A Measurement Of Patient Experiences In Private Hospitals In Saudi Arabia

Abstract

In health care practice, patient experiences and satisfaction are been utilized as a measure of the quality of the services. This measure is used by the health care providers and other relevant authorities to determine the quality of care and the areas of improvement. In Saudi Arabia, the measurement of patient experiences is being conducted both in the private and public sectors.

This research aims to determine how patients' experience and satisfaction impact their perception of the quality of health care and services. The study was carried at a private hospital in the Kingdom of Saudi Arabia. A sample size of 211 patients was chosen and questionnaires were utilized for the data collection. After data was obtained it was analysed b aid of SPSS.

The measurement of patient satisfaction was categorized in experiences of ease of access, moving through visit, nurse assistance, care provider, laboratory tests, pharmacy, radiology (X-ray) tests, and handling of personal issues. From the scores of each of the categories from the 211 patients, an overall assessment of patient satisfaction was determined to be 84.7 %.

The result of the patient experience and satisfaction of 84.7% is indicative of a better quality of health care. The study found that the level of patient satisfaction is influenced by the patient’s age, health conditions, and needs, past experiences, personal backgrounds, personality, and expectations.

Background

Quality of care is increasingly and continuously being recognized as important in health care. While a range of measures are used by doctors, health caregivers, policymakers and patients themselves to evaluate the quality of service rendered in hospitals, patient experience is the most commonly used, even preferred (Alyasin and Douglas, 2014). From these experiences, the resulting satisfaction becomes one of the key mechanisms or measures health care providers use to assess the quality as well as the outcome of their services. Besides being important by itself, patient satisfaction has also been termed as an indicator of quality care in most developed countries as it has been found to contribute to the improvement of health care strategies, as well as their services and delivery (Abalos-Fabia et al., 2016).

The past three decades have seen an increased improvement in terms of healthcare access in the Kingdom of Saudi Arabia. With this improved access, however, came several challenges for the various stakeholders in the healthcare industry. These challenges have brought about the need to improve the quality of medical and healthcare services, a need that has become rather so axiomatic. In order to ensure and promote better medical services and care for their patients and meet the standards for accreditation, Saudi Arabian hospitals and other health care centres have adopted different methods over the years. With the adoption of different methods aimed at improving quality comes the need to apply the same methods at all levels and sectors of healthcare in order to achieve the required quality, effectiveness and efficiency. It therefore goes without saying that the evaluation of patient satisfaction is a very crucial element that can be used to identify areas that need to be improved on, so as to deliver high quality health services in an optimal manner. As such, having quality as a priority and placing it higher on the agenda will go a long way in improving quality not only in hospitals in Saudi Arabia, but in any hospital anywhere. To achieve this, numerous monitoring and evaluation and improvement methods will have to be engaged.

Literature Review

To access medical care and services in the Kingdom of Saudi Arabia, patients can go through either if the two routes: they can use public health care centre services first before being referred to secondary care centres, or they can seek services at emergency department (commonly referred to as ED) while bypassing primary health care centres and later on seeking further secondary care at outpatient clinics.

This study will look at the quality of services in health care centres from the perspective of the patients while considering the likely differences between satisfaction and experience of the patients (Alyasin and Douglas, 2014). Patient satisfaction is a reflection of the patients’ experience as they seek medical services and it is closely linked to the outcomes of treatments, while also being used as a way of measuring the quality of health care services. Several previous studies conducted all over the world have proved the usefulness of patient experience and satisfaction, as well as the benefits that they offer. Whereas experience will focus on what the patient experiences (or does not experience) while interacting with care givers (Berkowitz, 2016), patient satisfaction will evaluate the patient’s overall perceptions of their experience(s) (Batbaatar et al., 2017).

If the health care services and quality offered to the patient do not meet the standards expected by the patient, patient dissatisfaction will occur. When their experience of the services offered provide the patients with sufficient information on their condition and treatment, meet their needs or exceed their expectations there will be patient satisfaction (Senitan et al.,2018). Previous studies have shown that patients that record high satisfaction levels were more likely to have their treatment benefit them. In this way, patient satisfaction brings about the aspect of success of treatment among other benefits such as: adherence to the health care procedure and plan by patients, improved medical results, reduced medical costs and expenses as a result of lesser visits to doctors, reduced hospitalization and minimization of the frequency with which untoward medical outcomes occur. A number of recent studies have shown that patient satisfaction also leads to the patients complying with health advice and follow ups (Kumah, 2019). It is therefore expected that this study will post similar results, in the case of the Kingdom of Saudi Arabia.

Factors Influencing Patient Experiences

According to (Alberto et al., 2014), various factors that have been found to relate to patient satisfaction include the patient’s age, their conditions, needs, past experiences, personal backgrounds, personality and expectations.

Under patient-doctor interactions component, there are aspects like communication and respect during the health service, the care provider’s courtesy or friendliness, the doctor listening to the patient, the doctor explaining to the patient their condition and course of action or medication, the doctor answering the patient’s questions and concerns or worries, inclusion of the patient in decision making by the doctor, advising the patient on the avoidance of future problems, giving the patient detailed instructions for their care at home and satisfaction of the treatment, and the patient’s confidence in the doctor. All these go along to satisfy the patient’s need for information. Previous studies have shown that the more information patients get from their health providers, the more satisfied they are likely to be (Batbaatar et al.2017; Kumah, 2019). Patients also rank this provision of information by their health care providers higher compared to other factors that contribute to patient satisfaction.

For the component of access and convenience, we focus on factors like: ease of getting the hospital on phone and scheduling an appointment, the convenience of the medical facility’s or office location, provision of convenient parking, office hours, information about any delays and the amount of time waited before seeing the doctor. A recent study had hypothesized that the amount of time a patient spent (whether scheduling an appointment or waiting for service) greatly contributed to overall patient satisfaction.

The quality time component will look at how long the patients waited before they saw the doctor, if the doctor spent sufficient time with the patients, and if the doctor addressed the patient’s concerns.

The person-focused care component will address factors including patient’s personal issues, facility’s and staff’s focus on patient safety, sensitivity to patient’s needs.

Under administrative efficiency and environment, factors that will come into play include; waiting time, comfort of the waiting area, availability of medication, level of service provided by the care giver, cleanliness levels of the facilities, availability of up-to-date facilities and recommendations given. The other global items will take into account the patient’s overall assessment of the care they got in the course of their treatment, how satisfied they were by the care they got from the doctors, if they will go back to the same facility or doctor and if they could recommend them to others.

The above components apply to outpatient patients.

It will, however, be difficult to measure patient satisfaction and medical systems responsiveness since patient satisfaction is influenced by not only clinical, but also non-clinical results of the care and services rendered.

Significance of the Study

The findings of this study will prove valuable to the manager of the private hospital as it will provide him with guidance on ways to improve the quality of their health services, and as a result, patient satisfaction as a measure or indicator of their quality.

Aim/Objectives

The aim of this research is to determine how the experience of patients will impact on their satisfaction and consequently, their perception of the quality of health care and medical services in a private hospital in the Kingdom of Saudi Arabia.

The purpose of this study will be to evaluate the overall satisfaction of patients who have received health care services at a private hospital in the Kingdom of Saudi Arabia. To do this, the study will focus on the experiences of the patients as they seek health care and medical services, the factors that affect the patient experience and the perception of the patients with regard to the quality of service they receive.

Methodology

For the purposes of ethics, the researcher will first have to get an ethical approval from the ethical committee of the University of Hail to undertake this study. The proposal used an analytical cross-sectional study of patients who provided their consent and agreed to participate. The cross-sectional study is crucial in that it enabled the researcher to conduct an unbiased evaluation of the impact of quality of care and patient experiences on their satisfaction (as perceived by the patients). Because patients are the only best viable source of data leading to information on their experiences while in pursuit of quick, stress free and quality medical care, we recruited 211 patients who had received treatment in a private hospital facility in the Kingdom of Saudi Arabia to participate in this study.

The study employed the use of conventional sampling technique to acquire the 211 participants of outpatient. A self-administered questionnaire was the most effective and efficient tool for collecting the needed information. One set of questionnaires, for outpatient was used. The questionnaires were in either English or Arabic, and can be completed in less than 15 minutes. The questionnaires were simple and easy to use. The data was developed in a way that enables it to know and evaluate the patient's satisfaction with the services provided by the hospital. Was in various matters and sections such as accessibility of medical care and the moving through visit and nurses/assistants, care providers, personal issues, the overall assessment, lab services conducted, radiology services (X-rays) conducted and pharmacy. The questionnaires were drafted with a 5-point response scale which ranges from 1 (Very Good) to 5 (Very Poor). 4 will represent ‘Good’, 3 ‘Fair’ and 2 ‘Poor’. A mixture of statements and questions, both positive and negative, was set so as to do away with the aspect of a standard way of answering. This required that the correspondents carefully read through each item before they respond. In order to have only relevant questions, a subset of respondents could be used to pilot test the questionnaires, after which questions deemed to be irrelevant to the study are dropped. The questionnaire was administered privately, with the researcher close by to offer guidance. Once all duly completed and the necessary data collected, version 21.0 of the SPSS was used to analyse the data. The data for categorical and quantitative variables was described through the use of descriptive statistics and will be presented in percentage and frequency forms. Pearson’s chi-square test will then be employed to analyse how the categorical variables’ distributions compare. To be considered significant, a variable need has to show a p-value that is 0.05 or less. Data for continuous variables is presented as mean and standard deviation. Mean satisfaction percentages is used as a way of estimating the general ranking of patients’ personal satisfaction ‘disciplines’ (components).

Results

The questionnaires was used in a manner such that it is able to evaluate the patient for satisfaction on various matters such as accessibility of medical care and services the moving through and nurse assistants , care providers , personal issues , the overall assessment , lab services conducted, radiology services (X-rays) conducted and pharmacy. The analysis of the above-mentioned parameters was expressed into five categories: very poor, poor, fair, good and very good. The questionnaires were also be drafted with a 5-point response scale which ranges from 1 (Very Good) to 5 (Very Poor). 4 will represent ‘Good’, 3 ‘Fair’ and 2 ‘Poor’. The present study used a cross-sectional study design of patients who had given their consent and had agreed to participate. The patient response was obtained through the self-administration questionnaire for the evaluation of the outpatient data. The questionnaire of the study was both in English and Arabic language and took 15 minutes to solve. The reason for keeping both the language is to provide uniformity in the study and to the patients. Varied ranges of parameters, as evident from the literature review of the study, were included in the questionnaire. The findings of the study were analysed using the version 21.0 of the SPSS. The categorical and quantitative variables were described through the use of descriptive statistics and therefore presented in the forms of percentage and analysis.

Among the survey questions was "Is this your first visit to this hospital?" Patient data indicated that 130 of the 211 patients visited the hospital "for the first time". As for the rest of the patients, it was not their first visit and they had previous visits and they totalled 81 patients.

Figure 4: A total of 211 patients gave response through the paper mode. The result for the patients’ satisfaction out of 211. The access item measures how easy it was for the patient to schedule his or her visit to the doctor’s office. It was achieved by 87.3%. The moving through visit achieved was 78.7% which measures patients’ perceptions of the amount of time spent at the hospital from arrival to departure. Nurse/ assistants achieved 83.4% it is that how well the nurse or nursing assistant showed concern when responding to problems presented by the patient and also the quality communication. Care providers were achieved by 86.2% this part assesses how well the care provider shared information about the illness, symptoms, or medical problems. Personal issues question addresses confidentiality and physical privacy. Perceptions of privacy are influenced by staff actions—including attitudes and the manner in which these actions are taken, it was achieved by 86.1%. Regard to laboratory tests procedures were achieved were 85.4%, radiology procedures (X-rays) were achieved by 82.8% and pharmacy were achieved 84.8%. Overall assessment a patient’s judgment on this question likely depends on the issues and qualities measured by the rest of the care provider questions on the survey. Because of this, it is often considered an outcome measure; the overall assessment achieved was 85.2%. The analysis of the above-mentioned parameters was expressed into five categories: very poor, poor, fair, good and very good. The data were expressed in the form of pie charts and bar charts.

Discussion

The above study is a cross-sectional one and used the conventional way of sampling to acquire from 211 patients. The patient response was obtained through the self-administration questionnaire for the evaluation of the outpatient data. The satisfaction levels were expressed as Very Good, Good, Fair, Poor, Very Poor with each being represented by values 1 to 5 respectively. The sample had 36% male and 64% female with the majority (71%) aged between 18 and 49 years. Among the 211 participants, 130 (62%) had visited the hospital for the first time during the time of the study. 48% of the first-time patients were males while 52% were females. From the results, the sample had 36% male and 64% female with the majority (71%) aged between 18 and 49 years. Among the 211 participants, 130 (62%) had visited the hospital for the first time during the time of the study.

The overall score of the patient was found to be very good (84.7%). Similarly, other categories results of the analysis of the access 87.3%, moving through visit 78.7%, nurse/assistant 83.4%, care providers 86.2%, personal issues 86.1%, overall assessment 85.2%, lab 85.4%, radiology 82.8%, and pharmacy were all rated good or very good.

The ease of access to the hospital scored the highest (87.3%) while moving through visit the lowest with 78.7%. These scores can be justified by the strategic location of the hospital, quality reception, and crowded corridors in the hospital due to the high number of patients. The quality of the care providers also scored high (86.2%). Being a private hospital, this was expected as the private health care providers generally offer quality and excellent service to the clients.

There was a high correlation between the results of the individual to their age, health conditions, gender, and past encounter with the hospital. The first-time patients' scores were high in all categories. This could be because their answers on categories of the services they had not received such as radiology and nurse assistant were based on perceptions. Further, female scores were slightly higher in overall compared to those of their male counterparts. It was evident that patients who had health conditions that incorporated inpatient services and long hours in the hospital scores were lower compared to their counterparts

Conclusion

The above study was conducted with aim to investigate the overall satisfaction of patients who have received health care services in a private hospital in the Kingdom of Saudi Arabia. Therefore, the study had focused on the experiences of the patients as they seek health care and medical services, the factors that affect the patient experience and the perception of the patients with regard to the quality of service they receive. The various factors that influence the patient satisfaction level were the patient’s age, their conditions, and needs, past experiences, personal backgrounds, personality and expectations. The study findings are in agreement with other which studies have also correlated the patient satisfaction parameter with the beneficial services that are provided in the hospital and based on the overall experience of the patient in regards to the benefits that have been provided. In the present study a varied range of parameters have been analysed to assess the satisfaction level of the patients and most of the parameters reported “very good” in their frequency analysis. The researchers got the ethical permission for conducting the study from the ethical committee of the University of Hail. The study used a cross-sectional study design of patients who had given their consent and had agreed to participate. The cross-sectional study was crucial in that it had enabled the researcher to conduct an unbiased evaluation of the impact of quality of care and patient experiences on their satisfaction (as perceived by the patients). At last, it can be concluded that the findings of the study proved to be beneficial to the administration section of the hospital as they would be able to evaluate their service and can also perform better in future to improve the present condition so that the quality of care service can be enhanced.

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