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Panganiban JMS, Loreche AM, De Mesa RYH, Camiling-Alfonso R, Fabian NMC, Dans LF, Galingana CLT, Lopez JFE, Casile RU, Aquino MRN, Rey MP, Sanchez JT, Javelosa MAU, Tan-Lim CSC, Marfori JRA, Paterno RP, Dans AL. Promoting equitable and patient-centred care: an analysis of patient satisfaction in urban, rural and remote primary care sites in the Philippines. BMJ Open Qual 2024; 13:e002483. [PMID: 38448041 PMCID: PMC10916135 DOI: 10.1136/bmjoq-2023-002483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 02/28/2024] [Indexed: 03/08/2024] Open
Abstract
OBJECTIVES This study measured changes in patient satisfaction levels before and after the introduction of primary care system strengthening interventions in urban, rural, and remote sites in the Philippines. METHODS A previously validated 16-item questionnaire was distributed to 200 patients per site before implementation of interventions and to a different set of 200 patients 1 year after implementation. We compared the percentage change in highly satisfied patients per site before and after implementing interventions using a two-proportion Z-test. RESULTS The urban site had a significant increase in patient satisfaction in 13 survey items, which corresponded to the domains of healthcare availability, service efficiency, technical competency and health communication. The rural site had a significant increase in six survey items, which corresponded to the domains of service efficiency, environment, location, health communication and handling. The remote site had a decrease in patient satisfaction in 10 survey items, with a significant increase in only 4 items under the domains of healthcare availability and handling. CONCLUSION Our findings support the 'inverse equity hypothesis', where well-resourced urban communities quickly adopt complex health interventions while rural and remote settings experience delays in effectively meeting patient needs and system demands. Extended intervention periods and targeted strategies may be necessary to impact patient satisfaction in underserved areas considerably.
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Affiliation(s)
| | - Arianna Maever Loreche
- National Clinical Trials and Translation Center, University of the Philippines Manila, Manila, Philippines
| | - Regine Ynez H De Mesa
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Romelei Camiling-Alfonso
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Noleen Marie C Fabian
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
- University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines
| | - Leonila F Dans
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
- Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines
| | - Cara Lois T Galingana
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Johanna Faye E Lopez
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Ray U Casile
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Maria Rhodora N Aquino
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Mia P Rey
- Department of Accounting and Finance, Cesar E.A. Virata School of Business, University of the Philippines Diliman, Quezon City, Philippines
| | - Josephine T Sanchez
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Mark Anthony U Javelosa
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
| | | | - Jose Rafael A Marfori
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
- Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines
| | - Ramon Pedro Paterno
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
| | - Antonio L Dans
- Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines
- National Institutes of Health, University of the Philippines Manila, Manila, Philippines
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Gaigl G, Täumer E, Allgöwer A, Becker T, Breilmann J, Falkai P, Gühne U, Kilian R, Riedel-Heller SG, Ajayi K, Baumgärtner J, Brieger P, Frasch K, Heres S, Jäger M, Küthmann A, Putzhammer A, Schneeweiß B, Schwarz M, Kösters M, Hasan A. The role of migration in mental healthcare: treatment satisfaction and utilization. BMC Psychiatry 2022; 22:116. [PMID: 35168572 PMCID: PMC8845273 DOI: 10.1186/s12888-022-03722-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
Migration rates increase globally and require an adaption of national mental health services to the needs of persons with migration background. Therefore, we aimed to identify differences between persons with and without migratory background regarding (1) treatment satisfaction, (2) needed and received mental healthcare and (3) utilization of mental healthcare.In the context of a cross-sectional multicenter study, inpatients and day hospital patients of psychiatric settings in Southern Germany with severe affective and non-affective psychoses were included. Patients' satisfaction with and their use of mental healthcare services were assessed by VSSS-54 and CSSRI-EU; patients' needs were measured via CAN-EU.In total, 387 participants (migratory background: n = 72; 19%) provided sufficient responses for analyses. Migrant patients were more satisfied with the overall treatment in the past year compared to non-migrant patients. No differences between both groups were identified in met and unmet treatment needs and use of supply services (psychiatric, psychotherapeutic, and psychosocial treatment).Despite a comparable degree of met and unmet treatment needs and mental health service use among migrants and non-migrants, patients with migration background showed higher overall treatment satisfaction compared to non-migrants. The role of sociocultural and migrant-related factors may explain our findings.
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Affiliation(s)
- Gabriele Gaigl
- Department of Psychiatry and Psychotherapy, University Hospital, Klinikum der Universität München, Ludwig-Maximilians University Munich, Nußbaumstraße 7, D-80336, Munich, Germany.
| | - Esther Täumer
- Department of Psychiatry and Psychotherapy, University Hospital, Klinikum der Universität München, Ludwig-Maximilians University Munich, Nußbaumstraße 7, D-80336, Munich, Germany
| | - Andreas Allgöwer
- Institute for Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Thomas Becker
- Department of Psychiatry II, Ulm University, BKH, Günzburg, Germany
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Klinikum der Universität München, Ludwig-Maximilians University Munich, Nußbaumstraße 7, D-80336, Munich, Germany
| | - Uta Gühne
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Reinhold Kilian
- Department of Psychiatry II, Ulm University, BKH, Günzburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | | | - Jessica Baumgärtner
- Department of Psychiatry, Psychotherapy and Psychosomatic, University of Augsburg, Medical Faculty, BKH Augsburg, Augsburg, Germany
| | | | - Karel Frasch
- Department of Psychiatry II, Ulm University, BKH, Günzburg, Germany
- District hospital Donauwörth, Donauwörth, Germany
| | | | - Markus Jäger
- Department of Psychiatry II, Ulm University, BKH, Günzburg, Germany
- District hospital Kempten, Kempten, Germany
| | | | | | | | | | - Markus Kösters
- Department of Psychiatry II, Ulm University, BKH, Günzburg, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatic, University of Augsburg, Medical Faculty, BKH Augsburg, Augsburg, Germany
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Laksono AD, Nantabah ZK, Wulandari RD, Khoiri A, Tahangnacca M. Barriers to Expanding the National Health Insurance Membership in Indonesia: Who Should the Target? J Prim Care Community Health 2022; 13:21501319221111112. [PMID: 35818670 PMCID: PMC9280783 DOI: 10.1177/21501319221111112] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: The Indonesian government initiated National Health Insurance (NHI) to reduce health service barriers. The study aimed to analyze specific targets for expanding the NHI’s membership in Indonesia. Methods: The study population was all populations in Indonesia. Meanwhile, the study involved a 47 644 weighted sample. The analyzed variables included NHI’s membership, residence, age, gender, education, employment, marital status, and wealth. The study employed binary logistic regression in the final step. Results: The urban population was 0.608 times less likely than the rural population to become a non-member of NHI. Aging younger was one of the barriers to becoming an NHI member, and the male gender is one of the barriers to becoming an NHI member. Meanwhile, the lower the education level, the greater the obstacles to becoming an NHI member in Indonesia. Besides, the unemployed population was 1.002 more likely than the employed population to become a non-member of NHI. The result shows that never married or married have a higher chance of becoming a non-member of NHI. Finally, all wealth status categories are more likely to become barriers to the most prosperous population becoming an NHI member. Conclusions: The study concluded that 7 population characteristics become specific targets for expanding NHI membership in Indonesia. The 7 characteristics are the population who live in rural areas, are young, male, poor education, unemployed, never married or married, and poor.
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Affiliation(s)
- Agung Dwi Laksono
- National Research and Innovation Agency, Republic of Indonesia, Jakarta, Indonesia.,The Airlangga Centre for Health Policy (ACeHAP), Surabaya, Indonesia
| | | | - Ratna Dwi Wulandari
- The Airlangga Centre for Health Policy (ACeHAP), Surabaya, Indonesia.,Faculty of Public Health, Universitas Airlangga, Surabaya, Indonesia
| | - Abu Khoiri
- Faculty of Public Health, Universitas Jember, Jember, Indonesia
| | - Minsarnawati Tahangnacca
- Faculty of Health Science, Syarif Hidayatullah Jakarta State Islamic University, Jakarta, Indonesia
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Alhozgi A, Feine JS, Tanwir F, Shrivastava R, Galarneau C, Emami E. Rural-urban disparities in patient satisfaction with oral health care: a provincial survey. BMC Oral Health 2021; 21:261. [PMID: 33992110 PMCID: PMC8122552 DOI: 10.1186/s12903-021-01613-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 05/06/2021] [Indexed: 11/17/2022] Open
Abstract
Background Identifying spatial variation in patient satisfaction is essential to improve the quality of care. Thus, the objective of this study was to investigate rural–urban disparities in patient satisfaction and to determine the factors that could influence satisfaction with oral health care. Methods Data from 1788 parents/caregivers of children who participated in the Quebec Ministry of Health clinical study were subject to secondary analysis. The Perneger model of patient satisfaction was used as the conceptual framework for the study. Satisfaction with oral health care was measured using the WHO-sponsored International Collaborative Study of Oral Health Outcomes (ICS-II). Explanatory variables included predisposing factors and enabling resources. Statistical analyses included descriptive statistics, as well as bivariate and linear regression models. Results Individuals with higher income, dental insurance coverage, having a family dentist, reporting ease in finding a dentist, and having access to a private dental clinic were more satisfied with oral health care (p < 0.001). There were statistically significant differences between rural and urban Quebec residents in their ratings of patient satisfaction on four items, including dental office location (p = 0.013), dental equipment (p = 0.016), cost of dental treatment (p < 0.001), and cleanliness of dental office (p = 0.004), with greater satisfaction for urban dwellers. The multiple linear regression model showed that major determinants of patient satisfaction were being born in Canada, income ≥ 40,000$ CAD, having a family dentist, and having visited the dentist in the last year for regular checkups. However, ethnicity, having difficulty finding a dentist, and being in need of dental treatment negatively influenced patient satisfaction with oral health care. Conclusions These findings suggest that Quebec rural–urban disparity exists in patient satisfaction with care and that determinants of health influence this outcome. Intensive and powerful knowledge dissemination activities are needed to mobilize policymakers in implementing public health strategies to reduce this disparity.
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Affiliation(s)
- Abdalgader Alhozgi
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada
| | - Jocelyne S Feine
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada
| | - Farzeen Tanwir
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada
| | - Richa Shrivastava
- Sri Aurobindo College of Dentistry, Sanwer Road, Indore, India.,Faculty of Dentistry, Université de Montréal, C.P. 6128, succursale centre-ville, Montreal, QC, H3C 3J7, Canada
| | - Chantal Galarneau
- Institut National de Santé Publique du Québec, 190 Boul Crémazie E, Montreal, QC, H2P 1E2, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada.
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