Objective: To develop attributes relevant to satisfying ophthalmic care among health providers and patients.
Design: Mixed-method study.
Settings: Harare Central Hospital Eye Unit, Zimbabwe.
Subjects: A convenience sample of 30 eligible adult patients who had come for eye care at the outpatients’ department and 18 health care providers.
Methods: This study was conducted as the first phase of a two-phase broader study. We held five focus groups with patients and doctors separately and twelve in-depth key informant interviews with nurses. Participants were asked to identify attributes of the care process they regarded as leading to satisfying eye care. We recorded full details and used a tallying method to record frequencies. We then ranked and identified key attributes, with the top three attributes regarded as the most important.
Results: The study developed nine attributes from health providers and seven attributes from health users. The most important attributes for health providers were the availability of drugs, good staff attitude and the availability of equipment. Patients prioritised good staff attitude, adequate information and the availability of doctors. All the attributes mentioned by health users were mentioned by health providers but ranked differently.
Conclusion: Both clinical and nonclinical attributes of care were considered by health providers and health users. Overall, attributes that were important to patients were linked to interpersonal relations (attitudes, communication, availability of, and access to doctors). Health providers’ preferences were mostly clinical (drugs and equipment). Acknowledging these differences in perspectives may help policymakers when designing frameworks for quality health services.
Ziaei H, Katibeh M, Eskandari A, Mirzadeh M, et al. Determinants of patient satisfaction with ophthalmic services. BMC Res Notes. 2011 Jan 15;4:7.
Ofovwe CE, Ofili AN. Indices of patient satisfaction in an African population. Public Health. 2005;119(7):582–586.
McHugh MD, Kutney-Lee A, Cimiotti JP, Jeannie P, et al. Nurses’ Widespread Job Dissatisfaction, Burnout, And Frustration With Health Benefits Signal Problems For Patient Care. Health Aff (Millwood). 2011 Feb 1;30(2):202–10.
Batbaatar E, Dorjdagva J, Luvsannyam A, Savino MM, et al. Determinants of patient satisfaction: a systematic review. Perspect Public Health. 2017 Mar;137(2):89–101.
Schoenfelder T, Klewer J, Kugler J. Determinants of patient satisfaction: a study among 39 hospitals in an in-patient setting in Germany . International Journal for Quality in Health Care. 2011 June; 23(5):503-9
Barr JK, Boni CE, Kochurka KA, Nolan KA, et al. Public Reporting of Hospital Patient Satisfaction: The Rhode Island Experience. Health Care Financ Rev. 2002;23(4):51–70.
Quality Chasm 2001 report brief. Crossing the Quality Chasm. http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2001/Crossing-the-Quality-/Chasm/Quality%20Chasm%202001%20%20report%20brief.pdf(2001, accessed Mar 9 2020).
Mead N, Bower P. Patient-centredness: a conceptual framework and review of the empirical literature. Soc Sci Med. 2000;51(7):1087–1110.
NEJM Catalyst. What Is Patient-Centered Care?]. https://catalyst.nejm.org/doi/full/10.1056/CAT.17.0559 (2017, accessed 16 Mar 2020
Larson E, Vail D, Mbaruku GM, Kimweri A, et al. Moving toward patient-centered care in Africa: a discrete choice experiment of preferences for delivery care among 3,003 Tanzanian women. PloS One. 2015;10(8):e0135621.
Jagero N. Client Satisfaction and Health Services: The Case off Mutare, Zimbabwe. https://www.academia.edu/14640365/Client_Satisfaction_and_Health_Services_The_Case_off_Mutare_Zimbabwe (2015, accessed 25 Mar 2020)
Ministry of Health Zimbabwe. National eye strategy ZIMBABWE 2014- 2018. https:iapblive.blob.core.windows.net/resources/120 National-Eye-Health-Strategy ZIMBABWE 2014-2018.pdf?width&height=150.(accessed 23 Jan 2019)
Green AR, Carrillo JE, Betancourt JR. Why the disease-based model of medicine fails our patients. West J Med. 2002 Mar;176(2):141–3.
Peabody FW. The Care of the Patient. JAMA. 2015 May 12;313(18):1868–1868.
Fitzpatrick R. Surveys of patients' satisfaction: Important general considerations. BMJ. 1991 Apr 13;302(6781):887–9.
Health systems in Africa. https://www.afro.who.int/sites/default/files/2017-06/english---health_systems_in_africa---2012.pd .(accessed 5 June 2020)
Mendoza Aldana J, Piechulek H, al-Sabir, A. Client satisfaction and quality of health care in rural Bangladesh. Bull World Health Organ. 2001;79(6):512–7.
Hanson K, McPake B, Nakamba P, Archard L. Preferences for hospital quality in Zambia: results from a discrete choice experiment. Health Econ. 2005;14(7):687–701.
Bruster S, Jarman B, Bosanquet N, Weston D. National survey of hospital patients. BMJ. 1994 Dec 10;309(6968):1542–6.
Murgic L, Hébert PC, Sovic S, Pavlekovic G. Paternalism and autonomy: views of patients and providers in a transitional (post-communist) country. BMC Med Ethics. 2015 Sep 29;16.
Patients’ Charter. https://www3.ha.org.hk/pwh/content/comm/patientchartermultimedia.html( accessed Feb 1 2020)
Stiggelbout A, Van der weijden T, Wit M, Frosch D. Shared decision making: Really putting patients at the centre of healthcare. BMJ. 2012 Jan 27; 344:256.
Honda A, Ryan M, Van Niekerk R. Improving the public health sector in South Africa: eliciting public preferences using a discrete choice experiment. Health Policy Plan. 2015 Jun 1; 30(5):600–11.
Montgomery AA, Fahey T. How do patients' treatment preferences compare with those of clinicians? Qual Saf Health Care. 2001;10(suppl 1):i39–i43.
McKenna SP. Measuring patient-reported outcomes: moving beyond misplaced common sense to hard science. BMC Med. 2011;9(1):86.