Assessment of outpatient satisfaction in Binh Dinh provincial general hospital in 2018

0000 VIETNAM NATIONAL UNIVERSITY, HANOI VIETNAM JAPAN UNIVERSITY NGUYEN NAM KHANH ASSESSMENT OF INPATIENT SATISFACTION IN BINH DINH PROVINCIAL GENERAL HOSPITAL IN 2018 MASTER’S THESIS BUSINESS ADMINISTRATION Hanoi, 2019 VIETNAM NATIONAL UNIVERSITY, HANOI VIETNAM JAPAN UNIVERSITY NGUYEN NAM KHANH ASSESSMENT OF INPATIENT SATISFACTION IN BINH DINH PROVINCIAL GENERAL HOSPITAL IN 2018 MAJOR: BUSINESS ADMINISTRATION CODE: 60340102 RESEARCH SUPERVISORS: ASSOC PROF DR VU ANH DUNG PROF DR HIROSHI MORITA Hanoi, 2019 ACKNOWLEDGEMENT First of all, I would like to give my sincere thanks to Vietnam Japan University, Yokohama National University, Japan International Cooperation Agency (JICA) with all the members, lecturers and assistants for giving me this opportunity to study and research in an international academic environment I have gained a lot of knowledge and experience through classes and seminars in Vietnam and Japan Secondly, I want to express my deep and sincere gratitude to my two supervisors, Associate Professor Vu Anh Dung, Vietnam Japan University and Professor Hiroshi Morita, Yokohama National University Their wide knowledge and critical thinking have given me motivation, confidence and value to my research They also encouraged and instructed me personally for my thesis I also want to thank Professor Matsui, Associate Professor Pham Thi Lien, Hanh sensei, Hino sensei for what all of you have done with VJU students You always support and share with us your valuable knowledge and experience To Huong san and IPO’s staff, YNU Thank you for your detailed caring to VJU students in Vietnam as well as in Japan Finally, I would like to thank my family, friends and colleagues who supported and encouraged me to finish my thesis Hanoi, 2019 Nguyen Nam Khanh i ABSTRACT Patient satisfaction is an important indicator used for measuring the quality of healthcare facilities Patient satisfaction has an effect on outcomes of medical service providers and reflects efficiency of provided services Therefore, patient satisfaction will be an effective indicator to measure the success of medical service providers This research introduces how to assess patient satisfaction in public hospitals, taking the case of Binh Dinh provincial general hospital In the strategy of Vietnam healthcare system for protecting, caring and improving healthcare in the period 2011-2020, vision 2030 Some issues have been mentioned: Health is the most valuable asset of individuals and all society; medical service is a special social service without profits in public service providers; investing in health is investing for the future and for good nature of society; improvement and modernization of healthcare system towards Equity-Efficiency-Development Currently, medical services in public hospitals are considered not as good as in private hospitals Therefore, the objectives of this research are assessing current situation of patient satisfaction in the hospital and providing some recommendations as the background or reference for public hospitals to improve their medical services ii TABLE OF CONTENTS ACKNOWLEDGEMENT i ABSTRACT ii LIST OF FIGURES vi LIST OF TABLES vii CHAPTER 1: INTRODUCTION 1.1 Background 1.2 Research objectives 1.3 Research questions 1.4 Introduction of Binh Dinh provincial general hospital 1.4.1 Policies of Vietnam healthcare system towards patient satisfaction 1.4.2 Establishment and development process of the hospital 1.5 Structure of research CHAPTER 2: LITERATURE REVIEW ON PATIENT SATISFACTION 2.1 Hospital services 2.2 Service quality 2.3 Customer satisfaction 2.4 Customer satisfaction and service quality 2.5 Overview of patient satisfaction 10 2.6 Role of patient satisfaction 10 2.7 The relationship between service quality and patient satisfaction 11 2.8 Factors impacting patient satisfaction 11 iii CHAPTER 3: RESEARCH METHODOLOGY 16 3.1 Research design 16 3.2 Research process 17 3.3 Data collection 17 3.4 Research model 20 CHAPTER 4: RESULTS OF INPATIENT SATISFACTION IN BINH DINH PROVINCIAL GENERAL HOSPITAL 23 4.1 General information of researched patients 23 4.2 Assessment of inpatient satisfaction 25 4.2.1 Inpatient satisfaction on accessibility .25 4.2.2 Inpatient satisfaction on Transparency on information, examination and treatment procedures .27 4.2.3 Inpatient satisfaction on Facilities and equipment 29 4.2.4 Inpatient satisfaction on Medical staff’s behavior and professional capacity .31 4.2.5 Inpatient satisfaction on Results of service provision 33 4.3 Summary of results on inpatient satisfaction 35 4.3.1 Inpatient satisfaction in general and classified by factors 35 4.3.2 Percentage of overall assessment of inpatient satisfaction .36 4.3.3 Classification of patients who will return or introduce to other patients 36 4.3.4 Odds Ratio Analysis .37 CHAPTER 5: RECOMMENDATIONS TO IMPROVE INPATIENT SATISFACTION IN BINH DINH PROVINCIAL GENERAL HOSPITAL 40 iv 5.1 Improving facilities in the hospital 40 5.2 Investing more in medical equipment and information technology to improve service quality .40 5.3 Simplifying complicated administrative procedures .41 5.4 Improving medical staff’s communication skills 41 5.5 Limitations of the thesis 41 CONCLUSIONS 42 LIST OF REFERENCES 43 APPENDIX 46 APPENDIX 50 APPENDIX 52 APPENDIX 53 v LIST OF FIGURES Figure Research process 17 Figure Research model 22 Figure Patient satisfaction by age 24 Figure Summary of inpatient satisfaction on Accessibility 26 Figure Summary of inpatient satisfaction on Transparency on information, examination and treatment procedures .28 Figure Summary of inpatient satisfaction on Facilities and equipment 31 Figure Summary of inpatient satisfaction on Medical staff’s behavior and professional capacity 33 Figure Summary of inpatient satisfaction on Results of service provision 35 vi LIST OF TABLES Table 4.1 Patient classification by sex .23 Table 4.2 The total number of days of hospitalization 24 Table 4.3 Patients using of health insurance card for this treatment .24 Table 4.4 Classification of inpatient satisfaction by accessibility 25 Table 4.5 Classification of inpatient satisfaction by Transparency on information, examination and treatment procedures .27 Table 4.6 Classification of inpatient satisfaction by Facilities and equipment 29 Table 4.7 Classification of inpatient satisfaction by Medical staff’s behavior and professional capacity 31 Table 4.8 Classification of inpatient satisfaction by Results of service provision 33 Table 4.9 Inpatient satisfaction in general and classified by factors .35 Table 4.10 Percentage of overall assessment of inpatient satisfaction 36 Table 4.11 Classification of patients who will return or introduce to other patients 36 Table 4.12 The relation between related factors and inpatient satisfaction .37 Table 4.13 The relation between related factors and patient return 38 vii CHAPTER 1: INTRODUCTION 1.1 Background Health is always among the most important issues and the most valuable asset of individuals and all society Investing in health is investing for development and growth, reflecting the good society With the development trend of health sector, public hospitals gradually have to be autonomous in finance meaning that they must cover all the costs for their operation such as salary, equipment, drugs…etc In this situation, to be survival in severe competition in market economy, public hospitals need to attract more patients Therefore patient satisfaction is one of the most important issues for hospitals as well as a principal indicator reflecting quality and efficiency of medical services For public hospitals, assessment of patient satisfaction will help improve quality of services and reputation, so that hospitals can increase revenue and have effects on other hospitals Pollack (2008) there is a relationship between service quality and patient satisfaction, level of satisfaction is a measurement for the suitability between medical services provided with expectation from patients Satisfied patients will lead to improved financial outcomes, reduce management claims, retain patients and succeed in a competitive environment In current circumstance, there is a difference of medical services between public and private hospitals, services at private hospitals are considered better than at public hospitals Nowadays, patients not only pay attention on quality of medical treatment but also the services that they would receive from medical staff With the development of modern technology in medical treatment, medical services have been highly focused on to increase the competitiveness Raising patient satisfaction in public health will play an important role for public healthcare providers because patient satisfaction determines the survival and development of public hospitals, according to Decree No 55/2012/ND-CP public healthcare providers will be dissolved if the task is not completed in three consecutive years A Accessibility Signboards and maps of direction to different departments of the hospital are clear and easy to see and find Time of patient visit is listed clearly The buildings, stairs and patient rooms are numbered clearly and easily able to be seen The hallways in the hospital are flat and easy to move Patients are able to call medical staff for help when needed B Transparency on information, examination and treatment procedures The process and procedures of hospitalization are clear, public and convenient Regulations and necessary information of hospitalization are announced clearly The condition of disease, methods and estimated time of treatment are explained clearly Before testing and using high technology equipment, patients are explained clearly Updated information of drugs and cost of treatment are listed clearly C Facilities and Equipment Patient rooms are spacious, clean and full of equipment such as fans, heaters or air conditioners Patient beds with pillows, sheets are safe and in good condition Toilets, bath rooms are convenient, clean and in good condition Patient rooms are safe and have good security Clean clothes are provided for patients Hot and cold water are provided for patients Is there a private area for patients when necessary such as clothes changing or examination Canteen of the hospital meets the expectation of patients for meals and other needs The environment in the hospital campus is green and clean 5 5 5 5 5 5 5 4 5 5 47 D Medical staff’s behavior and professional capacity Medical staff (doctors, nurses) has good words, behaviors and communication skills Serving staff (security guards, receptionist…) has good words, behaviors and communication skills Medical staff respects, treats and takes care of patients fairly Doctors and nurses have a good cooperation and the task is completed quickly Patients are visited and encouraged by doctors at the patient rooms Patients are consulted by doctors about meals, exercises and prevention from symptoms Medical staff not have suggestions of tips E Results of service provision Provision and usage instruction of drugs are explained clearly Equipment and medical supplies are complete, modern and meet your expectation The result of treatment meets your expectation Mr./Mrs evaluates the level of trust on quality of medical services Mr./Mrs evaluates the level of satisfaction on fee of medical services G1 Overall evaluation, how many percentage does the hospital meet your expectation before ………… % hospitalization? (fill in from 0% to 100% or more than 100% if the hospital provides good treatment that exceeds your expectation) G2 If you have the need for Never come back treatment in the future, Do not want to come back but there is no other you want to come choices back or introduce to Want to move to another hospital other patients? Maybe come back Definitely come back or introduce to other patients Others (details)……………………………… 48 H Do you have any other comments, please specify? THANK YOU VERY MUCH! 49 APPENDIX GENERAL INFORMATION OF PATIENTS Sex n % Male 149 49,67 Female 151 50,33 Total 300 100 34% 27.33% Age 60 50 Average days of hospitalization ± SD Min Max 7,22 ± 6,67 60 Health insurance card n % Yes 282 94,00 No 18 6,00 Total 300 100 51 APPENDIX ASSESSMENT OF INPATIENT SATISFACTION Average Min Max 4,3 2,8 Transparency on information, examination and 4,4 2,8 Accessibility treatment procedures Facilities and Equipment 4,2 2,3 Medical staff’s behavior and professional capacity 4,4 2,1 Results of service provision 4,4 2,8 Average point of inpatient satisfaction 4,3 2,9 Average percentage of inpatient satisfaction ± SD Min Max 90,1 ± 10,24 50 100 n % Never come back - - Do not want to come back but there is no other choices 1,00 Want to move to another hospital 0,67 Maybe come back 109 36,33 Definitely come back or introduce to other patients 186 62,00 Total 300 100,00 52 APPENDIX INPATIENT SATISFACTION BY EACH FACTOR Accessibility Signboards and maps of direction to different departments of the hospital are clear and easy to see and find Time of patient visit is listed clearly The buildings, stairs and patient rooms are numbered clearly and easily able to be seen The hallways in the hospital are flat and easy to move Patients are able to call medical staff for help when needed Very dissatisfied Dissatisfied or Very or Poor poor n % n % Normal Satisfied or Good n n % % Very satisfied or Very good n % 0,67 0,33 42 14,00 132 44,00 123 41,00 0,33 0,33 22 0,33 - - 47 15,67 121 40,33 131 43,67 - - - - 40 13,33 145 48,33 115 38,33 - - 0,67 23 7,33 7,67 152 50,67 124 41,33 141 47,00 134 44,67 53 28% Satisfaction 72% Dissatisfaction Figure Summary of inpatient satisfaction on Accessibility Transparency Very Very on dissatisfied Dissatisfied Satisfied satisfied Normal information, or Very or Poor or Good or Very examination poor good and treatment n % n % n % n % n % procedures The process and procedures of hospitalization 0,33 32 10,67 118 39,33 149 49,67 are clear, public and convenient Regulations and necessary information of 28 9,33 134 44,67 138 46,00 hospitalization are announced clearly 54 The condition of disease, methods and estimated time of treatment are explained clearly Before testing and using high technology equipment, patients are explained clearly Updated information of drugs and cost of treatment are listed clearly - - 0,67 36 12,00 115 38,33 147 49,00 - - 1,00 32 10,67 122 40,67 143 47,67 - - 0,67 25 8,33 121 40,33 152 50,67 19.33% Satisfaction 80.67% Dissatisfaction Figure Summary of inpatient satisfaction on Transparency on information, examination and treatment procedures 55 Facilities and Equipment Patient rooms are spacious, clean and full of equipment such as fans, heaters or air conditioners Patient beds with pillows, sheets are safe and in good condition Toilets, bath rooms are convenient, clean and in good condition Patient rooms are safe and have good security Clean clothes are provided for patients Hot and cold water are provided for patients Is there a private area for patients when Very dissatisfied Dissatisfied or Very or Poor poor n % n % Normal Satisfied or Good n n % % Very satisfied or Very good n % 0,33 1,33 48 16,00 134 44,67 113 37,67 0,67 2,00 42 14,00 139 46,33 111 37,00 0,33 1,33 59 19,67 111 37,00 125 41,67 - - 1,00 49 16,33 146 48,67 102 34,00 0,33 - - 30 10,00 141 47,00 128 42,67 1,00 1,33 46 15,33 159 53,00 88 29,33 1,00 2,67 51 17,00 146 48,67 92 30,67 56 necessary such as clothes changing or examination Canteen of the hospital meets the expectation of patients for meals and other needs The environment in the hospital campus is green and clean - - 1,33 - - - - 49 16,33 157 52,33 90 30,00 34 11,33 150 50,00 116 38,67 42% 58% Satisfaction Dissatisfaction Figure Summary of inpatient satisfaction on Facilities and equipment 57 Very Very Medical staff’s dissatisfied Dissatisfied Satisfied satisfied Normal behavior and or Very or Poor or Good or Very professional poor good capacity n % n % n % n % n % Medical staff (doctors, nurses) has good words, 0,67 25 8,33 125 41,67 148 49,33 behaviors and communication skills Serving staff (security guards, receptionist…) has good 1,00 31 10,33 132 44,00 134 44,67 words, behaviors and communication skills Medical staff respects, treats and takes care 0,67 27 9,00 138 46,00 133 44,33 of patients fairly Doctors and nurses have a good cooperation 0,33 23 7,67 143 47,67 133 44,33 and the task is completed quickly Patients are visited and encouraged by 25 8,33 135 45,00 140 46,67 doctors at the patient rooms 58 Patients are consulted by doctors about meals, exercises and prevention from symptoms Medical staff not have suggestions of tips - - 0,33 26 8,67 145 48,33 128 42,67 0,33 - - 23 7,67 136 45,33 140 46,67 19% Satisfaction 81% Dissatisfaction Figure Summary of inpatient satisfaction on Medical staff’s behavior and professional capacity 59 Results of service provision Provision and usage instruction of drugs are explained clearly Equipment and medical supplies are complete, modern and meet your expectation The result of treatment meets your expectation Mr./Mrs evaluates the level of trust on quality of medical services Mr./Mrs evaluates the level of satisfaction on fee of medical services Very dissatisfied Dissatisfied or Very or Poor poor n % n % Normal Satisfied or Good n % n 17 5,67 % Very satisfied or Very good n % - - - - 130 43,33 153 51,00 - - 0,67 33 11,00 145 48,33 120 40,00 - - 0,33 28 9,33 142 47,33 129 43,00 - - - - 28 9,33 143 47,67 129 43,00 - - - - 32 10,67 128 42,67 140 46,67 60 16.33% Satisfaction 83.67% Dissatisfaction Figure Summary of in patient satisfaction on Results of service provision 61