Understanding Patient Satisfaction Preferences Expectations And Patient Rights Of Practice In Public Hospital Settings Of Amhara Regional State Ethiopia

Background: Patient satisfaction has become an indicator and a standard part of evaluation ofrnthe health care system, despite its complex nature and multiple determinants of patientrnsatisfaction. Health care now a day is a major service area for the people, thus it should satisfy itsrncustomers. There have been different mechanisms to enhance patient satisfaction. Adhere tornservices on patients’ preferences, meeting expectations and health care practice based onrnpatients’ rights were among others. Making health care service more congruent with patients’rnpreferences, expectations and patients’ rights practice can be achieved through measurement andrnfeedback of patients’ satisfaction and interventions that address patient concerns. Even countriesrnhave guaranteed patients' rights to process for resolving dissatisfactions with health carernproviders. The implementation of patients’ rights can increase patient satisfaction, as well asrnachieve equal distribution of responsibility between the patients, and health service providers.rnThus research is needed to move forward with the structural changes regarding patients’ valuernjudgments in the health care service. Studies on patients’ preference to use health care, patientrnexpectation and patient rights practice as an important factor for patient satisfaction carernrendered at health care facilities in the developing country context like Ethiopia are oftenrnneglected in health service researches and rarely subjected to scientific inquiry.rnObjectives: The study aimed to examine patients’ preference, expectations, and the livedrnexperience of patients on patient rights practice as a factor of patient satisfaction at publicrnhospitals in Amhara Region, northern Ethiopia.rnMethods: The study was carried out in nine public hospitals of Amhara Region of Ethiopia. Itrnwas designed as a mixed method study in which both quantitative and qualitative data collectionrnand analyses were employed. About 1005 participants in the out and in patient departments ofrngeneral, medical and surgical departments were involved in the preference study which usedrnDiscrete Choice Experiment method. A stated-preference discrete choice experiment survey wasrnperformed among patients who visited the hospitals. Six attributes namely waiting time,rnphysician communication, nursing communication, drug availability, continuity of care, andrndiagnostic facilities were selected based on a literature review of the most importantrncharacteristics of hospital health care service. These attributes were reviewed and validated withrnviirninputs from patients and researchers in the field. Data were entered in SPSS Version 17 andrnanalyzed using STATA version 12. A random-effects probit model was used to perform thernanalysis.rnRegarding the quantitative Pre-and-Post consultation study of patient expectation, 776rnparticipants were involved in the study. Data were collected on two occasions; about thernexpectations before consultation, and how their expectations were met and their satisfaction afterrnthe consultation. Data were entered and analyzed using SPSS Version 17. Means were computedrnfor the overall and the sub categories of expectation items. Paired t-test and logistic regressionrnanalysis techniques were also employed.rnFor the qualitative study, data were collected using semi-structured interview from 22 patientsrnwho have had experience of health care service utilization in the hospital setting. Thernparticipants were selected purposively using maximum variation sampling technique based onrncriteria like age 18 and above years, both sexes, considering residence, educational status, andrnexperience in the outpatient and inpatient departments. The interview (data) were tape-recorded,rntranscribed, translated, reviewed, and analyzed using an iterative content approach ofrnphenomenographic researches. Open code software version 4.02 was used for data management.rnMain categories and sub categories were described. The outcome space was constructed based onrnmain categories of patients’ conceptions and ways of understanding the phenomenon of patientrnrights practice.rnResults: The attributes included in the preference study; waiting time, physician communication,rnnursing communication, drug availability in the hospital pharmacy, continuity of care andrndiagnostic facilities had significant impact on participants’ decisions in the choice of hospitals.rnThe waiting time coefficient showed a negative value in the main effects model (β=-0.773,rnP=0.026) indicated a higher probability of choosing a hospital with less waiting time for arnconsultation. Patients were willing to wait up to 3.3 (MRS, 3.263 95%, CI: 1.387-5.139) hoursrnand 2.7 (MRS, 2.66 95%, CI: 1.769-3.556) hours to get full drugs in the hospital and goodrnnursing communication, respectively.rnPreferences differ with sex occupation and type of hospitals. Farmers preferred a hospital withrngood nursing communication (=0.089, P

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