Skip to main content

Lund University Publications

LUND UNIVERSITY LIBRARIES

The nurse did not even greet me' : How informed versus non-informed patients evaluate health systems responsiveness in South Africa

Hompashe, Dumisani MacDonald ; Gerdtham, Ulf-G LU orcid ; Christian, Carmen S ; Smith, Anja LU and Burger, Ronelle (2021) In BMJ Global Health 6(4).
Abstract

INTRODUCTION: Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients' experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction.

METHODS: Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using... (More)

INTRODUCTION: Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients' experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction.

METHODS: Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients' exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients' experiences of non-clinical dimensions.

RESULTS: We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers' explanations of health conditions.

CONCLUSION: Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.

(Less)
Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cross-sectional survey, health education and promotion, health policy, health systems evaluation, public health
in
BMJ Global Health
volume
6
issue
4
article number
e004360
pages
9 pages
publisher
BMJ Publishing Group
external identifiers
  • pmid:33893142
  • scopus:85105080907
ISSN
2059-7908
DOI
10.1136/bmjgh-2020-004360
language
English
LU publication?
yes
id
aaf57b2e-5c6e-4b1b-98d9-56dc2737851d
date added to LUP
2021-04-25 21:42:07
date last changed
2024-04-20 05:26:02
@article{aaf57b2e-5c6e-4b1b-98d9-56dc2737851d,
  abstract     = {{<p>INTRODUCTION: Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients' experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction.</p><p>METHODS: Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients' exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients' experiences of non-clinical dimensions.</p><p>RESULTS: We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers' explanations of health conditions.</p><p>CONCLUSION: Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.</p>}},
  author       = {{Hompashe, Dumisani MacDonald and Gerdtham, Ulf-G and Christian, Carmen S and Smith, Anja and Burger, Ronelle}},
  issn         = {{2059-7908}},
  keywords     = {{cross-sectional survey; health education and promotion; health policy; health systems evaluation; public health}},
  language     = {{eng}},
  number       = {{4}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{BMJ Global Health}},
  title        = {{The nurse did not even greet me' : How informed versus non-informed patients evaluate health systems responsiveness in South Africa}},
  url          = {{http://dx.doi.org/10.1136/bmjgh-2020-004360}},
  doi          = {{10.1136/bmjgh-2020-004360}},
  volume       = {{6}},
  year         = {{2021}},
}