‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa
Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions...
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| Format: | Article |
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BMJ Publishing Group
2021-04-01
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| Series: | BMJ Global Health |
| Online Access: | https://gh.bmj.com/content/6/4/e004360.full |
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| author | Ulf-G Gerdtham Ronelle Burger Carmen S Christian Dumisani MacDonald Hompashe Anja Smith |
| author_facet | Ulf-G Gerdtham Ronelle Burger Carmen S Christian Dumisani MacDonald Hompashe Anja Smith |
| author_sort | Ulf-G Gerdtham |
| collection | DOAJ |
| description | Introduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction.Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions.Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions.Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct. |
| format | Article |
| id | doaj-art-e3188261f03d46e59d7d6af92e0ace57 |
| institution | Kabale University |
| issn | 2059-7908 |
| language | English |
| publishDate | 2021-04-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Global Health |
| spelling | doaj-art-e3188261f03d46e59d7d6af92e0ace572024-12-05T10:00:09ZengBMJ Publishing GroupBMJ Global Health2059-79082021-04-016410.1136/bmjgh-2020-004360‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South AfricaUlf-G Gerdtham0Ronelle Burger1Carmen S Christian2Dumisani MacDonald Hompashe3Anja Smith43 Economics, Lund University, Lund, Sweden2 Economics, Stellenbosch University Faculty of Economic and Management Sciences, Stellenbosch, South Africa4 Economics, University of the Western Cape, Cape Town, South Africa1 Economics, University of Fort Hare Faculty of Management and Commerce, Alice, South Africa2 Economics, Stellenbosch University Faculty of Economic and Management Sciences, Stellenbosch, South AfricaIntroduction Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction.Methods Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions.Results We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions.Conclusion Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.https://gh.bmj.com/content/6/4/e004360.full |
| spellingShingle | Ulf-G Gerdtham Ronelle Burger Carmen S Christian Dumisani MacDonald Hompashe Anja Smith ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa BMJ Global Health |
| title | ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa |
| title_full | ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa |
| title_fullStr | ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa |
| title_full_unstemmed | ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa |
| title_short | ‘The nurse did not even greet me’: how informed versus non-informed patients evaluate health systems responsiveness in South Africa |
| title_sort | the nurse did not even greet me how informed versus non informed patients evaluate health systems responsiveness in south africa |
| url | https://gh.bmj.com/content/6/4/e004360.full |
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