Promoting equitable and patient-centred care: an analysis of patient satisfaction in urban, rural and remote primary care sites in the Philippines.

Autor:	Panganiban JMS; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines., Loreche AM; National Clinical Trials and Translation Center, University of the Philippines Manila, Manila, Philippines., De Mesa RYH; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines., Camiling-Alfonso R; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines., Fabian NMC; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.; University of the East Ramon Magsaysay Memorial Medical Center Inc, Quezon City, Philippines., Dans LF; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.; Department of Pediatrics, Philippine General Hospital, University of the Philippines Manila, Manila, Philippines., Galingana CLT; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines., Lopez JFE; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines., Casile RU; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines., Aquino MRN; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines., Rey MP; Department of Accounting and Finance, Cesar E.A. Virata School of Business, University of the Philippines Diliman, Quezon City, Philippines., Sanchez JT; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines., Javelosa MAU; Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines., Tan-Lim CSC; Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines cctan7@up.edu.ph., Marfori JRA; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.; Department of Clinical Epidemiology, University of the Philippines Manila, Manila, Philippines., Paterno RP; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines., Dans AL; Center for Integrative and Development Studies, University of the Philippines Diliman, Quezon City, Philippines.; National Institutes of Health, University of the Philippines Manila, Manila, Philippines.
Jazyk:	angličtina
Zdroj:	BMJ open quality [BMJ Open Qual] 2024 Mar 05; Vol. 13 (1). Date of Electronic Publication: 2024 Mar 05.
DOI:	10.1136/bmjoq-2023-002483
Abstrakt:	Objectives: This study measured changes in patient satisfaction levels before and after the introduction of primary care system strengthening interventions in urban, rural, and remote sites in the Philippines. Methods: A previously validated 16-item questionnaire was distributed to 200 patients per site before implementation of interventions and to a different set of 200 patients 1 year after implementation. We compared the percentage change in highly satisfied patients per site before and after implementing interventions using a two-proportion Z-test. Results: The urban site had a significant increase in patient satisfaction in 13 survey items, which corresponded to the domains of healthcare availability, service efficiency, technical competency and health communication. The rural site had a significant increase in six survey items, which corresponded to the domains of service efficiency, environment, location, health communication and handling. The remote site had a decrease in patient satisfaction in 10 survey items, with a significant increase in only 4 items under the domains of healthcare availability and handling. Conclusion: Our findings support the 'inverse equity hypothesis', where well-resourced urban communities quickly adopt complex health interventions while rural and remote settings experience delays in effectively meeting patient needs and system demands. Extended intervention periods and targeted strategies may be necessary to impact patient satisfaction in underserved areas considerably. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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