Psychiatric out patients’ health service satisfaction at psychiatric outpatient 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 care
reforms 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 both
perspectives has been demonstrated in the literature. For example, satisfied patients are more
likely to complete treatment regimens and to be compliant and cooperative [14, 15]. Research
on health system satisfaction, which is largely comparative, has identified ways to improve
health, reduce costs and implement reform. Even though it is difficult to find an agreed-upon
definition, patient satisfaction is “health care recipient’s reaction to salient aspects of his or
her experience, expectation and preference of a service met by health care service and
provider [17] and is one desired outcome of mental health care service and core parameter for
the positive evaluation of a mental health care system [18-20]. For consumers of mental
health services, satisfaction has become a significant contributing outcome in the assessment
and 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 for
consumer 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 which
help identify tangible priorities for quality improvement.
The increasing importance of patient experience and the sustained interest in
comparing people’s satisfaction with the health system across different countries and time
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periods suggests the need to characterize the relationship between them. Research relating
global satisfaction ratings with patient experience has revealed strong associations between
the two [23]. Yet to what extent patient experience explains satisfaction with the health-care
system remains unclear. The literature suggests that much of the remaining variation in health
system satisfaction after adjusting for factors commonly used to measure the concept is a
reflection of patient experience [24, 25].
Different studies showed that the global level of patient satisfaction to psychiatric
services 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 prescribed
medications from the hospital pharmacies, the stigma of a psychiatric treatment service, long
waiting hours, results, and payment for psychiatric services. Consequently, a dissatisfied
patient is not psychologically and socially well becoming evident of lack of goal attainment
by the service provider or the clinician.[31–33] Different studies also indicated that, other
than the quality of service delivery, satisfaction is also affected by many factors such as
patients’ 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 that
patient experience accounts for only a small fraction of the unexplained variation in health
system satisfaction, even after adjustments for the demographic, health and institutional
factors 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 is
somehow a narrow concept; it is rather important to see how satisfied the patients are by the
service they received [42]. Despite psychiatric outpatient service being given in most of
referral hospitals in Ethiopia, there had been few evidences that examined patients’
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satisfaction with the quality of psychiatric care based on sound theoretical frameworks and
this 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 used
in other countries. Hence a need to understand more patients experience based on a mental
health service scale (MHSSS) scale, validated and tested in Ethiopia makes this study sound
helpful [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 reflects
their 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 among
consumers of mental healthcare.
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Keywords
health service satisfaction,Psychiatry