Original Article JCMCTA 2018 ; 29 (2) : 57-62

PATIENTS’ SATISFACTION WITH HEALTH CARE SERVICES

PROVIDED AT OUT PATIENT DEPARTMENT OF SELECTED
PUBLIC AND PRIVATE HOSPITAL
Ajoy Deb1*

Abstract (60.38%) and not satisfied with consent be-

Background: Now a days, the patients are fore examination (79.25%) in total of CMCH &
looking for hustle free and quick services in CMSOGH patients.55.26% female patients
this fast growing world. In order to improve were satisfied with attitude of the doctor
the satisfaction level of patients with health whereas 51.47% male patients are satisfied.
care provided at OPD, it is a requirement to 53.57% Secondary to graduate level patients
have knowledge of the level of satisfaction of were satisfied and Illiterate to primary level
patients and feedback, about the services group were 52.00%. Conclusion: This study
provided in the outpatient departments.The on patient satisfaction with health care serv-
study design was conducted to assess pa- ices provided at OPD will help the relevant
tients satisfaction with health care services policy makers and planners in making appro-
provided at outpatient department. Materials priate plan and policies to reduce the prob-
and Methods: This study was conducted at lems and improve their health.Moreover, the
outpatient department of a public hospital ie. study will reveal much useful information that
Chattogram Medical College Hospital (CMCH) will help physicians in Bangladesh to be more
and A Private Hospital ie. Chattagram Maa patient friendly; the researcher thinks in a nut-
Shishu-O-General Hospital (CMSOGH) Chatto- shell that these are the justification of the
gram, commencing from 1st January 2011 to study.
30th June 2011 and sample size was 106. Key words
Convenient type of sampling technique was Patients satisfaction; Health care services; Outpa-
followed.Data was collected by using ques- tient department.
tionnaire containing structured questions. Re-
sults: The mean age of the patients was 35 Introduction
years ± 6.9.In case of receiving services from A hospital is an institution that provides a broad
these two hospitals, the highest percentage range of medical services to sick, injured or preg-
was among the age group 30-39 years which nant patients. It employs medical, nursing, and
is about 36.66% and lowest among the age support staff to provide inpatient care to people
group 50-59 years which is about 16.98%. who require close medical monitoring and an out-
Maximum patients were not satisfied with the patient care to people who need ambulatory care.
hospital environment. Regarding OPD ticket Hospitals provide diagnosis and medical treatment
fee 86.67% patients in CMCH were satisfied of physical and mental health problems, surgery,
whereas only 26.09% patients were satisfied rehabilitation, health education programs, and
in CMSOGH.54.72% patients were satisfied nursing and physician training. Out Patient De-
with sympathy and respect shown to them partment in any hospital is considered to be a shop
by doctors. Privacy during examination window of the hospital1. Now a days, patients are
(71.70%) investigation from outside hospital looking for quality care and quick services2.
Satisfaction is an important element in the evalua-
1. Lecturer of Community Medicine tion stage. Once patients come to the hospital and
Chattogram Medical College, Chattogram. experience the facilities, they may then become ei-
*Correspondence: Dr. Ajoy Deb ther satisfied or dissatisfied. Satisfaction or dissat-
Email: ajoy97@gmail.com isfaction refers to emotional response to the evalu-
Cell : 01711749234
ation of service, consumption, experience. It has
Received on : 25.12.2018
Accepted on : 21.01.2019
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Original Article JCMCTA 2018 ; 29 (2) : 57-62

five key elements. They are Expectations, Per- useful information that will help physicians in
formance, Comparison, Confirmation/Disconfir- Bangladesh to be more patient friendly, the re-
mation, Discrepancy3. Satisfaction can be defined searcher thinks in a nutshell that these are the jus-
as the extent of an individual’s experience com- tification of the study.
pared with his or her expectations4. Patient satis- Materials and methods
faction is related to the extent to which general
health care needs and condition-specific needs are The study design was an observational, cross sec-
met5. tional and convenient type of sampling technique
was followed to assess patients level of satisfac-
The health care services may be defined as "to
tion with health care services provided at out pa-
meet by the use of available resources, knowl-
tient department of A Public Hospital ie. Chatto-
edge, and skills of the service providers”.The pur-
gram Medical College Hospital (CMCH) and A
pose of health care services is to improve the
Private Hospital ie. Chottogram Maa Shishu-O-
health status of the population. The scope of
General Hospital (CMSOGH) Chittagong. To
health services varies widely from country to
conduct this study written permission was taken
country and influenced by general and ever
from research council of Chattogram Medical
changing national, state and local health prob-
College, Director of CMCH and CMSOGH.The
lems, needs and attitudes as well as the available
study was conducted within six months time,
resources to provide these services6.
commencing from 1st January 2011 to 30thJune
This is unsatisfied a broad agreement that an ideal 2011. Purposively selected out-patient depart-
health care service should be appropriate, compre- ments are Surgery out-patient department and
hensive or balanced, adequate, available, accessi- Medicine out-patient department. Scale of satis-
ble, affordable, feasible7. The quality of service in faction level score for patients:the level of pa-
health means an inexpensive type of service with tients” satisfaction was evaluated as 5 for highly
minimum side effects that can cure or relieve the satisfied,4 for satisfied,3 for fairly satisfied,2 for
health problems of the patients8-9. dissatisfied,1 for complete dissatisfied.Data were
This study was therefore undertaken with the aim collected two to three days in a week for four
to find out the level of patient satisfaction related months of time by personal interview by myself.
to different parameters of quality health care in- In each day the relevant data were collected from
cluding the prescription at public health facilities 2-3 respondents. Data was collected by using
in the Chittagong, port city of Bangladesh. questionnaire containing structured questions
In order to improve the satisfaction level of pa- which had two parts. All interviewed questions
tients with health care provided at OPD, it is a re- were checked for completeness, correctness and
quirement to have knowledge of the level of satis- internal consistency to exclude inconsistent and
faction of patients and feedback, about the serv- missing data. For analyzing data frequency and
ices provided in the outpatient departments10-11. percentage were used. In order to find out the as-
Satisfaction of patient is a very important part of sociation between dependent variables chi-squar-
any clinical practice. Patient's satisfaction is di- etests were done. Data was presented in table.
rectly proportionate to the service delivered and Inclusion criteria
any decline in the quality of service ultimately
i) Patients whose age was more than 20 years and
leads to the dissatisfaction of the patient. Studies
less than 60 years
have shown that physicians who are more focused
on their patients benefit them more12. ii) Those who were willing to participate and give
consent in the interview among the selected pa-
This study on patient satisfaction with health care
tients
services provided at OPD will help the relevant
policy makers and planners in making appropriate iii) Those who were willing to give sufficient time
plan and policies to reduce the problems and im- for interviewing among the selected patient.
prove their health. Such improvement will in- Exclusion criteria
crease productivity of labor and promote general i) Patients whose age was less than 20 years and
well being with an objective to improve the quali- more than 60 years
ty of life. Moreover, the study will reveal much

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Original Article JCMCTA 2018 ; 29 (2) : 57-62

ii) Patients who were seriously ill. Table V reveals that female patients (44.74%)
iii) Mentally handicap and retarded patients were more satisfied with doctor’s examination
time than male patients (39.71%). In case of edu-
iv) Those who were not willing to give sufficient cational level,44.00% patients of Illiterate to pri-
time for interviewing mary level group were satisfied whereas 39.29%
v) Patients who had relation with doctor or any patients of secondary to graduate level group were
service provider of attending hospital. satisfied.44.26% patients who have monthly in-
come 500-10,000 are satisfied whereas 51.11%
Results patients were satisfied who have monthly income
A total of 106 patients, 68 male and 38 female, 10,001-20,000+.
were included in this study. The mean ageof the Table VI shows that 55.26% female patients were
patients was 35 years ± 6.9. Getting services from satisfied with attitude of the doctor whereas
these two hospitals, the highest percentage was 51.47% male patients are satisfied. 53.57% secon-
among the age group 30-39 years which is about dary to graduate level patients were satisfied and
36.66% and lowest among the age group 50-59 Illiterate to primary level group were 52.00%. Pa-
years which is about 16.98%. Among them, the tients of 500-10,000 monthly income (54.10%)
highest percentage (29.24%) were businessman were more satisfied than patients of 10,001-
and the lowest percentage (06.60%) were wager 20,000+ monthly income (51.11%) with attitude
and most of the patients were in primary level of the doctor.
both in CMCH (33.33%) and in CMSOGH Table I : Demographic features of the respond-
(30.43%). Out of 106 patients the percentage of ents (n=106)
patients having income of 5001-10000 taka is
33.33% which was more than others in CMCH CMCH (n=60) CMSOGH (n=46) Total (n-106)
and the percentage of patients having income of n % n % n %
10001-15000 taka is 30.44% which was more
1. Gender
than others in CMSOGH (Table I).
a. Male 42 70.00 26 56.52 68 64.15
Regarding satisfaction of respondents about hos- b. Female 18 30.00 20 43.48 38 35.84
pital environment eg waiting time, cleanliness of 2. Age group (Years)
waiting room, cleanliness of toilet, Seating ar- a. 20-29 12 20.00 15 32.61 27 25.47
rangement, Attitude of hospital staffs and Inter- b. 30-39 22 36.67 14 30.43 36 33.96
ruption of service negative response was more c. 40-49 14 23.33 11 23.91 25 23.58
than the positive response both in CMCH and d. 50 – 59 12 20.00 6 13.04 18 16.98
CMSOGH. On the other side 86.67% patients in 3. Occupation
CMCH were satisfied with the OPD ticket fee a. Service holder 27 45.00 12 26.09 39 36.79
whereas only 26.09% patients were satisfied in b. Business 13 21.67 18 39.13 31 29.24
CMSOGH (Table II). c. Housewife 9 15.00 15 32.61 24 22.64
Patients were satisfied with sympathy and respect d. Wagers 5 8.33 2 4.35 7 06.60
(54.72%) by doctors, Privacy during examination e. Other 6 10.00 9 19.57 15 14.15
(71.70%) Investigation from outside hospital 4. Level of education
(60.38%) and not satisfied with consent before ex- a. Uneducated 8 13.33 8 17.39 16 15.09
amination (79.25%) in total of CMCH & b. Primary 20 33.33 14 30.43 34 32.07
CMSOGH patients. On the other side, 56.52% pa- c. Secondary 14 23.33 10 21.74 24 22.64
tients were satisfied with time given for examina- d. Higher secondary 8 13.33 7 15.22 15 14.15
tion in CMSOGH whereas 46.67% were satisfied e. Graduate 10 16.67 7 15.22 17 16.03
in CMCH (Table III).
5. Monthly family income
Table IV shows that patients who were Illiterate to a. 500-5000 17 28.33 9 19.57 26 24.52
primary level group more satisfied with hospital b. 5001-10,000 20 33.33 10 21.74 30 28.30
environment except OPD ticket fee than secon- c. 10,001-15,000 12 20.00 14 30.43 26 24.52
dary to graduate level group. 60.71% secondary to d. 15,001-20,000 7 11.67 7 15.22 14 13.20
graduate level patients only satisfied with OPD e. >20,000 4 6.67 6 13.04 10 09.43
ticket fee.
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Original Article JCMCTA 2018 ; 29 (2) : 57-62

Table II : Satisfaction of the respondents about the Table IV : Educational level based satisfaction of
hospital environment (n=106) the respondents about the hospital environment
(n=106)
Factors Satisfaction CMCH CMSOGH Total
(n=60) (n=46) (n-106) Factors Educational level Yes No
n % n % n % n % n %
1. Waiting time Yes 14 23.33 16 34.78 30 28.30 1. Waiting time Illiterate to primary (n=50) 18 36.00 32 64.00
No 46 76.67 30 65.22 76 71.70 Secondary to graduate (n=56) 12 21.43 44 78.57
2. Cleanliness of Total (n=106) 30 28.30 76 71.70
waiting room Yes 24 40.00 18 39.13 42 39.62 2. Seating
No 36 60.00 28 60.87 64 60.38 arrangement Illiterate to primary (n=50) 23 46.00 27 54.00
3. Cleanliness of Secondary to graduate (n=56) 21 37.50 35 62.50
toilet Yes 13 21.67 10 21.74 23 21.70 Total (n=106) 44 41.51 62 58.49
No 48 80.00 36 78.26 84 79.25 3. Attitude of
4. Seating hospital staffs Illiterate to primary (n=50) 22 44.00 28 56.00
arrangement Yes 26 43.33 18 39.13 44 41.51 Secondary to graduate (n=56) 18 2.14 38 67.86
No 34 56.67 28 60.87 62 58.49 Total (n=106) 40 37.74 66 62.26
5. Attitude of 4. OPD ticket fee
hospital staffs Yes 22 36.67 18 39.13 40 37.74 Illiterate to primary (n=50) 30 60.00 20 40.00
No 38 63.33 28 60.87 66 62.26 Secondary to graduate (n=56) 34 60.71 22 39.29
6. Interruption of Total (n=106) 64 60.38 42 39.62
service Yes 26 43.33 16 34.78 42 39.62
No 34 56.67 30 65.22 64 60.38 Table V : Patients’ opinion regarding doctor’s
7. OPD ticket fee examination time (n=106)
Yes 52 86.67 12 26.09 64 60.38 Features Subgroups Yes No
No 08 13.33 34 73.91 42 39.62 n % n %
Gender Male (n=68) 27 39.71 41 60.29
Table III : Satisfaction of the respondents about the
Female (n=38) 17 44.74 21 55.26
service of the doctors (n=106)
Total (n=106) 44 41.51 62 58.49
Factors Satisfaction CMCH CMSOGH Total Educational level Illiterate to primary (n=50) 22 44.00 28 56.00
(n=60) (n-106) (n=46) Secondary to graduate (n=56) 22 39.29 34 60.71
n % n % n % Total (n=106) 44 41.51 62 58.49
1. Sympathy and Monthly income 500 – 10,000 (n=61) 27 44.26 34 55.74
respect by 10001 – 20,000 (n=45) 17 37.78 28 62.22
doctor Yes 32 53.33 26 56.52 58 54.72 Total (n=106) 44 41.51 62 58.49
No 28 46.67 20 43.48 48 45.28
2. Consent before Table VI : Patients’ opinion regarding attitude of
examination Yes 12 20.00 10 21.74 22 20.75 the doctor (n=106)
No 48 80.00 36 78.26 84 79.25 Features Subgroups Yes No
n % n %
3. Privacy during
Gender Male (n=68) 35 51.47 33 48.53
examination Yes 44 73.33 32 69.57 76 71.70
Female (n=38) 21 55.26 17 44.74
No 16 26.67 14 30.43 30 28.30
Total (n=106) 56 52.83 50 47.17
4. Time given for
examination Yes 28 46.67 26 56.52 54 50.94 Educational level Illiterate to primary (n=50) 26 52.00 24 48.00
No 32 53.33 20 43.48 52 49.06 Secondary to graduate (n=56) 30 53.57 26 46.43
5. Investigation Total (n=106) 56 52.83 50 47.17
from outside Monthly income 500 – 10,000 (n=61) 33 54.10 28 45.90
hospital Yes 36 60.00 28 60.87 64 60.38 10001 – 20,000+ (n=45) 23 51.11 22 48.89
No 24 40.00 18 39.13 42 39.62 Total (n=106) 56 52.83 50 47.17

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Original Article JCMCTA 2018 ; 29 (2) : 57-62

Discussion the time spent by the doctors during consultation

Patient satisfaction studies began in Sweden in 96.5% of the patients were satisfied. With regard
1990s with an aim to improve quality of services to the doctors’ attitude 56% said that doctors were
and increase efficiency and effectiveness of health well behaved, compassionate and patient, while
care services. Bangladesh has a good healthcare 35.5% felt that they were well behaved but would
network covering both rural and urban areas. The have been better if they were more patient.
healthcare-delivery system of the country com- It is revealed from this study that, out of 60 pa-
pares favorably with that of many other Asian tients in CMCH, 14 (23.33%) agreed that they
countries. However, overall healthcare use/con- were satisfied about waiting time to consult with
sumption in Bangladesh is low and is of great the doctor while in CMSOGH 16 (34.78%) out of
concern to society.A study conducted by the 46 patients were satisfied about waiting time . It
Health Economics Unit (HEU) of the Ministry of may be due to giving more attention to the pa-
Health and Family Welfare (MoHFW) Govern- tients by the doctors of private hospital than the
ment of Bangladesh, found that the unavailability public hospital. Most of the patients were unsatis-
of doctors and nurses, their attitudes and attitude, fied with toilet facilities which are 80% in CMCH
lack of drugs, waiting time, travel time, etc. con- and 78.26% in CMSOGH.Most of the patients
tributed to the low use of public hospitals13. were not satisfied with the attitude of hospital
A good number of studies regarding patients’ sat- staffs (MLSS) the percentage of dissatisfaction
isfaction have been carried out at home and was (63.34%) in CMCH and (60.86%) in
abroad. But the main purpose of this study was to CMSOGH.Most of the patients of CMCH (60%)
determine the patients’ satisfaction towards the were unsatisfied with respect to doctor’s willing-
OPD services. Patients’ satisfaction was the out- ness to listen with compassion and reassure the
come variable which was an important component patients with their problems. The percentage of
for program evaluation. Therefore this study dissatisfaction was (56.52%) in CMSOGH which
would benefit health managers for improving ef- is a bit higher than CMCH.
fectiveness and efficiency of the hospital in future. In this study, the percentage of satisfaction regard-
ing attitude of doctor is 53.34% in CMCH and
This study was conducted in two hospitals, 52.17% in CMSOGH which is a bit higher in
CMCH and CMSOGH during working hours. The CMCH.
questionnaire was designed for interviewing in or- Satisfaction regarding waiting time were inversely
der to minimize any confusion about questions related to education and by monthly family in-
and missing data.Majority of patients are male. In come of the patients of both hospitals.Regarding
CMCH, 70% are male and 30% are female while consultation with doctors, patients’ satisfaction
in CMSOGH 56.52% are male and 43.47% are fe- varied with sex, females being significantly more
male. yes than males. Satisfaction with regard to consul-
A study conducted at Poland showed that younger tation by doctors was also found to be inversely
patients tend to be less satisfied with the health related both to education and income.Higher edu-
care than older patients. 62% in the youngest (Till cated patients are less satisfied than lower educat-
35 years old), 70.2% in the middle (36-45 years) ed patients and higher income group patients are
84.3% in the group of 46-55 years and 87.5% in less satisfied than lower income group patients.
the group of 56 and more years reported satisfac- Patients’ satisfaction regarding health care serv-
tion with the services14. ices provided by CMCH and CMSOGH it was
found that level of patients’ satisfaction between
A study revealed that about the waiting time, 57% two hospitals was very close but comparatively
said that they need to wait occasionally for long patients were more satisfied with the support of
hours and 15% said that they never waited for CMCH.
long hours to see the doctor. With regard to the
cleanliness in the hospital, 50% of patients were Limitations
highly satisfied whereas 15.5% said that the This study has several limitations, i.e. since the
cleanliness can surely be improved.With regard to sample size is small and purposively selected

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Original Article JCMCTA 2018 ; 29 (2) : 57-62

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Disclosure satisfaction with the health care services provided
The author declared no conflict of interest. by Ambulatory Care Units June 2004 -LODZ,
POLAND EUROPHAMILI AESCULAPIUS.
62