Patient satisfaction in Jamaican hospitals

To measure the impact on public hospital clients of the types of inputs provided by the project, interviews were conducted in 1994 with 1,213 systematically selected patients in six Jamaican hospitals to determine their satisfaction with and payments for services. To facilitate interpretation of the findings, the evaluators also interviewed administrative staff and reviewed utilization and staffing data for each hospital. The survey showed that satisfaction was uniformly higher for most variables in one hospital which had a professionally trained administrator in the years prior to the survey (Savanna-la-Mar). Though the HSIP project had not contributed to the placement of the administrator, she did practice the types of cooperative management skills which the project is trying to replicate. Administrative hospital staff also acknowledged, and appeared to value, many other types of training provided by the project. While the survey found no difference in satisfaction between the three hospitals which already had Chief Executive Officers (CEOs) at the time of the survey (Spanish Town, May Pen, and Mandeville) compared with two control hospitals which did not (Princess Margaret and Port Antonio), the CEO program may have still been too new at the time of the survey to show any differences. Data on charges to patients suggest that official charges average about 14% of the costs (assuming unspecified charges were forgiven or waived). On average, charges by the hospital are equivalent to 4 days of per capita GNP. When private payments to doctors, pharmacies, labs, and others are included, the total averages 7 days of per capita GNP. While these averages seem affordable, the few patients incurring private charges pay substantially more. Most of the services provided by the HSIP, such as training to improve revenue collection, serve all hospitals, rather than just those with CEOs. Thus, the most important use of this survey is likely to be as a baseline for future surveys to measure whether satisfaction increases in public hospitals as a whole. The cost of the survey (about $10 per patient) was affordable and could be substantially reduced by sampling prevalent rather than discharged patients. Satisfaction surveys are a valuable tool for monitoring and improving the quality of services. (Author abstract)