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Article-5: Patient’s Perceptions of The Quality Of Care At A Large Teaching Hospital Of Kashmir

Keywords:
Quality, perception, satisfaction, Structure, Process, Outcome, Content, Delivery, Customers, Organization, Evaluation, Expectation, Effectiveness, Efficiency, Optimality, Acceptability, Legitimacy, Equity, Amenities

ABSTRACT
Background : The range of perceptions of quality is limitless. Quality in Healthcare should include as assessment of structure, process and outcome. In recent years, the emphasis of quality assurance and quality improvement efforts has shifted from a structure and process orientation to an outcome.

Objective : To study inpatients’ profile and opinion about Quality care with special reference to the factors influencing their satisfaction or dissatisfaction with hospital services.

Study Design : The prospective observational study of 1 year duration at Inpatient Department of SKIMS.

Methods : 1 year study on the basis of ‘Exit Interviews’ carried out by simple random sampling in the inpatient wards of SKIMS w.e.f., 1 Jan.2011 to 31 Dec.2011. The standard questionnaire used to determine inpatients opinion was based on Likert Scale. Test-Retest Reliability Test of the interview schedule was performed. However, patients of chemotherapy on day care basis, children below the age of 12 years, and semiconscious or unconscious patients in ICU were excluded from the study.

Results : A total of 4800 patients were included in the study during year 2011 taking the sample size as 10%. Initially, the profile of inpatients including gender, dwelling, literacy, socioeconomic status, clinical specialty, age and length of stay were studied among these sampled inpatients. The average percentage of total satisfaction score among patients was 71.87% whereas 28.13% patients were found out to be dissatisfied with the hospital services. Using Chi-square test, p-value of each aspect of hospital services in view of satisfied or dissatisfied patients was evaluated by depicting their significant or insignificant values. Overall ranking of 45 different hospital services among questionnaire was conducted based on the top and gradually shifting to mildly satisfied with dissatisfied patients occupying the last positions at the bottom with least mean values.

Conclusion : Vital suggestions given by the patients and their attendants were tabulated. Major Recommendations for overcoming the shortcomings and improving the hospital staff and supportive services functioning were devised with an aim to take the quality services at SKIMS to new heights of perfection.

 

 

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