Abstract
BackgroundPatient satisfaction is an important factor for both assessing the quality of healthcare and predicting positive health outcomes. This study assesses the influence of HIV/AIDS patients’ perception of the quality of health services on adherence to antiretroviral treatment using the decentralized care model in Manaus, Brazil.MethodsWe conducted a non-randomized, cross-sectional analysis to explore the relationship between patient satisfaction and adherence to antiretroviral treatment (ART) in Manaus, Amazonas, Brazil. We also compared patient satisfaction levels at the city’s main hospital with those at smaller health units established to decentralize HIV/AIDS healthcare. Using survey responses from 812 patients and health data from 713 patients, we conducted descriptive and regression analyses to identify health center characteristics associated with higher patient satisfaction and higher adherence to treatment.ResultsWe found a clear and positive relationship between patient satisfaction with the quality of health services and adherence to ART. Patients who had better access to their health center and its services –mainly in the form of convenient location, shorter commute times, and shorter wait times— tended to rate the quality of services higher and were also more likely to adhere to ART. We also found higher levels of patient satisfaction and adherence to ART among patients served at decentralized health units than among patients served at the main hospital.ConclusionsThe study’s results emphasize the importance of patients’ experience at the health center for improved health outcomes. While many of the factors that play a role in whether a patient adheres to ART or not are beyond the control of the health center, our findings highlight that health centers can importantly contribute to increased ART adherence by improving such experience. The study also showcases the potential benefits of decentralizing HIV care to increase patient satisfaction and, with it, adherence to ART.
Highlights
Patient satisfaction is an important factor for both assessing the quality of healthcare and predicting positive health outcomes
Patients who had better access to their health center and its services tended to rate the quality of services higher and were more likely to adhere to antiretroviral treatment (ART)
After controlling for several patient and health center characteristics, patients who rated the overall quality of services as “excellent” were nearly two times more likely to adhere to ART than patients who were less satisfied or not satisfied at all with the services
Summary
Patient satisfaction is an important factor for both assessing the quality of healthcare and predicting positive health outcomes. This study assesses the influence of HIV/AIDS patients’ perception of the quality of health services on adherence to antiretroviral treatment using the decentralized care model in Manaus, Brazil. Patient satisfaction with health services has been found to be an important factor in assessing the quality of healthcare It has been associated with increased adherence to treatment, utilization of health services, continuity of care, and even improved health conditions [1,2,3]. In an effort to improve the delivery of HIV/AIDS healthcare services in the city of Manaus, the capital city of the Brazilian state of Amazonas, the Brazilian Ministry of Health (MoH) developed a plan to decentralize HIV/AIDS patients from Manaus’ only reference hospital, the Fundação de Medicina Tropical (FMT), to several smaller specialized health units (SAEs for their acronym in Portuguese) with the capacity to provide HIV/AIDS care. While many factors influencing a patient’s adherence to ART are beyond the control of the health center, the results of this manuscript enlarge the available literature by identifying health center characteristics that can importantly contribute to increased ART adherence through enhanced patient satisfaction
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