Abstract
BackgroundPatient satisfaction is an important measure of quality of care and a determinant of health service utilisation and the choice of health facility. Measuring patients’ experiences is important for understanding and improving the quality of care at health facilities. The aim of this study was to assess levels and identify associated factors of caregivers’ satisfaction and provider-caregiver communication within child healthcare in Nepal.MethodsSecondary analysis of Sick Child Exit Interviews (n = 2092) sourced from 2015 Nepal Health Facility Survey data. Satisfaction was measured through caregivers’ satisfaction with services received and their willingness to recommend the health facility visited. Communication indicators were chosen based on the 2014 WHO IMCI guidelines and aggregate communication scores were calculated based on the number of indicators acknowledged during assessments. Logistic regression was used for analysis.ResultsAlthough most respondents (82.1%) reportedly were satisfied with the care provided, only 35.9% experienced good communication with their providers. Caregivers who had ever attended school were more likely to be satisfied with services (1.44, CI 95% 1.04–1.99). Type of provider, sex of child or who the caregiver was had no association with caregivers’ satisfaction. Having been given a diagnosis doubled the chances of satisfaction (AOR 2.04, 95% CI 1.38–3.00), as did discussion of the child’s growth (OR 1.71, 95% CI 1.06–2.76) and having discussed any of the included topics (AOR 1.98, CI 95% 1.14–3.45).ConclusionsInterventions to improve healthcare staff’s communication skills are needed in Nepal to further enhance satisfaction with services and increase quality of care. However, this is an area that need further investigation given the high levels of satisfaction displayed despite poor communication. Other factors in the health care exchange between provider and clients are influencing the level of satisfaction and need to be identified and promoted further. High-quality care is no longer a goal for the future or only for high income settings; it is essential for reaching global health goals.
Highlights
Patient satisfaction is an important measure of quality of care and a determinant of health service utilisation and the choice of health facility
Study setting The 2015 Nepal health facility survey (NHFS) collected information from health facilities run by government, private not for profit Non-Governmental Organisations (NGOs), private for profit and missionary organisations across all 75 districts of Nepal
The multivariate logistic regression analysis of these results showed that the association between good communication and provider type, mother as caregiver and caste/ ethnicity was confounded by the level of education of the caregiver, which was the only determinant that displayed an association with provider-patient communication (AOR 1.55, Confidence interval (CI) 95% 1.16–2.08)
Summary
Patient satisfaction is an important measure of quality of care and a determinant of health service utilisation and the choice of health facility. Measuring patients’ experiences is important for understanding and improving the quality of care at health facilities. Quality of care is about the medical quality of clinical care, and includes patient experience [2]. Medical quality applies to the use of clinical knowledge and method to solve a health problem, whereas patient experience relates to the responsiveness of the health system to fulfil non-health needs and meet expectations. Patient experience is intrinsically linked to the clinical care received and associated with better health outcomes [3, 4], as satisfaction has a strong relationship to patients’ adherence to medication and other interventions. Information on patient satisfaction can assist in identifying system problems like gaps in coordination and communication
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