| Abstract [eng] |
Evaluation of Nursing Services in Private and Public Primacy Health Care Institutions: the Patient’s Perspective The aim of the thesis: evaluating and comparing patients’ attitude to nursing services in private and public primary health care institutions. Tasks of the thesis: 1. To evaluate factors determinig the choice of provider in primary health care. 2. To assess and compare the patients' opinion about the quality of nursing services in private and public primary health care institutions. 3. To identify the factors which, according to patients' opinion, have the greatest influence on the quality of nursing services in private and public primary health care institutions. Data and methods of the study. The study was carried out in 2015-2016 (in the 5-th clinics). The survey included 187 patients. Two part questionnaire devised by the the authors was used in the study: 1) socio-demographic information about the respondents; 2) questions assessing the quality of services, grouped into 4 sections: 1. Organization and quality of services; 2. Technical quality of services. It is described by the statements that evaluate the tangible things in the process of service provision. 3. External effectiveness. It can be assessed by the intentions to recommend the clinic to others, the probability of the repeated use of the services, overall satisfaction with the services and overall evaluation of quality. 4. Functional quality of nursing care. It can be assessed by the dimension of human interaction in the process of service provision. Results and conclusions: 1. The most common criteria for selecting a certain primary health care institution were: convenience - close to the residence (39 percent), high quality of services (21.4 percent), recommendations from relatives and acquaintances. 70 percent of respondents would recommend their primary health care institution to relatives / family members. 2. The highest scoring average of all assessments was awarded for organization and quality of services (in private health care institutions - 4.29 points, in public - 3.82 points). The lowest scores were given for functional quality of services – 3.88 and 3.47 points respectively. 80.7 percent of the respondents rated quality of treatment services and 76.5 percent rated quality of nursing services as good and very good. Most of them were satisfied with tidy and appropriate staff clothing (92 percent), their sensitivity, attentiveness (91.4 percent), competence (81.2 percent), high quality of procedures (81.2 percent). One-third (34.8 percent) of the patients were dissatisfied with not being admitted by a doctor at a suitable time and quickly, one-fifth (23 percent) of them were dissatisfied with the problems they faced being solved for too long. According to the opinion of one-third of the patients (33.7 percent and 31.5 percent), nurses do not inform them about healthy diet and side effects of medications. 29.4 percent of respondents lack individual attention from nurses. Patients of the private institutions were satisfied with the services they received more than respondents visiting public primary health care institutions (p <0.001) – they rated higher the work of receptionists, quality of treatment and nursing care, attentiveness of the staff. They also stated more often that they can be admitted faster by the doctor, receive better services, and would recommend health care institution to their relatives. 3. According to the opinion of patients, the quality of care depends mostly on the efforts of the staff to provide high-quality services and make patients feel respected (p <0.001). The quality of services is also related to caring for patients, problem solving time, competence and qualification of the staff, attentiveness, understanding and information, as well as to how quickly patients can be admitted by the doctor (p <0.001). |
