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An Extensive Review of Patient Satisfaction with Healthcare Services in Bangladesh Patient Experience Journal Volume 7 Issue 2 Special Issue: Sustaining a Focus on Article 14 Human Experience in the Face of COVID-19 2020 An extensive review of patient satisfaction with healthcare services in Bangladesh Abdul Kader Mohiuddin Dr. M. Nasirullah Memorial Trust, [email protected] Follow this and additional works at: https://pxjournal.org/journal Part of the Health and Medical Administration Commons, Health Services Administration Commons, and the Health Services Research Commons Recommended Citation Mohiuddin, Abdul Kader (2020) "An extensive review of patient satisfaction with healthcare services in Bangladesh," Patient Experience Journal: Vol. 7 : Iss. 2 , Article 14. DOI: 10.35680/2372-0247.1415 This Research is brought to you for free and open access by Patient Experience Journal. It has been accepted for inclusion in Patient Experience Journal by an authorized editor of Patient Experience Journal. An extensive review of patient satisfaction with healthcare services in Bangladesh Cover Page Footnote I’m thankful to Dr. Mamun Rashid, Assistant Professor of Pharmaceutics, Appalachian College of Pharmacy Oakwood, Virginia for his valuable time to audit my paper and for her thoughtful suggestions. I’m also grateful to seminar library of Faculty of Pharmacy, University of Dhaka and BANSDOC Library, Bangladesh for providing me books, journal and newsletters. This article is associated with the Policy & Measurement lens of The Beryl Institute Experience Framework. (http://bit.ly/ExperienceFramework). You can access other resources related to this lens including additional PXJ articles here: http://bit.ly/ PX_PolicyMeasure This research is available in Patient Experience Journal: https://pxjournal.org/journal/vol7/iss2/14 Patient Experience Journal Volume 7, Issue 2 – 2020, pp. 59-71 Research An extensive review of patient satisfaction with healthcare services in Bangladesh Abdul Kader Mohiuddin, Dr. M. Nasirullah Memorial Trust, [email protected] Abstract Patient satisfaction is a useful measure for providing quality indicators in healthcare services. Assessing patients’ satisfaction is important since it often helps, in absence of healthcare service quality indicators, to determine the quality of health-care delivery and health system responsiveness. Higher levels of patient satisfaction indicate higher levels of patient empowerment, commitment to care and compliance to recommended management–all of which results in better health outcomes. Concern over the quality of healthcare services in Bangladesh has resulted in a loss of faith in healthcare providers, low utilization of public health facilities, and increased outflows of patients from Bangladesh to hospitals abroad. The main barriers to accessing health services are inadequate services and poor quality of existing facilities, shortage of medical supplies, the busyness of doctors due to high patient load, long travel distance to facilities, and long waiting times once facilities were reached, very short consultation time, lack of empathy of the health professionals, their generally callous and casual attitude, aggressive pursuit of monetary gains, poor levels of competence and, occasionally, disregard for the suffering that patients endure without being able to voice their concerns—all of these service failures are frequently reported in the print media. Such failures can play a powerful role in shaping patients' negative attitudes and dissatisfaction with healthcare service providers and healthcare itself. The Ministry of Health and Family Welfare plans and implements the public healthcare delivery through various healthcare infrastructure, from national to the community level. Keywords Doctor consultation length, patient waiting time, quality of future doctors, rural health facilities, Bangladesh, hospital avoidance during COVID-19 crisis, COVID-19, patient satisfaction, patient experience Introduction authorities address complaints and disputes independently, without involving the government or legal entities.11 Bangladesh, a South Asian low-middle-income economy, Bangladesh's post-disaster management is inadequate due has experienced a demographic and epidemiological to a lack of adequate compensation, inadequate or transition with rapid urbanization and a gradual increase in inaccessible health care facilities and the slow rehabilitation life expectancy.2 It is the seventh most populous country process to accommodate disaster survivors within the in the world and population of the country is expected to mainstream society. Joint survey of the Power and be nearly double by 2050.3 The rising burden of non- Participation Research Centre and BRAC Institute of communicable diseases (NCDs) in Bangladesh can be Governance and Development (PPRC-BIGD Rapid related to rapid urbanization, and nearly 50 percent of the Response Survey) reveals that per capita daily income of country's slum dwellers live in Dhaka.4,5 According to the urban slum drops by 82%, rural poor by 79% due to 2018 Country Environmental Analysis (CEA) report of the present countrywide shutdown enforced by the World Bank, air pollution causes the deaths of 46,000 government to halt the spread of Covid-19. More than people in Bangladesh per year.6 Less than 10% hospitals of 50% urban and 36% rural population took loans to meet this country follow the Medical Waste Management the daily expenses.12 Policies.7 In 2017, 26 incidents of disease outbreak were investigated by Institute of Epidemiology, Disease Control Discussion and Research (IEDCR).8 Out-of-pocket (OOP) treatment cost raised nearly 70% in the last decade.9 About 2/3rd of Methodology the total health expenditure is from OOP, and of this, Research conducted a year-round comprehensive literature 65% is spent at the private drug retail shops.10 There is search, which included technical newsletters, newspaper little assessment of the quality of provider care, low levels journals, and many other sources. The present study was of professional knowledge and poor application of skills. started at the beginning of 2019. PubMed, ALTAVISTA, Bangladesh does not have a formal body for arbitration of Embase, Scopus, Web of Science, and the Cochrane complaints against health providers. Hospital or clinic Central Register were thoroughly searched. The keywords Patient Experience Journal, Volume 7, Issue 2 – Special Issue: Sustaining a Focus on Human Experience in the Face of COVID-19 © The Author(s), 2020. Published in association with The Beryl Institute Downloaded from www.pxjournal.org 59 Patient Satisfaction in Bangladesh, Mohiuddin were used to search for different publishers’ journals such Doctors usually give little time, often less than one minute, as Elsevier, Springer, Willey Online Library, and Wolters to examine patients and mistreat them; fixated mind-set of Kluwer which were extensively followed. Medicine and hospital staff who overestimate their own performance, technical experts, representatives of pharmaceutical care little about the patients’ experiences and don’t know companies, hospital nurses and journalists gave their that patients’ satisfaction index is related to clinical valuable suggestions. Projections were based on patient outcome.17 experience, expectations, and reasons for dissatisfaction with the present healthcare facilities among Bangladesh’s Present Healthcare Situation population. Harvard Professor Sue Goldie credited Bangladesh with reducing child mortality by 80%, the highest in South Asia Implication of Medical Law and Ethics and targeting the reduction of the 1990 maternal mortality Unsurprisingly, death due to oversight of physicians or ratio by three quarters in the 2015-MDG5 target.18 medical laxity and doctors' incompetence have been According to WHO, the current doctor-patient ratio in reported in the media all the year-round. Laws such as the Bangladesh is only 5.26 to 10,000, which places the Penal Code 1860, Code of Criminal Procedure 1898, country second from the bottom, among the countries of Consumer Rights Protection Act, 2009 under which cases South Asia.19 According to the Bangladesh Medical and can be filed for legal remedies. In the event of death due Dental Council, there were 25,739 registered male doctors to medical laxity, cases may be filed under the penal code, in the country between 2006 and 2018 (47%) and 28,425 1860, as death by laxity is a criminal offence and is female doctors (53%).20 Average consultation length is punishable under section 304A of the penal code.13,14 used as an outcome indicator in the primary care There are also provisions for imprisonment and fine which monitoring tool which was found was found a less than a are equally applicable to both the doctors and the minute to an outdoor patient.5 An average 1.5 hours is to complainants. In the realm of therapeutic care, challenges spend to see a doctor in Dhaka Medical College and other are: public hospitals face no competition, have neither public hospital outdoors, sometimes there are no doctors built-in incentive system nor any culture to enforce due to post vacancy.21-23 Patients’ struggle for essential discipline and conduct rules and punish the recalcitrant; services during any disease outbreak in hospital indoor and there is no mechanism either to evaluate individual’s outdoor is common (Figure 1). Overall, 67% of the performance or that of any healthcare institution.15,16 healthcare cost is being paid by people, whereas global Figure 1. Patients’ struggle in a private medical college indoor during a pandemic situation
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