Assessment of the patient satisfaction level with outpatient department services in a tertiary care hospital of Jammu region

INTRODUCTION

Outpatient department (OPD) is termed as “Shop-Window of the Hospital”.¹ Patient satisfaction is one of the important goals of any health system.² It depends on many factors such as: quality of clinical services provided, availability of medicine, behavior of doctors, cost of services, hospital infrastructure, physical comfort, emotional support, and respect for patient preferences. Mismatch between patient expectation and the service received is related to decreased satisfaction. So, assessing patient perspectives gives them a voice, which can make public health services more responsive to people's needs and expectations.³ Other factors also have been shown to influence patient’s satisfaction with health care services which include patient’s socio-demographic characters, physical health status, patient’s personal understanding and expectations from various health care services. The general physical appearance of the hospital, as well as the general environment of the premises, also influences the overall satisfaction of the client.⁴

Healthcare service quality depends on personal factors of the healthcare service provider and the patient and factors pertaining to the healthcare organization and broader environment. Differences in internal and external factors such as availability of resources and collaboration and cooperation among providers affect the quality of care and patient outcomes.⁵

Objectives

Objective of the study was to assess the level of patient satisfaction with OPD services in a tertiary-care hospital in Jammu city of Union Territory (UT) of Jammu and Kashmir (J&K), India.

METHODS

The present cross-sectional study on patient satisfaction was conducted among patients who were availing OPD services in a tertiary care teaching hospital in Jammu city of J&K, India. The tertiary care teaching hospital has four OPD blocks viz., dermatology, obstetrics and gynaecology, ear nose and throat (ENT) and paediatrics. The study period was three months from 01 January 2023 to 31 March 2023.

The study was conducted four days in a week and a minimum of 20 patients were interviewed on a daily basis. Thus a total of 1040 patients were registered during the study period. Due permission was sought from institutional ethical committee (IEC) GMC Jammu before the conduct of the present study. After availing the OPD services the patients were approached and informed about the purpose of the study. Those willing to respond were interviewed after taking the informed written consent. The patients were administered, a pre-structured questionnaire after obtaining socio-demographic information from study subjects. Information was sought about following parameters i.e., cleanliness, doctors behaviour, staff behaviour, public utility services and waiting time. The answer was captured on a Likert scale (1-dissatisafied, 2-mild satisfied, 3-satisfied) and the score was used to calculate the overall satisfaction.

Inclusion criteria

All the adult persons who were attending the OPD and willing to participate in the study were included whereas in case of children their parents were included.

Exclusion criteria

Patients who were advised admission after OPD consultation and were in need of immediate health care were excluded.

Data analysis

The data collected was entered into the excel sheet and was represented as ratios and proportions. Responses about satisfaction from the respondents were categorized on the basis of Likert scale with 1 indicating lowest satisfaction score and being “dissatisfied”, 2 indicating the “mild satisfaction”, however 3 indicating the highest satisfaction score and being “satisfied”.

RESULTS

Table 1 represents total OPD patients registered in the months of January, February and March 2023. Gyneacology OPD recorded a total of 30439 patients, while dermatology recorded 19392 patients in these three months.

Among the 1040 sampled patients at SMGS Hospital in Jammu majority (61%) were female and more than half (56%) were married. Two third (62%) belongs to rural area and majority (79%) were literate, while (43%) were visiting the hospital for the first time (Table 2).

Table 3 represents levels of satisfaction among respondents regarding various parameters while availing services from OPD.

Figure 1 shows the average percentage of total satisfaction score reached 68.13% with a corresponding mild dissatisfaction score of 11.00%, while the average percentage of total dissatisfaction score stood at 20.87%.

DISCUSSION

Quality in healthcare is a product of cooperation between the patient and the healthcare provider in a supportive environment. Healthcare service quality depends on personal factors of the healthcare service provider and the patient and factors pertaining to the healthcare organization and broader environment. Differences in internal and external factors such as availability of resources and collaboration and cooperation among providers affect the quality of care and patient outcomes.⁵

The results of the present study revealed 68.13% as total satisfaction score which was more or less in agreement with that reports by Kulkarni et al.⁶ A similar study was conducted in outpatient department in a tertiary care teaching hospital, AIIMS, Bhubaneswar 84% of patients are satisfied with the cleanliness of the OPD.⁷ However in contrast, Jawahar et al in their study reported a higher rate of satisfaction (95%) with the services offered in the OPD of the concerned hospital.¹

Patients were satisfied with the time given for discussion with consultant doctor and doctor's explanation about the treatment as well as procedures that would be done; thereby clearing their doubts and 80.99% of patients had full confidence and trust upon the consultant. Patient satisfaction is a key important parameter for evaluating the quality of patient care services being delivered by Health care organization. Satisfaction regarding the attitude of providers towards these services is expected to affect treatment outcome and prognosis. Patient satisfaction is thus, a multidimensional concept and a subjective phenomenon that is related to patient expectation and perception.⁸ During the present study, a variety of reasons were found to be responsible for the sense of satisfaction among the respondents. The most important factors regarding satisfaction in the present study were good doctor behavior, availability of medicines, cleanliness in the hospital premises and provision of clean drinking water in each of the four OPD areas. Further analysis of results revealed that amenities like fan and electricity, availability of refreshment counters besides comfortable seating arrangements in the OPD waiting area were among other reasons for a high satisfaction rate among the respondents in the present study.

Good signage system and easy accessibility provide a good image for the health institution but satisfaction was found to be lower regarding staff behavior and waiting time in OPD. Since SMGS hospital is a tertiary care hospital and caters to all the district of Jammu province, the queues in the OPDs are usually too long and hence the prolonged waiting time for patients.

In this study, 81.24% of the patients were satisfied with the cleanliness of the OPD, however 11.10% of patients expressed further need to improve the cleanliness of OPDs and 7.66% of the patients expressed that the OPD areas were not cleaned properly. The better cleanliness could be due to sufficient and trained class IV staff in hospital. A similar study was conducted in outpatient department of tertiary care hospital, Jabalpur, Madhya Pradesh, India which indicated that 70% of patients are satisfied with the cleanliness of the OPD.⁹

Another similar study was conducted in outpatient department measuring OPD patient satisfaction with different service delivery aspects at public hospitals in Pakistan, findings confirmed that services provided by doctors and nurses emerged to be significant factors that influence patient satisfaction with healthcare service delivery in Pakistan.¹⁰

The present study shows a low level of satisfaction regarding Waiting time, however there is high level of satisfaction in cleanliness, doctor's behavior, staff behavior and public utility services.

Limitations

As the study is being conducted in only one hospital with limited number of OPDs, generalization of the study finding was limited. Period of time is limited for the study project.

CONCLUSION

Overall study showed that the patients are satisfied with OPD services obtained from this tertiary care SMGS hospital Jammu. OPD services in a hospital need to be improved by getting patient feedback and reducing the waiting time. The study found that patients are satisfied with doctor's behavior, Public utility services and cleanliness but however patients are least satisfied with waiting time at registration counter. The findings of the study will help us to educate the staff about improving their behavior and registration which will go a long way to develop a consistent relationship between the providers and the beneficiaries.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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