ARTICLE INFO

Article Type

Descriptive & Survey Study

Authors

Maftoon   F. (1)
Mousavi   B. (*)
Soroush   M.R. (2)
Mohammad   K. (3)
Rahimpoor   D. (2)
Khobyaryan   A. (2)






(*) Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
(1) 1Health Metrics Research Center, Institute for Health Sciences Research, Tehran, Iran
(2) Janbazan Medical and Engineering Research Center (JMERC), Tehran, Iran
(3) Epidemiology & Biostatistics Department, Health Faculty, Tehran University of Medical Sciences, Tehran, Iran

Correspondence

Article History

Received:  February  6, 2017
Accepted:  May 7, 2017
ePublished:  November 6, 2017

BRIEF TEXT


… [1-4]. Hospitalization services are of particular importance. Customer satisfaction is an important tool in measuring the quality of services in health system [5].

… [6, 7]. Patient satisfaction and service quality play an important role in the design and implementation of marketing strategies in health services [8]. On the other hand, examining the quality of health services is one of the important steps in assessing and improving the quality of services. Patient satisfaction is an important indicator of quality of services [9]. The results of the studies indicate that investigation and evaluation of patient satisfaction and the quality of health services in both conceptual and operational areas is a complex process. However, the collection of patient satisfaction data is easier compared to professional quality indicators [8, 10]. … [11, 12].

The purpose of this study was to assess the satisfaction of veterans with supplementary insurance and their families from hospital services.

This research is descriptive-cross sectional.

This research was conducted in 2015 among individuals covered by supplementary insurance in the Foundation of Martyrs and Veterans Affairs of the country. These insured persons included veterans and persons covered by them (spouse, children or parents) who has subsidiary insurance services at the Foundation of Martyrs and Veterans Affairs.

Based on relative satisfaction of 75% in previous studies and accuracy of 0.06, the sample size was estimated to be 200. To collect data, 1800 people were questioned, and 210 of them (11.7% of the studied population) who had used hospital services for one year before the start of the study were enrolled. Samples were selected using the available statistics in the Foundation of Martyrs and Veterans Affairs using simple random sampling.

The data gathering tool was a researcher-made questionnaire. The initial questionnaire after the preparation was reviewed by 20 scientific and executive experts in the field. After further reforms, following the comments of the experts, necessary changes were made to the questionnaire. The questionnaires were then evaluated at a health center under Iran supplementary insurance. The research group completed the questionnaire in a pilot form for the clients of the Foundation of Martyrs and Veterans Affairs. Based on the assessment of this stage, some points were added to the questionnaire and minor modifications were made. The reliability of completed questionnaire was calculated using Cronbach's alpha test which was equal to 0.84. The questionnaire consisted of 25 questions including 15 demographic information questions (age, sex, level of literacy, employment status, residence, and self-esteem status) and 10 questions related to satisfaction. Questions about the satisfaction section were designed in three sections: A) Satisfaction with the process of providing the service: The recipient's satisfaction at the time of visit for the purpose of admitting the entire process that has benefited from it. B) Satisfaction with the distance from the place of receiving hospitalization service: the satisfaction of the spatial distance to receive hospital hospitalization service. C) Satisfaction with the process of reimbursement of the cost of hospitalization: satisfaction with all the processes that the referral has incurred to repay its costs. In order to measure satisfaction, the five-point Likert scale (very low, low, moderate, high, and very high) was used. To analyze the data, the options “high” and “very high” were combined with each other and the options “low” and “very low” were also combined. The method of scoring was in the way that the option “very low” was given the score one and the option “very high” was given the score of 5. The interviewers were trained to collect data and data was collected through telephone interviews. There is only information on the veteran person in the list of Foundation of Martyrs and Veterans Affairs. Therefore, a telephone conversation was done with the veterans and the demographic information and personal information of the last referral for receiving hospitalization services were taken. The last referral could be a veteran person or any other members of his family. For each one, three times phone call was made that if it was not answered, they were deleted from the study, and another sample was randomly placed. Data were analyzed by SPSS software version 18 using descriptive and inferential statistics. The logistic regression analysis was used to determine the satisfaction of the distance from the place of admission to hospital based on the demographic factors of age, sex, level of literacy, occupation, residence, and self-esteem status.

The mean age of the subjects was 46.1±13.7 years (Table 1). Concerning satisfaction with hospitalization services, the frequency of satisfaction was more than 91.4%. Frequency of satisfaction with hospital distance was generally about 79.5%. With regards to the cost, among 50 people who had paid for, 38.0% had high satisfaction of repayment process (Table 2). None of the factors related to age, gender, education level, employment status, place of residence, and self-esteem status were significantly correlated with satisfaction with the distance from the place of admission (Table 3).

… [13-16]. Most of the subjects were satisfied with the hospitalization service. In a similar study on the satisfaction of insured persons covered by rural insurance in villages and cities under 20 thousand population, the frequency of satisfaction with the use of rural insurance for admission cases was approximately 78% [17, 18]. Compared to this study, the satisfaction of veterans and their families was higher in this study. In a study in a general hospital, satisfaction rates of hospital services were reported to be 66% [1]. This amount is lower than the present study. However, in line with the findings of this study, the satisfaction rate of nursing and medical services, both during admission to another similar study in hospitals was about 90% [19, 20]. … [21-27]. In the present study, the satisfaction with the distance from the place of admission was significantly lower than the satisfaction rate of the hospitalization process. This is also the case in other veteran studies regarding the location of receiving drug services [24, 25]. … [28, 29]. The level of satisfaction with the reimbursement process was generally around 38% which is clearly at a low level. The level of satisfaction with the reimbursement of hospitalization costs in other studies was also low that is in outpatient services, drug services, and para-clinic services has been 42&, 31% and 17 to 40% respectively [24, 25, 27]. … [30].

Regarding the fact that the satisfaction rate of the hospitalization service was favorable in all groups, it is recommended to take steps to maintain this situation and prevent it from falling. For future studies, the continuous assessment of patient satisfaction with hospitalization services, evaluation of the quality of these services, and an examination of the ways to improve the repayment of costs and the results of its process modification is recommended.

The limitation of this study was to win the trust of the subject for providing information by introducing a creditor plan (which is the Foundation of Veterans). Also, given that the subjects were selected from the whole country and were randomly selected, not being natively Persian was another limitation of the study that it was attempted to resolve by coordination and helping of the children.

Satisfaction of veterans with supplementary insurance and their families with hospitalization services is favorable in the field of service delivery, and in terms of satisfaction with the distance from the place of receiving hospitalization service, it is in optimal level. While satisfaction with the reimbursement of hospitalization costs is not desirable.

The authors express their gratitude to the Department of Statistics and the Department of Health of Foundation of Martyrs and Veterans Affairs.

Non-declared

The subjects were included in the study with satisfaction. This study was conducted at the Ethics Committee of Veterans Medical and Engineering Research Center of Iran, No. 93-P-101.

This research was funded by the financial support of the Veterans Medical and Engineering Research Center.

TABLES and CHARTS

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CITIATION LINKS

[1]Mosadeghrad AM. Essentials of healthcare organization and management. Tehran: Dibagaran Publishing; 2003. p. 534. [Persian]
[2]Mosadeghrad AM. Assessment of Patients Satisfaction with Hospital Services in Razi Hospital in Qazvin. J Manag Inform Health. 2005;1(1):28-32. [Persian]
[3]Abbaspour A, Davarani SH, Masoumi M, Modirian E, Khateri Sh, Mousavi B, et al. Satisfaction of child victims of landmines with services of veterans and martyr affair foundation (VMAF). Daneshvar. 2015;22(118):43-50. [Persian]
[4]Torabi M. Utilization Model of Health Services in Retirees Covered by DANA Insurance [Dissertation]. Tehran: Islamic Azad University; 2003. [Persian]
[5]Mosadeghrad AM. The role of participative management (suggestion system) in Shahid Fayazbakhsh Hopital effectiveness and efficiency. J Res Med Sci. 2003;8(3):85-89. [Persian]
[6]Applebaum R, Straker J, Georn S. Assessing satisfaction in health and long term care: Practical approaches to hearing the voices of consumers. Salmon Tower Building New York City: Springer Publishing Company; 1999.
[7]Avis M, Bond M, Arthur A. Satisfying solutions? a review of some unresolved issues in the measurement of patient satisfaction. J Adv Nurs. 1995;22(2):316-22.
[8]Taylor SA, Cronin JJ Jr. Modeling patient satisfaction and service quality. J Health Care Mark. 1994;14(1):34-44.
[9]Johansoon P, Oleni M, Fridlund B. patient satisfaction with nursing care in the context of health care: A literature study. Scand J Caring Sci. 2002;16(4):337-44.
[10]Kravitz R. Patient satisfaction with health care: Critical outcome or trivial pursuit?. J Gen Intern Med. 1998;13(4):280-2.
[11]Puor Aghaei M. Medical equipment and quality of life in veterans. First Veterans and Families Scientific Conference, Veterans Institute for Engineering and Medical Sciences. Tehran: Deputy of Cultural Affairs and Sports Affairs of Veterans Affairs; 2003. [Persian]
[12]Mousavi B, Maftoon F, Sorush MR, Mohammad K, Rahimpoor D, Khoubyarian A. Satisfaction with outpatient visits in veterans covered by supplementary health insurance. J Iran Institut Health Sci Res. 2017;16(2):142-9. [Persian]
[13]Williams S, Dale J. Doctor-patients communication and patient satisfaction: A review. Fam Pract Int J. 1998;15(5):480-92.
[14]Winefield HR, Murrell TG, Clifford J. Process and outcomes in general practice consultations: Problems in defining high quality care. Soc Sci Med. 1995;41(7):969-75.
[15]Loblaw DA, Bezjak A, Bunston T. Development and testing of a visit-specific patient satisfaction questionnaire: The Princess Margaret hospital satisfaction with doctor questionnaire. J Clin Oncol. 1999;17(6):1931-8.
[16]Kane RL, Maciejewski M, Finch M. The relationship of patient satisfaction with care and clinical outcomes. Med Care. 1997;35(7):714-30.
[17]Maftoon F, Mohannad K, Montazeri A, Farzadi F, Aeenparast A. Care receivers satisfaction in family physician and referral system: a national study from Iran. J Int Res Med Pharm Sci. 2016;7(4):180-6.
[18]Maftoon F, Montazeri A, Farzadi F, Jahangiri K, Aeenparast A, Mohammad K, et al. Survey of satisfaction of rural insured covered by the health insurance organization and providers in the referral implication plan and family physician. Tehran: Health Insurance Organization; 2009. [Persian]
[19]Hajian K. Satisfaction rate of hospitalized patients from the provision of health services in Shahid Beheshti and Yahya Nejad hospitals in Babol. J Babol Univ Med Sci. 2008;9(2):51-60. [Persian]
[20]Soleimani V, Ghalyabtab F. Inpatient satisfaction: Medical services delivery in social security hospital (Chamran) in Saveh. J Hospital. 2006;6(1-2):9-10. [Persian]
[21]Shojaei Baghini H, Nakhaei N, Aghaei Afshar M. Satisfaction of janbazan and azadegan referring health center of janbazan foundation of Kerman City to Rcceive Medical Services in the Year 2003-2004. J Rafsanjan Univ Med Sci. 2006;4(1):41-8. [Persian]
[22]Mousavi B, Jafari F, Davati A, Soroush MR, Narenjkar J. Health services satisfaction among chemical warfare survivors: A national survey from Iran. Iran J War Public Health. 2009;2(1):1-5. [Persian]
[23]Soroush MR, Mousavi B, Ganjparvar Z. Health care service satisfaction among chemical warfare survivors with severe ophthalmogic complications. Iran J War Public Health. 2008;1(1):12-21. [Persian]
[24]Mousavi B, Maftoon F, Soroush MR, Mohammad K, Rahimpoor D, Khoubyarian A. Satisfaction with outpatient visits in veterans covered by supplementary health insurance. Pyesh. 2017;16(2):142-9. [Persian]
[25]Mousavi B, Maftoon F, Mohammad K, Soroush MR, Asgari M. Satisfaction with supplemental health insurance and pharmaceutical care among veterans and their families. Pyesh. 2016;15(6):609-17. [Persian]
[26]Jandaghi Gh, Tabarsa Gh, Heidari H, Heidari F. Satisfaction of veterans from health services and their impact on mental well-being. Iran J War Public Health. 2010;3(9):30-6. [Persian]
[27]Maftoon F, Mousavi B, Mohammad K, Soroush MR, Ganjparvar Z. satisfaction of martyrs’ families of supplemental insurance in receiving para-clinical services. Iran J War Public Health. 2015;7(4):225-32. [Persian]
[28]Newman RD, Nyangezi JM, Machobo F, Muiser J. Satisfaction with outpatient health care services in manica province, Mozambique. Health Policy Plan. 1998;13(2):174-80.
[29]Wright SM, Craig T, Campbell S, Schaefer J, Humble Ch. Patient Satisfaction of Female and Male Users of Veterans Health Administration Services. J Gen Intern Med. 2006;21(Suppl 3): S26-32.
[30]Soroush MR, Mousavi B, Maftoon F, Mohammad K, Ganjparvar Z. Satisfaction of supplementary insurance and medical services during trips in war survivors and their families. Int J Travel Med Glob Heath. 2016;4(2):65-8.