- RESEARCH PAPER ANALYSIS -- TITLE -

CLIENT SATISFACTION EXIT INTERVIEW : ASSESSING QULITY OF

PUBLIC HEALTH INSTITUTIONS THROUGH GENERATED FEEDBACK

- TITLE -CLIENT SATISFACTION EXIT

INTERVIEW : ASSESSING QULITY OF PUBLIC HEALTH INSTITUTIONS

THROUGH GENERATED FEEDBACK

Topic

The topic examines : •how the user’s perceptions are shaped,•If there is bias in these perceptions &•How these perceptions can be used in improving efficiency of the health institutions as well as the policy & practices.•The method used here is “Exit Interview”.•An exit interview is a survey conducted with an individual who is separating from an organization or relationship. 

Need of the subject

• To know the perception of customers.

• To know the client’s experience with the public health services.

• To find out the inadequacies in many aspects of healthcare services in M.P.

• To know the effectiveness of customer centric approach in service sector.

Scope of the Subject• Dissatisfaction to provided services

reduces if the respondents are availing benefits of medicines compared to those not availing this benefit. So it is the chance to develop the better accessibilities in the hospitals.

• The conclusively prove that the perceptions on services provided are also shaped by apart from the other factors.

Objective of the study• To analyze the prospective towards

the healthcare institutions in M.P.

• To use the exit interview as the tool of advocacy.

• To prove the priority and authentication of the exit interview system in district health plan in state level.

• To use the results as the indicators for state or nation in identifying the needs, perceptions & concerns.

Future scope of the study• Future scope of the study is implications for

health MIS.

• District health plan may include findings of exit survey that is conducted on a regular basis either by an independent agency or by local health department.

• Results of these surveys may be used as performance indicators at state or national level in identifying consumer’s perception and concerns , area of service failure , and scope of improvement.

• Apart from understanding patient satisfaction dimensions, it is beneficial for managers to understand patient expectations and perceptions

Review of Literature • Brody. D., Miller,S Lerman,C,.Smith,.D,.

Laxaro,G,. & Blum,M.(1989). The relationship between patients satisfaction with their physicians and perceptions about interventions they desired and received

• Calnan, M.Katosouyiannopoulos ,. Ovcharov,V.K,.Prokhorskas,r.Ramic H,. Williams,S. (1994). Major determinants of consumer satisfaction with primary care in different health systems.

• Das,P,. Mausumi,B,. Tikadar,.T. Biswas,G.c., Mridha,p,. & Pal,R,. (2010),Client satisfaction on maternal & child health services in rural Bengal- 478- 481

Research Methodology• The research was conducted through

structured exit interview questionnaire.

• The key method was used is quantitative.

• The tabular analysis was used to understand the socio economic characteristics and the level of satisfaction reported by the respondents.

• This identified the main factors that were used in analysis of variance (ANOVA).

• As the data on the level of satisfaction is ordinal it was thought appropriate to use the Analysis of Variance to identify the factors that explain variation in patient satisfaction.

Sampling Design & Data Collection

• The present study was spread across the different geographical regions of the state Madhya Pradesh.

• The districts were grouped into 5 clusters for ease of data collection.

• These clusters included the poorest region & economically backward districts.

• Total 4,219 individuals were selected randomly for interview.

Data Analysis

• In all 4219 patients were interviewed from 12 districts of M.P & the satisfaction levels of patients were recorded on three different issues, such as

• Behavior of the health professionals (I.e. doctor, ANM, nursing staff, ward boy etc.)

• Infrastructure (Building, waiting room, general cleanness, toilets, safe drinking water, bed, testing instruments, meals , ward cleanness, & services of health institutions).

• Services (quality & capability of the doctors/ ANM, ambulance, OPD timings, laboratory tests, free medicines & availability of medicines.)

• The findings reveal that while 61.8 % of the patients are satisfied with the behavior of the health professionals, rest are indifferent or dissatisfied.

• In case of infrastructure ,only 42.5% of the patients are satisfied & the rest are dissatisfied.

• In case of services provided by the health institutions, patient satisfaction is relatively low at 41.8 %.

Explaining levels of satisfaction using ANOVA:• As only 11% of the variations in satisfaction with

the behavior of the healthcare professional are explained by the factors considered.

• The findings clearly revels that the three most significant interaction are 1- Institution & cost,

• 2- Institution & Caste , 3 – Institution & Travel.

The previous explanation are highly significant but there are 3 major factors explaining the variations in the satisfaction level with infrastructure of the PHI are interaction between

• Cost & Institution

• Cost & other health benefits & travel

• Cost & other benefits

While the respondents incurring less expenses in availing services they are not satisfied with the services provided.

Those who have not availed the other benefits are significantly dissatisfied with infrastructure.

As per the explanation suggests about 17 % variation in satisfaction with the services provided, important explanatory variable must be missing from the explanation.

Findings & Conclusions• The findings of the exit survey data from M.P

suggests that client satisfaction responses in user exit surveys are not positively biased and are substantially critical.

• What distinctively emerge from the exit interview are the subjective but positive perceptions on the behavior of perceptioners and the respondents’ overall dissatisfaction with the service quality.

• The perception is that public healthcare institutions at the sub- district level have poor infrastructure & poor service delivery and their health personnel display a dissatisfactory behavior.

• This obvious calls for changing the functioning of SHC,PHC,&CHCs both in terms of staff capabilities as well as the service.