Abstract

Outpatient departments (OPDs) need to monitor the quality of care and patient satisfaction for continuous quality improvement. Additionally, there is a need for an increase in focused literature on patient satisfaction and quality of health care at a tertiary care level. The purpose of this paper is to attempt to fulfil this need. A cross-sectional hospital-based study among OPD patients was undertaken, where investigators conducted interviews with 120 patients at entry (registration), 120 patients at the OPD clinic (60 doctor-patient interactions and 60 exit interviews), and a further 120 patients at investigation facilities. Patient satisfaction, client convenience facilities, prescription quality, doctor-patient interaction and other quality elements as described in the study were given score of 0 or 1. At exit, 52 (86.6 percent) patients were satisfied with the OPD care. The mean total quality score was 80.9 percent of the total scores. It was above 90 percent of the total score for patient convenience facilities and for doctor-patient interaction, 76 percent for the prescription quality of the doctors and 43.3 percent for signage display. The mean score for patient-doctor interaction was found to be significantly lower (3.6/5) among dissatisfied patients compared to the satisfied patients (4.7/5). Satisfied patients reported a significantly higher consultation time (12.4 minutes) with a doctor compared to dissatisfied patients (8.5 minutes) (p = 0.04). Not using a Likert scale to measure patient satisfaction could be considered a limitation However, the authors also arrived at similar conclusions with their tools as with the use of Likert scales in other studies. Furthermore, findings are limited to medicine and surgery general OPDs in a tertiary care setting. Any interpretation beyond this frame may be done with caution. Hospitals should encourage good patient-doctor interaction as it has emerged as the key factor associated with patient satisfaction. Quality improvements in public sector health institutes can lead to better utilization of health care by the poor and compromised sections of society and can lead to a reduction in the inequity associated with health care. This paper fulfils the need to evaluate quality of hospital care in public sector hospitals at the tertiary care level. The methods and tools used are simple and extensive enough to capture information at multiple service points.

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