Opinion of patients on accessibility of services in primary health care centres

Aim. To evaluate accessibility, satisfaction on patients’ quality of health services in primary health care centers in rural and urban settings in Lithuania. Research objectives were as following: 1) to establish patient’s satisfaction in primary health care centers; 2) to identify what factors affects the poor accessibility to health care; 3) to compare opinion, attitudes of patients on health care services in urban and rural settings. Methods. Two samples of respondents (patients of one primary health care center in small rural town Simnas and one in big city Kaunas) were selected. Anonymous questionnaire was filled in by 308 patients in Simnas (Primary Health care Centre) and 202 in Kaunas (Central Policlinic), response rate was 77% and 26%, respectively. Questionnaire form was developed by the authors has covered 31 question on different issues of quality of health care services: health status and reasons of visit to health care center; different issues on accessibility to health services (waiting time, registration for services, transportation and distance), satisfaction by competencies of physician, reasons of dissatisfaction, satisfaction by services provided by the health care institution. SPSS 10,0 and Excel statistical packages were used for making statistical data anlysis. Statistically significant difference was established when p<0,05. Results. 45 % of respondents were satisfied by the competencies of their family doctors. 58% of patients were not satisfied by length of waiting time; 57% indicated lack of doctors-specialists in health care centers. Some patients (56%) complained of insufficient information about their health status and diseases, alternative ways of treatment. Most of respondents were not satisfied of their health care centers help. Waiting time at the doors of the family doctors (86%) also was the reason of complains. Patients were afraid of treatment and procedures, also they were afraid of diagnosed diseases. Average Transportation time to approach primary health care center for rural patients was 30 minutes and for urban patients 60 minutes (p<0,05). Respondents from rural area were better informed about possibility of contacting their family doctor by phone tan in the city (p<0,05). Waiting time for appointment to the family doctor was 0-1 day in rural town and 4-7 days bin the city. Patients from the city have expressed higher number of complains on accessibility than respondents from the small town ( p<0,05). Conclusion. Half of all respondents were satisfied of their family doctor competence, women were more tolerant then men. p<0,05 Respondents who lived in small rural town were more satisfied by their doctors competence than respondents in city Kaunas (p<0.05). Students and employees of the physical work were the most satisfied by the competencies of their family doctor ( p<0,05). The youngest group of adult patients were the mostly satisfied group of customers (p<0.05). Waiting time at the door of doctor’s office, lack of doctors in narrow specialties, problems of registration for appointment, lack of attention to the patients inquiries are the main problems, which affect accessibility of primary health care. Work status, age, family status and education also had relation on patient’s opinion about accessibility in primary health care. Limited number of patients used phone to contact he family doctor p<0,05 Patient who lived in small town knew more about registration by phone. Patients from Kaunas were exposed for longer waiting time at the doors of doctors office (60 min.) in comparison with patients from Simnas (30 min., p