CHAPTER ONE

INTRODUCTION

1.1 Background of the Study

To ensure the high quality of future health systems and address the issues of chronic diseases, financial constraints on healthcare, and the rapid advancement of technology, patients must take a more proactive role in their health and in health policy. This will also advance the idea that patients are “co-producers” of their own health  [1]. The modern day patient is more aware and educated, has access to information, and has expectations from the health system. Hence, it is more important today than ever before to address issues related to service delivery in this context. A patient with positive perceptions has a greater chance of translating it into positive outcomes. Whereas, negative attitudes in the patient and dissatisfaction with health care provided leads to poor compliance and, in extreme cases, patients resort to negative word-of-mouth that discourages others from seeking health care from the system [2]. The transparency of healthcare activities and systems and the availability of reliable, independent and user-friendly information to patients should be optimized. Healthcare practices should be informed by feedback from, and communication with patients [3] .

The delivery of high quality healthcare services and patient satisfaction are therefore essential components of a well-functioning healthcare system. Patient satisfaction reflects the extent to which healthcare services meet or exceed patient needs. Quality in health services includes technical (clinical) quality and functional (non-clinical) quality. The former focuses on the skills, accuracy of procedures and medical diagnosis while the latter refers to the way that health services are provided to the patients [4]. Measuring patient satisfaction directly assesses the latter. Level of patient satisfaction is an internationally accepted factor, which needs to be studied routinely to complement other methods of quality assessment and assurance for smooth functioning of the health care system [5].

In the past, quality of health services was traditionally based on professional practice standards [5]. The process of clinical quality assessment was conducted without considering the viewpoints and feedback of patients; however, nowadays, emphasis is placed on the importance of patients’ views in assessing the quality of services, and mere reliance on clinical effectiveness is not much supported [4]. Nowadays, quality assessment studies usually measure one of three types of results: medical results, costs, and client satisfaction. For the last mentioned, clients are asked to assess their satisfaction with the services delivered not their health status after receiving care [6].

Patient-reported outcome measures (PROM) and Patient-reported experience measures (PREM) are the two common measures used to assess a patient’s opinion on the treatment process, care received and its associated factors. PROM captures specific aspects of treatment outcome, while PREM captures information on a patient’s view of their health service experience. It aims at providing direct feedback to healthcare providers with the intention of improving the system and achieving integrative care [7].

Many public health researchers have, over the past years, shown a lot of interest in measuring the performance of health systems provoked by the rising cost of caring for an ever-increasing population of countries, growths in medical innovations and technology [8]. Studies suggest that further research on the determinants of satisfaction and the relationship between quality and satisfaction among patients is recommended, due to the fact that a large number of studies have addressed the detection of patient satisfaction determinants, yet the results are still vague and inconclusive [9]. In developed countries, healthcare providers and researchers use patient experience and satisfaction levels for general, indication-based, and disease-specific patient feedback as tools to improve patient centered healthcare or due to requirements by government or other regulatory authorities to conduct patient surveys on a regular basis [7]. Encouraging healthcare providers to consider patient feedback and address identified issues and is the most effective strategy to guarantee that services achieve objectives [10].

Studies indicate that a satisfied patient complies with the medical treatment prescribed, service provider recommendation, and continually using medical services at a specific health provider, which might result in improved attendance at return visits and better outcomes with regard to the disease healing process, healthier and happier clients, who are contributing to the development of the country [5],[6]. Also, high patient-perceived quality is effectively and positively related to financial performance and profitability of healthcare institutions [4].

WHO highlights that getting the patients perspective on quality is among the six policy recommendations to improve quality of care [11].  Measuring patient satisfaction is therefore crucial for evaluating the effectiveness of health services, identifying areas for improvement, and ultimately enhancing the overall patient experience within a healthcare setting.

1.2 Research Problem

The health care system is a service based industry and customer satisfaction is of utmost importance just as in other service oriented sectors. The extent to which health care users are satisfied with their local providers may be a key factor underpinning their health behavior and health care utilization.

Among the variety of indicators that have been used to measure quality of health service delivery and to track its development over time, the recommended strategy for health care professionals at all levels is to routinely monitor patient satisfaction levels for improvement.

Despite the continuous effort to enhance the quality of healthcare services, the comprehensive understanding of patient satisfaction and its determinants in the Cameroonian context is limited. Dissatisfaction with health care services may lead to poor compliance and treatment outcomes. Therefore, information on the underlying factors associated with patient satisfaction may allow for a more targeted approach to improving the patient experience.

1.3 Research Questions

1. What is the level of patient satisfaction with health service delivery in the Buea Health District?
2. What are the key factors that contribute to patient satisfaction with health care services in the Buea Health District?
3. What are the patient’s perceptions on health service quality in the Buea Health District?

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