Original Article UpDCJ | Vol. 8 No.
1 | April 2018
Patient Satisfaction With Health Care Services In Outpatient Depart-
ment Of A Dental College Hospital In Pakistan
Soomro M H1, Magsi M2, Lahmar O3
Received: 20.10.17 Accepted: 07.04.18
Abstract:
Introduction: Patient satisfaction is one of the important factors to determine the success of health
care facility. The real challenge is not getting ready with mere requirements, but also delivers services
ensuring good quality. Thus, there is a need to assess the health care systems regarding patient satis-
faction as often as possible. The aim of this study was to determine the patient satisfaction with health
care services in out-patient department (OPD) of a dental college hospital in Pakistan.
Materials and Methods: A descriptive cross-sectional pilot study was undertaken during the month of
May 2015 in the OPD of Bibi Asifa Dental College and Hospital, Larkana, Pakistan. A randomly select-
ed 100 patients were interviewed by using pre-structured questionnaires. The questionnaires had
semi-structured, open-ended and closed questions. While analyzing, they were grouped into catego-
ries like availability of services, clinical care, waiting time and cost.
Results: The overall opinions about the satisfaction level of patients for availability of health services
in the hospital were good. As location of the hospital and timings of the OPD were convenient to the
most of the patients 86% and 93% respectively. Availability of the doctors was also found adequate.
However, regarding seating arrangements one fourth of the total patients were found to be unsatis-
fied. Efficiency of the doctor was found satisfactory by 83%, while majority of the patients did not faced
any kind of language problem.
Conclusion: According to patient’s opinion, the study revealed that the degree of satisfaction was
satisfactory with respect to waiting time and availability of the doctors in the hospital, which need to
be further explored and corrected.
Key Words: Patient satisfaction, dental outpatient department, health care.
1. Munawar Hussain Soomro, Department of Community Medicine, Al-Nafees Medical College, Isra Universi-
ty-Islamabad Campus, Pakistan.
2. Mansoor Magsi, Department of Medicine, ShaheedMohtarma Benazir Bhutto Medical University, Larkana,
Pakistan.
3. Oussama Lahmar, University of Sciences Tunis, Tunis El Manar University, Tunisia.
Correspondence : Dr Munawar Hussain Soomro, Email: [email protected],
Tel No. +33 7 83 38 95 45
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Update Dental College Journal Vol. 8 No. 1 | April 2018
Introduction ble for this purpose is the finding the level of patient
Health care quality is a globally concerned issue. The satisfaction. Only a satisfied patient can confirm the
main purpose of health care services is to provide high quality of medical care provided by the OPD.
quality of care and to improve health status of the Bibi Asifa Dental College and Hospital is a recently
population[1, 2]. The scope of the health services varies developed teaching dental hospital attached with
widely from place to place and country to country. Shaheed Mohtarma Benazir Bhutto Medical Universi-
Further health services are influenced by general and ty, Larakana in Pakistan, providing dental health care
ever changing national, state and local health prob- services to the patients. Therefore, this study was
lems, their needs, attitude and available resources to designed to determine the patient satisfaction with
provide these services. History reveals that health health care services in OPD of the Dental college
care has seen many changes over the time according hospital.
to the requirement of the society and availability of
the resources and technologies. Materials and Methods
In the recent years much attention has been paid to A descriptive cross-sectional pilot study was under-
improve health care and decrease inequalities within taken during the month of May 2015 in the OPD of
the health care systems. Health system research is Bibi Asifa Dental College and Hospital, Larkana,
essential for the continuous evolution and refinement Pakistan. In this pilot study a total number of 100
of health services. Nowadays managers and policy patients were interviewed by using simple random
makers of health care systems are much more inter- sampling technique. The main purpose was to deter-
ested in the improvement of quality care[3, 4]. Patient mine the patient satisfaction with health care services
satisfaction is an individual’s feeling of pleasure or in OPD of the dental college hospital. Patients aged
disappointment resulting for comparing a service’s 18 years and older were included in the study for
perceived performance or outcome in relation to his interviews. Patients with age below 18 years (usually
or her expectations. Patient satisfaction has considered as children in Pakistan and many other
remained one of the most essential and important countries), severe toothache and unwilling to partici-
focus point for health care providers. Panchansky R pate in the study were excluded. Validity and reliabili-
and Thomas JW, defined patient satisfaction as the ty was done by extensive literature review and
degree of congruency between a patient’s expecta- followed by consultation with experts while develop-
tions of ideal nursing care and his perception of real ing of interview guidelines. Pre-designed question-
nursing care that he or she received[5].while Swan JE naires were used and were also pre-tested. The
et.al suggested that patient satisfaction is a positive questionnaires had semi-structured, open-ended and
emotional response that is desired from a cognitive closed questions which includes;
process in which patient compare their individual 1. Socio-demographic characteristics (to know
experience to a set of subjective standards[6]. It can the distribution of study population according to differ-
be concluded that patient satisfaction happens when ent indicators).
all needs are met according to their expectations. 2. Approach to the hospital and doctors.
Patient satisfaction is essential due to the multiple 3. Out-patient department timings and process-
reasons. Any unsatisfied patient will not come back to es of registration.
the hospital, and it will lead to loss of money of patient 4. Services provided and behavior by the health
as well as wastage of resources. High satisfaction will care providers.
indicate that hospital is working efficiently. On the The data collected through interviews were recorded
other hand, poor satisfaction level will indicate man- and analyzed by using Microsoft excel and IBM
agement to improve the health services. SPSS Statistics version 20. Descriptive statistics
Presence of services in multiple specialties, attend- were applied, using frequencies and cross-tabula-
ance of out-patient department (OPD) by a large tions. All participants were explained about the nature
number of patients and allocation of huge resources of the study before proceeding further. Confidentiality
demand that quality of care provided by the hospital was ensured by not disclosing the identity of partici-
should be determined. The most reliable tool availa- pants and informed consent was taken from all.
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Update Dental College Journal Vol. 8 No. 1 | April 2018
All of the interviews were conducted by the primary institutions. Satisfaction is achieved when the
investigator. Sindhi language was used for inter- patients’ perception of the quality of care and services
views, which allow communication between that they receive in healthcare setting has been
researcher and information provider and this also positive, satisfying, and meets their expectations[9].
reduces the misunderstanding between interviewees Patient satisfaction is relatively new area of study in
and interviewers. health system researches especially in Pakistan and
is based on patients’ perception of the treatment. This
Results study was conducted to focus on various aspects of
The study population consisted of 100 patients meet- health care in a newly established dental institution
ing the inclusion criteria. Table-1 revealed that majori- and thereby find solutions to bring positive change or
ty of the patients (78%) belongs to the reproductive improvement in the health facilities.
age (18-59). Forty seven percent respondents were The result of our study shows that patients were satis-
females while 53% were males. About one fourth fied with the services and care provided at hospital.
(23%) patients were single, while 59% were married. Similar kind of study was conducted in Pakistan
Literacy rate was 73%, including more than one third Railway Hospital Rawalpindi[10] showed same pattern
(35) with higher secondary and above education. On of patients’ satisfaction. The best rated was doctors’
categorizing by patients occupation, it was observed availability and courteousness (98.3%) and 96.8%
that 37% were in service, 26% unemployed, 23% were satisfied with the attitude of nursing staff. Shakhi
were labourer and 14% were students. MR et al[11] reported that 94.4% patients were satis-
Table-2 shows that the overall satisfaction level of fied with hospital services in their study conducted in
patients for availability of health services in the hospi- provincial teaching hospital in Ghazvin Iran.
tal were good. As location of the hospital and timings The study[12] on out patient satisfaction at a super
of the OPD were convenient to the most of the specialty hospital in India, had reported that, as much
patients 86% and 93% respectively. Similarly, 84% of as 50% of the patients were satisfied with regard to
patients about cleanliness in OPD and 81% patients the cleanliness of the hospital. In another study by
regarding services provided by paramedical staff, Prasanna K S. et al[13], on consumer satisfaction
were found satisfied. Availability of the doctors was about hospital services: A study from the outpatient
also found adequate. However, regarding seating department of a private medical college hospital at
arrangements one fourth of the total patients were Mangalore, it was shown that patients were fully
found to be unsatisfied. We did not observed patient satisfied in respect to seating arrangement, cleanli-
satisfaction difference between males and females. ness in the OPD and OPD timing, which was almost
However, older patients (60 and above) were found similar to our study. While satisfaction level regarding
more satisfied than other age groups. services by the availability of doctor in hospital, para-
Compliance of the patients in respect to the clinical medical staff and finding the specialist in the depart-
care was more towards the satisfactory side Table-3. ment in OPD were 99%, 88% and 84% respectively.
As it was 88% for approach by the doctor, 83% for The findings of the study by Hassan Soleimanpour et
good communication by the doctor and 79% explana- al[14], on emergency department patient satisfaction
tion about the disease provided by the doctor to the survey in Imam Reza Hospital, Tabriz, Iran revealed
patient. Efficiency of the doctor was found satisfacto- that the satisfaction level of patients in regard to the
ry by 83%, while majority of the patients did not faced information given by care provider about medication
any kind of language problem. was very good in 49.4% of patients.
The study[15] in a tertiary care teaching hospital in
Discussion Pakistan on patient satisfaction: A comparative study
One of the primary aims of dental treatment is to win at teaching versus DHQ level hospital in Lahore,
the patients’ satisfaction and it is an important criteri- Pakistan; noted that location of hospital was conven-
on for judging the success and quality of dental care ient in 38% of patients for teaching hospitals and 42%
delivered[7, 8]. Patient satisfaction is one of the most of patients for DHQ level hospital; while 80% of
important quality indicator(s) at the health care patients in teaching and 95% in DHQ level hospital
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Update Dental College Journal Vol. 8 No. 1 | April 2018
were satisfied with the time waited by them to be Table 1: Distribution of respondents based on their
seen by doctor. And regarding satisfaction level of socio-demographic characteristics.
patients with the amount spent for medical needs,
Characteristics No. Percentage
medications available free of cost in the hospital were
18-39 37 37
74% and 76% for teaching hospitals, and 95% each
Age 40-59 41 41
for DHQ level hospital respectively.
Most of the patients were satisfied from the behavior 60 & above 22 22
of doctors and staffs but wanted more awareness Female 47 47
Gender
against dental diseases and their prevention. A Male 53 53
survey in New Zealand[16] showed that almost all the Single 23 23
patients wanted to be informed in detail about their Marital status Married 59 59
dental treatment. Similarly, Rankin and Harris[17] Others 18 18
reported that 97% of the patients surveyed favored a Graduate & higher 7 7
dentist who explained what the treatment and proce-
Higher secondary 28 28
dure entailed.
Education Secondary 15 15
We observed that patients, in particular the uneducat-
Primary 23 23
ed and the elderly found it difficult to reach to the
sections to which they were referred. They suggested Illiterate 27 27
that placing sign boards and volunteers would ease Service 37 37
the situation. Patients felt, many a time they were not Labour 23 23
Occupation
given any appropriate explanations for the delay in Unemployed 26 26
the treatment. Some of the patients commented that Student 14 14
there were instances when they or other patients Rural 37 37
around them were sent back or recalled later Background
Urban 63 63
because the doctor/house-surgeon/student allotted
to the patient were not there.
Satisfaction with the quality of care provided is a very Table-2: Distribution of responses according to avail-
sensitive issue, but little work has been done in this ability of the services.
country about this important aspect of patient care.
Variables No. Percentage
One reason is that we are still struggling for the
Convenient 86 86
primary care provision to all of our population rather Location of the Hospital
than talking about its quality. By literature search, we Inconvenient 14 14
were unable to find any reference about satisfaction Convenient 93 93
OPD timings
with the Dental OPD but reports on satisfaction in Inconvenient 7 7
some other domains were found. Studies have Seating arrangements in Satisfactory 73 73
shown that expectations of patients are based on OPD Unsatisfactory 27 27
their experiences, environment, social background Satisfactory 84 84
and personality[18-21]. Cleanliness of the OPD
Unsatisfactory 16 16
Adequate 89 89
This information could be included into undergradu- Availability of Doctors
Inadequate 11 11
ate training curriculum of dentists and continuing
Services by paramedical Satisfactory 81 81
education programs. The systematic collections of
patients’ opinion could help the hospital administra- staff Unsatisfactory 19 19
tion, staff, and dental faculty to get clear idea what
their patients are expecting from them.
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Update Dental College Journal Vol. 8 No. 1 | April 2018
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