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Original Research DOI: http://dx.doi.org/10.4314/star.v5i1.10 ISSN: 2226-7522 (Print) and 2305-3372 (Online) Science, Technology and Arts Research Journal Sci. Technol. Arts Res. J., Jan-March 2016, 5(1): 69-75 Journal Homepage: http://www.starjournal.org/ Original Research Levels of Inpatient Satisfaction with Health Service Provision among Patients Admitted to Nekemte Referral Hospital, Nekemte, Ethiopia Tahir Hasen* Department of Nursing and Midwifery, College of Health Sciences, Wollega University, P.O. Box: 395, Nekemte, Ethiopia Abstract Article Information In health care services, satisfaction is a positive feeling of patients towards the health care Article History: provided to them. It is one of the methods of measuring quality of health care. Even if Received : 08-11-2015 satisfaction is a subjective concept, it is one of the most important factors to improve health care services. The health care systems in most developing countries suffer from serious Revised : 24-02-2016 deficiencies in financing, efficiency, equity and quality and are poorly prepared to meet these Accepted : 01-03-2016 challenges. The objectives of the study was to assess the level of inpatient satisfaction with health care provision among patients admitted to Nekemte Referral Hospital. An institution Keywords: based cross-sectional study was conducted on inpatient satisfaction with health care provision Inpatient among patients admitted to Nekemte referral Hospital from 27/10/2014 to 24/12/2014. Valid Waiting room and reliable questionnaires and in-depth interviews were administered to patients admitted to the hospital during the study period. A total of 422 respondents were participated in the study Levels of satisfaction with 38.6 mean ages and standard deviation of 14.7. The age ranges were 15-90 years. Western Ethiopia Protestant 229(54.3%) was the leading religion followed by Orthodox 121(28.7%). Oromo 362(86%) was the major ethnic group. The overall satisfaction of inpatients with health care Nekemte Referral Hospital provision was 148(35.1%). Patient satisfaction with the attractiveness of the physical structure *Corresponding Author: of the hospital were 242(57.3%), 224(53.1%) replied the hospital blocks were not sufficient, and 344(81.5%) replied the hospital compound was not neat, clear and planted with sufficient Tahir Hasen grasses and flowers, 283(67.1%) respondents answered the hospital lacks sufficient waiting rooms at each clinic. Most patients 387(91.7%) were interested to be visited by their relatives; E-mail: therefore, adequate time has to be allocated for visitors. Copyright@2016 STAR Journal, Wollega University. All Rights Reserved. [email protected] INTRODUCTION Consumer satisfaction is playing an increasingly A study in Mozambique on satisfaction with the important role in quality of care reforms and health-care outpatient health care services showed 55% satisfaction delivery more generally. However, consumer satisfaction rate and failure to receive prescribed medications was studies are challenged by the lack of a universally found to be the most common complaint associated with accepted definition or measure (Carr-Hill, 1992; Ross, lower satisfaction rates. Another study in the Tororo Stewart and Sinacore, 1995; Sitzia and Wood, 1997, district also concluded that the availability of drugs in the Crow et al., 2002; Hudak and Wright; 2000 and Sofaer, rural health facilities brought satisfaction not only to the Firminger, 2005) and by a dual focus: while some users, but also to the providers (World development researchers focus on patient satisfaction with the quality report, 2004). A study in Singapore hospitals also showed and type of health-care services received (Linder and that out of the total 300 respondents, 30(11.9%) rated the Pelz, 1982; Kane et al., 1997; Jackson, Chamberlin and service quality very good, 122 (48.4%) rated the service Kroenke, 2001 and Nguyen. Thi et al., 2002) others focus quality good, 70(31.0%) rated the service quality fair, on people’s satisfaction with the health system more 18(7.1%) rated the service quality poor and 4(1.6%) rated generally (Stewart, Stewart and Roter, 1989; Blendon et the service quality very poor (Peter and Berman, 2000). al., 2003 and Blendon et al., 1990 and European Commission, 2007). The importance of both perspectives A study on outpatient performance of a teaching has been demonstrated in the literature. For example, hospital in Gondar town showed 22.0% satisfaction rate satisfied patients are more likely to complete treatment (Mitike, Mekonnen and Osman, 2002). A study done at regimens and to be compliant and cooperative (Stewart, selected health facilities in six regions of Ethiopia depicted Stewart and Roter, 1989; Zapka et al., 1995). Research that the percentage for high mean score satisfaction with on health system satisfaction, which is largely health providers' characteristics ranged from 77.25% to comparative, has identified ways to improve health, 93.23%; with service characteristics 68.64% to 86.48%; reduce costs and implement reform (Blendon et al., 2003). and satisfaction with cleanliness ranged from 76.50% to 90.57% (Ministry of Health, 2003). A Peer-reviewed Official International Journal of Wollega University, Ethiopia 69 Tahir Hasen Sci. Technol. Arts Res. J., Jan-March 2016, 5(1): 69-75 Another study in Tigrai Zonal Hospitals found that the were expected to be greater than 10,000. The actual client satisfaction level with the outpatient departments in sample size was calculated using single proportion the zonal hospitals was 43.6%. Satisfaction was rated formula. highest with courtesy and respect by the health workers The formula to calculate the sample size was with 93.8% satisfaction rate. Dissatisfaction was rated highest by respondents with the lack of drugs and n = (zα/2)²p(1-p) = (1.96)²x 0.5(1-0.5) = 384 + 38= 422 supplies in the hospitals pharmacies with 64.9% reporting D² (0.05)² dissatisfaction (Dagnew and Zakus, 1997). In a survey On the sample size 10% contingency (38) were added, undertaken in private clinics in Addis Ababa, high rates of therefore, the total sample size was 422. satisfaction (64- 99%) were found in all aspects of medical care except affordability of service Charges (Mitike, Zα/2 =the confidence limits of the survey result (critical Mekonnen and Osman, 2002). Another study in Jimma value at 95% confidence interval of certainty) = (1.96); P= hospital showed 57.1% level of satisfaction with outpatient the proportion of study population to inpatient health services (Abebe et al., 2008). satisfaction= 50%; D= the desired precision of the estimate (the margin of error between the sample and In analyzing the quality of integrated healthcare, as a population (5%) and n= the total sample size (422). new form of care, 75% of the respondents were 'very satisfied' or 'rather satisfied' with the range of services In this study Nekemte hospital was selected to study offered within the opti-mum project. In addition, about inpatient satisfactions who were admitted at the time of 80% of the respondents would again participate in the data collection. The sampling technique selected for the project and recommend it. But the survey also study was probability sampling (stratified and systematic). demonstrated that there is potential for improving the The stratification was used to see all the wards and provision of information (Rundle-Thiele and Russell- systematic method was applied to collect data from each Bennett, 2010). ward using k=3. There are a total of 178 beds in the hospital. The total wards bed numbers were as follows: - There is lack of studies about level of inpatient (medical ward=45 beds, surgical ward=38, Obstetrics satisfaction with health service provision among patients ward=44 and Pediatrics ward=51 beds). The data admitted to Hospitals in western Ethiopia. Therefore, the contains quantitative and qualitative analysis. For aim of this study is to find out patient satisfaction with quantitative data, structured questionnaires were used health services and to explore the associated factors in and for qualitative, indepth-interview was applied. Nekemte Referral hospital. The inclusion criteria were patients who were voluntary MATERIALS AND METHODS to participate in the study, had no history of mental illness This study was conducted in Nekemte, Referral and were able to communicate. Mentally ill, critically sick, hospital found in Western Ethiopia, east Wollega zone, deaf and unconscious patients who were unable to Oromia region, 331 kms far away from Addis Ababa. It communicate were excluded from the study. has an altitude of 2045 meters above sea level. Nekemte town is the capital of east Wollega zone. It is divided in to The dependent variable is levels of inpatient six sub cities. The total population of the town is estimated satisfaction and the independent variables were to be 96,864 (CSA, 2000). sociodemographic variables, method and quality of care, confidentiality and privacy, condition of the rooms and The existing health facilities in the town include: one hospital structures. hospital, two health centers (both governmental), two NGO clinics, nine midlevel and 16 small private clinics, Valid and reliable structured questionnaires and in- five drug stores and supplies, seven pharmacies and five depth interviews were used to collect data from rural drug vendors. The town has got 24hours electricity respondents. Pre-test was done before the main study on and telecommunication services. Nekemte hospital is clients whose number were about 10% of the total established in 1932 by Sweden missionaries. It has eight respondents and not be included in the main study. For specialists, eleven general practitioners, 71 nurses, 9 qualitative data, in-depth interviews were used and video health officers, 8 laboratory technicians, 7 pharmacy recorded. For patients or their attendant who can read technicians, 2 sanitarians and 78 administrative staffs. Afaan Oromo and Amharic can fill the questionnaires by The hospital has 178 beds.
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