|Year : 2018 | Volume
| Issue : 4 | Page : 658-663
Patients satisfaction with consultation at primary health care centers in Abha City, Saudi Arabia
Abdullah Khlofh Tabekhan1, Yahia Mater Alkhaldi2, Abdullah Khalufah Alghamdi3
1 Department of Research, Joint Program of Family Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
2 Department of Family Medicine and Research, General Directorate of Health Affairs in Aseer Region, King Khalid University, Abha, Saudi Arabia
3 Department of Family Medicine, College of Medicine, King Khalid University, Abha, Saudi Arabia
|Date of Web Publication||4-Sep-2018|
Dr. Abdullah Khlofh Tabekhan
Building No. 3261, Almansak, Alburdah Street, Abha City, Aseer Region
Source of Support: None, Conflict of Interest: None
Aim of Study: This study aims to assess patients satisfaction regarding consultations at the General Clinics of primary health-care (PHC) centers, in Abha City. Patients and Methods: This cross-sectional study design was conduct among adult patients attending training PHC centers in Abha City, Saudi Arabia during September 2016. The researcher designed a data collection sheet that comprised patients' personal characteristics and the consultation satisfaction questionnaire, which contained 18 questions within four dimensions, i.e., general satisfaction; professional care; depth of relationship; and length of consultation. Results: The total number of the patient included in this study was 400, more than half of them were male (54%). Most of them were Saudi (90%), married (79%), and educated (93%). More than half 53% were dissatisfied, 20% were satisfied with consultation while 27% were natural. The most important factor affecting satisfaction with consultation was age, education level and income. Conclusions: Patients satisfaction toward their consultation experience at general clinics of training PHC centers in Abha City was suboptimal. Total consultation scores differ significantly according to their age groups, education level, and monthly income. Recommendations: PHC physicians should be more concerned with improving medical consultations provided to their patients. Continuing medical education and training of PHC physicians about provision of medical consultation.
Keywords: Consultation, Consultation Satisfaction questionnaire, Patients satisfaction, Primary Care
|How to cite this article:|
Tabekhan AK, Alkhaldi YM, Alghamdi AK. Patients satisfaction with consultation at primary health care centers in Abha City, Saudi Arabia. J Family Med Prim Care 2018;7:658-63
|How to cite this URL:|
Tabekhan AK, Alkhaldi YM, Alghamdi AK. Patients satisfaction with consultation at primary health care centers in Abha City, Saudi Arabia. J Family Med Prim Care [serial online] 2018 [cited 2018 Sep 25];7:658-63. Available from: http://www.jfmpc.com/text.asp?2018/7/4/658/240412
| Introduction|| |
Patients satisfaction regarding health care has often been considered as an objective of the health care. It has also been considered as one of the most important measures for evaluating the health care. It constitutes a complex relationship between patients' perceived needs and expectations from the health services received. Therefore, satisfaction is one of the main variables affecting the outcomes of health care and use of services.
Patient satisfaction is a special form of consumer attitude – that is, as postexperience phenomenon reflecting how much a patient liked or disliked the service. It has been a widely recognized indicator of quality of care in medical practice.,
Assessments of patients satisfaction regarding primary health-care (PHC) physicians is important, not only as a measure of the quality of care patients receive, but also in identifying potential areas for improving the content of care provided by PHC physicians. Research proved that improving patient satisfaction with physician consultation increases the likelihood that a patient will return to a given health-care provider.,
A widely accepted model views patients' consultation as a dialogue between the patient and the physician which takes variable durations and involves elements of negotiation to create a common reality to which agenda setting is paramount. Wilson and Childs  noted that there had been a general increase in the length of consultation time over the prevailing 20 years. However, consultation length still remains insufficient.
During medical consultation, both the physician and the patient meet on common grounds with tolerance for each other's rights. This consultation, by necessity, requires a physician who is expected to possess the requisite knowledge which will be useful in solving the problems the patient presents with the assumption that the doctor will act in the best interest of the patient. Guided by rules of professional conduct, objectivity, and being emotionally detached the physician is guaranteed the right to examine the patient physically and to proceed into intimate areas of the patient's physical and emotional life.
Since the core activity in PHC is the “consultation,” irrespective of whether patients consult for cure, services, counseling, prevention, or care, there is an increasing interest in the study of the consultation process and patients satisfaction with it.
Therefore, this study aims to assess patients' satisfaction regarding provided consultations at the General Clinics of PHC centers, in Abha City.
| Patients and Methods|| |
Following a cross-sectional study design, 400 adult attendants of four PHC centers in Abha City were interviewed by the researcher.
The researcher designed a data collection sheet that comprised the following two parts:
Age, gender, nationality, educational status, marital status, and monthly income.
The consultation satisfaction questionnaire
The researcher professionally translated the consultation satisfaction questionnaire (CSQ) into simple Arabic language to be used with Arabic speaking attendants of PHC centers in Abha City. This questionnaire was designed to measure patient satisfaction with recent consultations. It contains 18 questions, and the results of these are combined to produce the following four dimensions/scales: general satisfaction, professional care, depth of relationship, and length of consultation.
Within each domain of the CSQ, some of the statements are “positive,” i.e., while others are “negative.”, as shown in [Table 1].
|Table 1: Classification of statements according to different domains of the Consultation Satisfaction Questionnaire|
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Scoring of CSQ responses was carried out as follows:
- 100% for strongly agree (for positive statements) or for strongly disagree (for negative statements)
- 75% for agree (for positive statements) or for disagree (for negative statements)
- 50% for neutral (for both positive or negative statements)
- 25% for disagree (for positive statements) or agree (for negative statements)
- 0% for strongly disagree (for positive statements) or strongly disagree (for negative statements).
The Statistical Package for the Social sciences (SPSS version 21, IBM, California, Los Angeles, USA). Statistical tests of significance, (e.g., Student's independent t-test and ANOVA) were applied. P < 0.05 was considered as statistically significant.
| Results|| |
[Table 2] shows that about one-third of participants (33.5%) aged 25–34 years, while about one-fourth of them (25.5%) aged 35–44 years. About one-half of participants (53.8%) were males, while the majority (89.8%) was Saudi. Less than half of the participants (45.3%) had university level of education, while 27.3% had secondary education. Most participants (74.3%) were married. The monthly income of 45% of participants was 5,000–10,000 SR.
[Table 3] shows that 37.5% of participants were dissatisfied and 16% were very dissatisfied with consultation, while 15% of participants were satisfied and 4.3% were very satisfied.
|Table 3: Satisfaction with consultation among attendees of primary health-care centers|
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[Table 4] shows that the participants' satisfaction was highest regarding professional care (80.1 ± 17.1), while it was least concerning the length of consultation (22.4 ± 19.5). The total score for participant satisfaction toward consultation was 57.7 ± 6.3.
|Table 4: Participants' satisfaction scores for different components of consultation|
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[Table 5] shows that participants' total consultation scores differed significantly according to their age groups (P = 0.031), with lower satisfaction scores among younger participants. However, their component scores did not differ significantly according to their age groups. Participants' scores for their consultation satisfaction did not differ significantly according to their gender. Participants' scores for their consultation satisfaction did not differ significantly according to their nationality. Participants' scores for the length of consultation differed significantly according to their educational status (P = 0.049), with lower satisfaction scores among higher educated participants. However, their scores for other components of consultation satisfaction did not differ significantly according to their educational status. Participants' scores for their consultation satisfaction did not differ significantly according to their marital status. Participants' general satisfaction scores differed significantly according to their monthly income (P = 0.028), with lowest scores among those with monthly income 5,000–10,000 SR and highest scores among those with monthly income >10,000 SR. Conversely, their total consultation scores differed significantly according to their monthly income (P = 0.025), with lowest satisfaction scores among those with monthly income >10,000 SR and highest among those with monthly income 5,000–10,000 SR. However, other component scores did not differ significantly according to their monthly income.
|Table 5: Participants' satisfaction with different components of consultation according to age groups|
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| Discussion|| |
Results of this study revealed that participants' satisfaction toward their medical consultation experience at the General Clinics of PHC centers in Abha City was suboptimal. More than 50% of participants were either dissatisfied or very dissatisfied, while <20% were either satisfied or very satisfied. Out of a possible score of 100 for each satisfaction component, participants' total score for their satisfaction toward consultation was 57.7 ± 6.3. Satisfaction was highest regarding professional care (80.1 ± 17.1), while it was least concerning the length of consultation (22.4 ± 19.5).
These findings indicate lower levels of patients satisfaction compared with those reported by some other studies.,,
Harrison, in the United Arab Emirates stated that patients satisfaction during medical consultation has been shown to be affected by factors such as waiting time, amount of information provided, and the time devoted to psychosocial and biomedical discussions, health education, physical examination, history-taking, and discussion of treatment effects.
Kabatooro et al. reported that 53.9% of patients attending the Mulago Assessment Centre at a teaching hospital in Kampala, Uganda were satisfied with their received medical consultations.
In Trinidad and Tobago, patients' satisfaction with medical consultation reached 74%, while in the Netherlands, Van Uden et al. reported 84% rate of satisfaction among PHC patients toward consultation.
Al-Shahrani et al., in Ahad Rufeida City, Saudi Arabia, noted that at PHC clinics, physicians with longer consultation times tend to provide more preventive measures. They can also give more advice on lifestyle and other health-promoting issues. Moreover, Bener et al. noted that longer consultations have been significantly associated with handling of psychosocial problems.
In the UK, Baker. reported higher mean scores for different components of consultation than those shown in the present study, with general satisfaction (78.1 ± 7.2); professional care (82.1 ± 6.1); depth of relationship (71.2 ± 7.1); and length of consultation time (65.7 ± 7.6).
Regarding factors related to patients' satisfaction with medical consultation at primary care centers' general clinics, the present study showed that participants' total consultation scores differed significantly according to their age groups, with lower satisfaction scores among younger participants. However, participants' satisfaction scores toward their medical consultation did not differ significantly according to their gender, nationality, or marital status.
In addition, regarding participants' educational status, their scores for the length of consultation differed significantly, with lower satisfaction scores among higher educated participants. Participants' general satisfaction mean scores differed significantly according to their monthly income (with lowest scores among those with monthly income 5,000–10,000 SR and highest scores among those with monthly income >10,000 SR). Conversely, participants total consultation scores differed significantly according to their monthly income (with lowest satisfaction scores among those with monthly income >10,000 SR and highest among those with monthly income 5,000–10,000 SR). However, other component scores did not differ significantly according to their monthly income.
The lower levels of satisfaction toward received medical consultation among participants with certain characteristics may be explained by their higher expectations. Unmet high expectations experienced by educated patients may provoke their sense of dissatisfaction toward the received medical consultation.
Different findings were reported by different studies. Kabatooro et al. reported higher scores among the elderly compared with younger patients. In South Glamorgan, Wales, UK, Kinnersley et al. reported that older patients reported higher levels of satisfaction toward medical consultations at PHC centers than younger patients, but there were no differences between male and female patients.
Danielsen et al., in Norway, reported younger patients who demanded more from their physicians scored less for patient satisfaction when compared with the elderly who were more conservative toward their consultation and had higher satisfaction scores.
In Ahad Rufeida, Saudi Arabia, Al-Shahrani et al. found that patients' satisfaction toward medical consultation did not differ according to their age or gender.
Udonwa NE and Ogbonna UK, in Calabar Teaching health-care facility, Nigeria, reported that none of the patients' sociodemographic variables studied (e.g., age, gender, and income) were found significantly associated with their satisfaction toward medical consultations.
However, Rodriguez et al. attributed variations in satisfaction toward received medical consultations among patients visiting primary care centers by that between 28% and 48% of variation were due to system-related factors, with more variation being due to differences between doctors than to differences between localities.
Lemon and Smith  stressed that doctor-specific factors explain 22.5% of the consultation length in comparison to 2.9% of the patient's age and 11.6% regarding the presenting complaint.
The limitations of this study include the fact that, being a cross-sectional design, it only could capture satisfaction for one visit while periodic surveys could be more informative to the center.
Moreover, the study setting of the present study comprised PHC centers' general clinics in Abha City. Therefore, the present study findings are limited to primary care centers and cannot be expanded or generalized to all levels of health care or specific health-care services such as chronic diseases clinics, antenatal care clinics, or well-baby care clinics.
| Conclusions|| |
Patients satisfaction toward their medical consultation experience at the General Clinics of training PHC centers in Abha City is suboptimal. More than half of the primary care patients are either dissatisfied or very dissatisfied. Total consultation scores differ significantly according to their age groups, with lower satisfaction scores among younger participants. All patients satisfaction components toward medical consultation do not differ significantly according to their gender, nationality, or marital status. Highly educated patients have lower satisfaction toward their consultation length of time. General satisfaction and total consultation scores differ significantly according to patient's monthly income.
Therefore, it is recommended that PHC physicians should be more concerned with improving medical consultations provided to their patients. Continuing medical education and training of primary care physicians about provision of medical consultation.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Almoajel A, Fetohi E, Alshamrani A. Patient satisfaction with primary health care in Jubail City, Saudi Arabia. World J Med Sci 2014;11:255-64.
Prakash B. Patient Satisfaction. J Cutan Aesthet Surg; 3: 151-5.
Press I. Patient Satisfaction: Defining, Measuring, and Improving the Experience of Care. Chicago: Health Administration Press; 2002.
Laurence CO, Gialamas A, Bubner T, Yelland L, Willson K, Ryan P, et al.
Patient satisfaction with point-of-care testing in general practice. Br J Gen Pract 2010;60:e98-104.
Federman AD, Cook EF, Phillips RS, Puopolo AL, Haas JS, Brenna TA, et al
. Intention to discontinue care among primary care patients: Influence of physician behavior and process of care. J Gen Intern Med 2001;16:668-74.
Peltenburg M, Fischer JE, Bahrs O, van Dulmen S, van den Brink-Muinen A. The unexpected in primary care: A multicenter study on the emergence of unvoiced patient agenda. Ann Fam Med 2004;2:534-40.
Wilson A, Childs S. The relationship between consultation length, process and outcomes in general practice: A systematic review. Br J Gen Pract 2002;52:1012-20.
Udonwa NE, Ogbonna UK. Patient-related factors influencing satisfaction in the patient-doctor encounters at the general outpatient clinic of the university of Calabar teaching hospital, Calabar, Nigeria. Int J Family Med 2012;2012:517027.
Makoul G. Essential elements of communication in medical encounters: The Kalamazoo consensus statement. Acad Med 2001;76:390-3.
Baker R. Development of a questionnaire to assess patients' satisfaction with consultations in general practice. Br J Gen Pract 1990;40:487-90.
Kabatooro A, Ndoboli F, Namatovu J. Patient satisfaction with medical consultations among adults attending Mulago hospital assessment centre. S Afr Fam Pract (2004) 2016;58:87-93.
Singh H, Haqq ED, Mustapha N. Patients' perception and satisfaction with health care professionals at primary care facilities in Trinidad and Tobago. Bull World Health Organ 1999;77:356-60.
van Uden CJ, Ament AJ, Hobma SO, Zwietering PJ, Crebolder HF. Patient satisfaction with out-of-hours primary care in the Netherlands. BMC Health Serv Res 2005;5:6.
Harrison A. Patients' evaluations of their consultations with primary health clinic doctors in the United Arab emirates. Fam Pract 1996;13:59-66.
Al-Shahrani AA, Nasser AA, Al-Qarni S. Determinants of consultation time at a family medicine center. Med J Cairo Univ 2015;83:1101-4.
Bener A, Al-Marri S, Abdulaziz A, Ali BS, Al-Jaber K, Mohammed H. Do minutes count for health care? Consultation length in a tertiary care teaching hospital and in general practice. Middle East J Fam Med 2007;5:3-8.
Baker R, Smith A, Tarrant C, McKinley RK, Taub N. Patient feedback in revalidation: An exploratory study using the consultation satisfaction questionnaire. Br J Gen Pract 2011;61:e638-44.
Kinnersley P, Stott N, Peters T, Harvey I, Hackett P. A comparison of methods for measuring patient satisfaction with consultations in primary care. Fam Pract 1996;13:41-51.
Danielsen K, Garratt AM, Bjertnaes ØA, Pettersen KI. Patient experiences in relation to respondent and health service delivery characteristics: A survey of 26,938 patients attending 62 hospitals throughout Norway. Scand J Public Health 2007;35:70-7.
Rodriguez HP, Scoggins JF, von Glahn T, Zaslavsky AM, Safran DG. Attributing sources of variation in patients' experiences of ambulatory care. Med Care 2009;47:835-41.
Lemon TI, Smith RH. Consultation content not consultation length improves patient satisfaction. J Family Med Prim Care 2014;3:333-9.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5]