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Ulf Gerdtham. Photo.

Ulf Gerdtham

Professor

Ulf Gerdtham. Photo.

The nurse did not even greet me' : How informed versus non-informed patients evaluate health systems responsiveness in South Africa

Author

  • Dumisani MacDonald Hompashe
  • Ulf-G Gerdtham
  • Carmen S Christian
  • Anja Smith
  • Ronelle Burger

Summary, in English

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.

Department/s

  • Department of Economics
  • EpiHealth: Epidemiology for Health

Publishing year

2021-04

Language

English

Publication/Series

BMJ Global Health

Volume

6

Issue

4

Document type

Journal article

Publisher

BMJ Publishing Group

Topic

  • Health Care Service and Management, Health Policy and Services and Health Economy

Keywords

  • cross-sectional survey
  • health education and promotion
  • health policy
  • health systems evaluation
  • public health

Status

Published

ISBN/ISSN/Other

  • ISSN: 2059-7908