PATIENTS’ PERCEPTIONS OF THE QUALITY OF OUTPATIENT CARE AT THE PORT MEDICAL CENTRE IN TEMA COMMUNITY ONE

ABSTRACT

Introduction: Ghana is an emerging market with high demands on its health, especially to achieve universal health coverage while maintaining quality of care. Quality of care is a standard that is measurable from different perspectives, including the patients’ perspectives. The government is pushing for private public partnership in all areas of the economy including the health sector where the state owned health facilities are inadequate to mop up all the cases reporting for healthcare delivery. Quality of care has been studied extensively in Ghana among public health facilities yet presently, very little is known about the concept in the private healthcare setting. Understanding quality of care issues from the perspective of private providers will improve healthcare delivery in the country. The objective of this study is to assess patients’ perspectives of quality of care at the outpatient department of Port Medical Centre.

Methodology: Study was a quantitative cross-sectional study undertaken at the outpatient department of Port Medical Centre using exit pre- tested self-administered questionnaires. The consecutive sampling technique was used to select 390 study participants. Quality of care was measured using a modified form of the Service Quality (SERVQUAL) model gap analysis and satisfaction measured with the Short Assessment of Patient Satisfaction (SAPS) instrument. Data was entered into Microsoft excel and imported into Stata 15.0 for analysis. Descriptive statistics were used to describe the characteristics of the participants. The paired t test, simple linear and logistic regression techniques were used to examine relationships between patient satisfaction and socio- demographic and quality of care variables. Multiple linear regression was used to examine the association between satisfaction and quality of care dimensions. A p-value of 0.05 was used to determine statistical significance.

Results: Satisfaction measured was 74% Mean percentage of perceptions of quality was 86.0% while mean expectations of quality was 87.6% and the mean difference between the

two was -0.08 (p = 0.002). Out of 25 service quality factors, 12 showed significant negative gaps in service quality between perceptions and expectations. All 5 positive gaps were not statistically significant. As composite variables, holding perceptions of quality constant, as expectations increase, satisfaction with quality of service reduce by 0.46% (p= 0.079) and holding expectations constant, as perceptions of quality of care increases, satisfaction with outpatient service quality increases by 2.4% (p < 0.001). Significantly, increasing perceptions of reliability and assurance, increase satisfaction; and increasing expectations of empathy and tangibility significantly reduce and increase satisfaction respectively. Together, these four (after controlling for socio- demographic characteristics) explain only 24% of satisfaction with outpatient care.

Conclusions: There are high expectations as well as high perceptions of quality of care at the Port Medical Centre outpatient department but with a significant negative gap. There are 12 significant negative gaps in quality factors noted that can be improved. Satisfaction in this study is not significantly different from that noted in government hospitals in Ghana. Only perceptions of assurance and reliability and expectations of tangibility and empathy are associated with patient satisfaction.

Key words

Quality of care, Outpatient Department, outpatients, patient satisfaction, SERVQUAL dimensions; SAPS, expectations, perceptions