Patient satisfaction regarding quality of health care services in medicine outpatient department at secondary care hospital of district Jamshoro, a mix method study

Assessment of health service quality has presumed expanding significance in the last twenty years globally. Quality health care services are described as those services which meet the set standards and as well as satisfy the needs of both clients and health care providers. Patients\u27 satisfaction is a useful indicator of quality and thus should be measured frequently. The published information regarding patient satisfaction in low & middle income countries is relatively scarce. This study aims to analyze level of satisfaction of patients and the factors influencing it using Donabedian\u27s quality analysis framework, in the patients attending the medicine outpatient department in secondary care hospital (DHQ) of district Jamshoro. The study tried to explore the input, processes and output factors that affect the patient satisfaction. Methodology: A cross-sectional mix method (quantitative and qualitative) study was conducted during July-September 2017 by involving patients, health care providers and health managers at medicine outpatient department at District Head Quarter (DHQ) Hospital Kotri, district Jamshoro. The mix methods comprised of triangulation by including patient perspective through exit interviews (quantitative part) along with health care providers\u27 and health managers\u27 perspective through key informant interviews (qualitative part) on quality of health care services. The systematic sampling technique was used for exit interviews, however, for key informant interviews all health care providers including physician and medical officers of medicine OPD and relevant health managers of hospital were interviewed. The findings of the exit interviews were analyzed through SPSS 19.0 Inc Windows version 10 & of qualitative part by manual transcription and content analysis. Results: Overall, patient satisfaction level was recorded to be 57%. The results showed low satisfaction level for the physical environment of OPD but high satisfaction levels were observed from interaction with health care providers. Moreover, from health managers and health care providers\u27 perspective lack of infrastructure and shortage of human resource were considered the restraining structural factors in providing the quality medicine OPD health care services. The attitude of health care provider and quality of services provided by them were mostly found satisfactory. However, unnecessary involvement of paramedical staff and overburdened available staff were the major barriers in establishing quality culture at the hospital for the administration. Conclusion: Overall a good level of patient satisfaction was recorded from this study with major contribution of physician services and least by the overall physical environment. Furthermore, appropriate and timely patient satisfaction surveys will help in optimizing the performance of outpatient department to achieve better health outcomes. Initiating a quality improvement process in resource limited setting is in itself a huge task, taking into consideration the number of challenges these facilities face