PERCEPTION AND SATISFACTION OF CLIENTS TOWARDS HEALTH SERVICE DELIVERY IN THE ACCIDENT AND EMERGENCY DEPARTMENT OF UNIVERSITY COLLEGE HOSPITAL IBADAN, NIGERIA

Abstract

Client's satisfaction, a measure of outcome of health care provided to patients, is indispensable in the assessment of health care services. In Nigeria, information relating to clients' perception and satisfaction of service delivery at the Accident and Emergency Department (AED) in tertiary healthcare facilities is sparse. This study was, therefore, designed to investigate the perception and satisfaction of clients concerning health service delivery at the AED of the University College Hospital, lbadan. A cross-sectional study was adopted and 450 consenting patients and relatives at the AED and wards were purposively selected. An interviewer -administered, semi-structured questionnaire which included questions on socio-demographic characteristics, Clients' Perception (CP) of quality of care, level of satisfaction (LS) and service delivery, was used for data collection. Clients satisfaction and clients perception were measured on 15-point and 9-point scales respectively. Satisfaction scores (SS) <23 and ≥ 23 were rated as not satisfied and satisfied respectively. Perception scores (PS) <15 and ≥15 were classified as poor and good respectively. Data were analyse using descriptive statistics and Chi-square test with level of significance set at 0.05. Age of respondents was 57.9 ± 9.8 years, 50.0% were patients and 50.0% were patients' relatives, 50.2% were males and 62.7% were married. The PS was 14.4±3.71 while SS was 22.3±5.7. Majority (77.3%) of respondents had good perception of health service delivery at the AED. Educational status of the respondents was significantly associated with level of satisfaction, as clients with tertiary education sere more satisfied (75.3%) than clients with secondary (64.4%), primary (53.3%) or no formal education (52.1%). A significantly higher proportion of respondents aged 21-40 years (36.3%) were unsatisfied with service delivery compared with those aged 41-60 years (35.1%) and 61-80 years. Factors which reportedly accounted for clients' refusal of admission included lack of money (53.3%) and negative attitudes of staff (46.9%). Respondents' suggestions on how to improve services at the AED included: provision of trolleys for moving patients (73.3%) and increase in the amount of attention paid to personal needs (61.1%). Pharmacists were less likely to contribute to poor perception (OR-0.648 95% CI=0.530-0.793) compared to other personnel while doctors were also less likely to contribute to clients dissatisfaction (OR=0.542 95% CI-0.422-0.697) compared other personnel. The level of satisfaction to health service delivery at the Accident and Emergency was inadequate. Patients and relatives still have poor perception about health services in the Accident and Emergency despite the majority having a good perception. Therefore, provision of affordable, readily available and conducive health services should be paramount to the hospital management. In addition, the training of health care providers on interpersonal relationship should be organized regularly to improve the quality of care.