale, validated and tested in Ethiopia makes this study soundhelpful [45].Patient’s responses to their experiences of using services are under-researched in
the context of mental healthcare in low income countries.Therefore, the purpose of this study is to explore the factors underlying psychiatric
patients’ satisfaction with the health-care system and the extent to which satisfaction reflectstheir experience of care with the validated MHSSS (mental health service satisfaction scale)tool in Ethiopia, written in Amharic and English version as a measure of satisfaction amongconsumers of mental healthcare.
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health service satisfaction,Psychiatry