Impact of socioeconomic status on patient experience on quality of care for ambulatory healthcare services in tertiary hospitals in Southeast Nigeria

Henry E Aloh,Obianuju G Aloh,Chijioke Joel Nweke,Obinna E Onwujekwe,Ijeoma L Okoronkwo

doi:10.1186/s12913-020-05332-0

Henry E Aloh, Obianuju G Aloh + Show 3 more

Open Access

https://doi.org/10.1186/s12913-020-05332-0

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Abstract

BackgroundTo determine how socioeconomic factors, such as level of education and employment status, affect patient experiences on quality of care for ambulatory healthcare services in teaching hospitals in southeast Nigeria.MethodsThe study is of a cross-sectional design and exit poll was used to collect its data. A pre-tested structured questionnaire was administered to clients accessing care in the outpatient departments of three tertiary hospitals in Nigeria. The assessment of patient experiences for quality of care was based on five (5) domains of care: waiting time; environment of the outpatient department; quality of doctor’s care; quality of care by nurses/other health workers; and responsiveness of care. In addition, the overall quality of care was assessed.ResultsThe mean rating of patient experience for quality of care for ambulatory healthcare services (outpatients’ care) was 74.31 ± 0.32%. Moderate differences were observed between the hospitals assessed for various levels of patients’ care, especially for waiting time, quality of doctors’ care and overall quality of care. Employment status was a statistically significant (p ≤ 0.05) determinant of overall patient experience rating for quality of care, while the level of patient’s education was an influence on the perception of waiting by the patients and their rating of care from nurses/other healthcare providers (apart from medical doctors).ConclusionThe study showed that educational and employment status (measures of socioeconomic status) of patients determined how patients receiving ambulatory (outpatient) healthcare services perceived the quality of care in the hospitals. Hence, in order to ensure equity, there is need to institutionalize patient-centered care, while full consideration is given to the patients’ socioeconomic status.

Highlights

To determine how socioeconomic factors, such as level of education and employment status, affect patient experiences on quality of care for ambulatory healthcare services in teaching hospitals in southeast Nigeria
The present study focused on how socio-economic factors represented, in the context of this study, by level of education and employment status of outpatients affect Patient experience (PE) on quality of care
The present study showed that employment status, and not level of education, had direct significant association with patients’ rating for overall quality of care

Summary

Introduction

To determine how socioeconomic factors, such as level of education and employment status, affect patient experiences on quality of care for ambulatory healthcare services in teaching hospitals in southeast Nigeria. The health sector targets often relate to traditional hospital functions such as diagnosis, outpatient treatment and inpatient care Outpatient services are those hospital services that do not require an overnight stay and may include care such as diagnostic tests, prescriptions or simple treatment/procedures [3]. These services are offered on ambulatory basis, and they account for the majority of patient-medical professional encounters than any other hospital services (approximately four times than that of inpatients). Patient experience (PE) evaluates what happens at the point of contact between the patient, the practice, and the provider [5] It captures health system responsiveness, including the manner and environment in which people are treated when they seek healthcare [6]. It includes sufficient information and education of the patient, coordination of care, physical comfort, emotional support, respect for patient preferences, involvement of family and friends [4]

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