| Abstract [eng] |
Master’s thesis in Nursing Author of the work: Aliona Jurgelevic Title of the work: Quality of Care and Accessibility of Ambulatory Health Service Research Adviser: Doc., med. Dr. R. Gurevicius, VUMF IPH DSM The objective of the research: to research quality and accessibility of out-patient services rendered in N.Vilnia Polyclinics, by emphasizing nursing services and their accessibility prior to reorganization of the polyclinics. Tasks of the research: To analyze main efficiency indices of N.Vilnia Polyclinic’s activity from 2000 to 2004; To evaluate accessibility of services rendered by N.Vilnia Polyclinics; To assess quality of out-patient services; To determine expectations of N.Vilnia Polyclinic’s clients. The subject and methodology of the research: quality of primary health care services, expectations of clients and change of the Polyclinic’s efficiency indices. The research was carried out at N.Vilnia Polyclinics. 488 respondents, both men and women over 18 year old were surveyed, 476(97,5%) of which were involved in the research. The survey was performed with the help of our supplemented questionnaire, made of two sources and comprising 44 questions. The efficiency indices of N.Vilnia Polyclinic’s activity were assessed using Harvard Graphics 4.0 package. Data of the questionnaire were analyzed with statistical processing program SPSS 11v. and difference among groups was considered reliable, where P<0,05. Results of the research: In the course of assessment of efficiency indices of the Polyclinic’s activity, the number of patients underwent a slight increase (only 2,5 thous. new patients were registered for the year 2000-2004). Dynamics of diseases remained the same during these years, while newly diagnosed diseases tended to decrease. If the tendency remains unchanged, it is expected that in 2005 new diseases will decrease up to 583 cases. In Polyclinics dominate respiratory diseases, which were diagnosed to 9193 patients in 2004 and 8586 in 2000. The Analysis of data of the questionnaire showed that it is very difficult to register with a GPP. One third of respondents were unsatisfied with waste of time by the reception or consulting-room (32 and 33% respectively). It takes on average 31-79 min. to wait for any consultation, while the very consultation lasts 13-23 min. 39% of respondents may not reach a physician after working hours or on weekends, and 19% were not informed on such possibility. Only 35% of respondents are fully satisfied with working quality of their physicians, while the vast majority of them (57%) only in part. 49% of respondents receive sufficient information on their health state and 39% sometimes receive incomplete data. 61% of respondents stated that not all physicians show their sympathy, understanding and politeness to their patients. The high and partial quality of nursing work was evaluated by 45% of respondents of each group. 45% of respondents recognized nurses’ contribution to the treatment, whereas every sixth respondent emphatically stated that such contribution is insignificant. 64% of respondents believe that their contribution to the treatment is limited by filling-in different forms 82 and 70% of patients requested that more time and willingness were showed by physicians and nurses in respect to their health problems and care respectively. Conclusions of the research: 1.General number of visits tends to slightly increase, while newly diagnosed diseases decrease in Polyclinics. Here prevail respiratory diseases and the number of such patients tends to grow 2.A quarter of patients have limited accession to the registration with general practice physicians 3.Respondents criticised quality of rendered services. Only one third of respondents were fully satisfied with work of their physicians. Half respondents were content with work of nurses 4.Most respondents requested that their physicians and nurses would show a greater attention to them and their health problems. |
