Assessment Of Outpatient Satisfaction In Binh Dinh Provincial General Hospital.pdf

0000 VIETNAM NATIONAL UNIVERSITY, HANOI VIETNAM JAPAN UNIVERSITY NGUYEN NAM KHANH ASSESSMENT OF INPATIENT SATISFACTION IN BINH DINH PROVINCIAL GENERAL HOSPITAL IN 2018 MASTER’S THESIS BUSINESS ADMINIS[.]

0000 VIETNAM NATIONAL UNIVERSITY, HANOI

VIETNAM JAPAN UNIVERSITY

NGUYEN NAM KHANH

ASSESSMENT OF INPATIENT

SATISFACTION IN BINH DINH PROVINCIAL GENERAL

HOSPITAL IN 2018

MASTER’S THESIS BUSINESS ADMINISTRATION

Hanoi, 2019

VIETNAM NATIONAL UNIVERSITY, HANOI

VIETNAM JAPAN UNIVERSITY

NGUYEN NAM KHANH

ASSESSMENT OF INPATIENT

SATISFACTION IN BINH DINH PROVINCIAL GENERAL

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ACKNOWLEDGEMENT

First of all, I would like to give my sincere thanks to Vietnam Japan University, Yokohama National University, Japan International Cooperation Agency (JICA) with all the members, lecturers and assistants for giving me this opportunity to study and research in an international academic environment I have gained a lot of knowledge and experience through classes and seminars in Vietnam and Japan Secondly, I want to express my deep and sincere gratitude to my two supervisors, Associate Professor Vu Anh Dung, Vietnam Japan University and Professor Hiroshi Morita, Yokohama National University Their wide knowledge and critical thinking have given me motivation, confidence and value to do my research They also encouraged and instructed me personally for my thesis I also want to thank Professor Matsui, Associate Professor Pham Thi Lien, Hanh sensei, Hino sensei for what all

of you have done with VJU students You always support and share with us your valuable knowledge and experience

To Huong san and IPO’s staff, YNU Thank you for your detailed caring to VJU students in Vietnam as well as in Japan

Finally, I would like to thank my family, friends and colleagues who supported and encouraged me to finish my thesis

Hanoi, 2019

Nguyen Nam Khanh

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ABSTRACT

Patient satisfaction is an important indicator used for measuring the quality of healthcare facilities Patient satisfaction has an effect on outcomes of medical service providers and reflects efficiency of provided services Therefore, patient satisfaction will be an effective indicator to measure the success of medical service providers This research introduces how to assess patient satisfaction in public hospitals, taking the case of Binh Dinh provincial general hospital

In the strategy of Vietnam healthcare system for protecting, caring and improving healthcare in the period 2011-2020, vision 2030 Some issues have been mentioned: Health is the most valuable asset of individuals and all society; medical service is a special social service without profits in public service providers; investing in health

is investing for the future and for good nature of society; improvement and modernization of healthcare system towards Equity-Efficiency-Development

Currently, medical services in public hospitals are considered not as good as in private hospitals Therefore, the objectives of this research are assessing current situation of patient satisfaction in the hospital and providing some recommendations as the background or reference for public hospitals to improve their medical services

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TABLE OF CONTENTS

ACKNOWLEDGEMENT i

ABSTRACT ii

LIST OF FIGURES vi

LIST OF TABLES vii

CHAPTER 1: INTRODUCTION 1

1.1 Background 1

1.2 Research objectives 2

1.3 Research questions 2

1.4 Introduction of Binh Dinh provincial general hospital 2

1.4.1 Policies of Vietnam healthcare system towards patient satisfaction 2

1.4.2 Establishment and development process of the hospital 4

1.5 Structure of research 5

CHAPTER 2: LITERATURE REVIEW ON PATIENT SATISFACTION 6

2.1 Hospital services 6

2.2 Service quality 6

2.3 Customer satisfaction 8

2.4 Customer satisfaction and service quality 9

2.5 Overview of patient satisfaction 10

2.6 Role of patient satisfaction 10

2.7 The relationship between service quality and patient satisfaction 11

2.8 Factors impacting patient satisfaction 11

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CHAPTER 3: RESEARCH METHODOLOGY 16

3.1 Research design 16

3.2 Research process 17

3.3 Data collection 17

3.4 Research model 20

CHAPTER 4: RESULTS OF INPATIENT SATISFACTION IN BINH DINH PROVINCIAL GENERAL HOSPITAL 23

4.1 General information of researched patients 23

4.2 Assessment of inpatient satisfaction 25

4.2.1 Inpatient satisfaction on accessibility 25

4.2.2 Inpatient satisfaction on Transparency on information, examination and treatment procedures 27

4.2.3 Inpatient satisfaction on Facilities and equipment 29

4.2.4 Inpatient satisfaction on Medical staff’s behavior and professional capacity 31

4.2.5 Inpatient satisfaction on Results of service provision 33

4.3 Summary of results on inpatient satisfaction 35

4.3.1 Inpatient satisfaction in general and classified by factors 35

4.3.2 Percentage of overall assessment of inpatient satisfaction 36

4.3.3 Classification of patients who will return or introduce to other patients 36

4.3.4 Odds Ratio Analysis 37

CHAPTER 5: RECOMMENDATIONS TO IMPROVE INPATIENT SATISFACTION IN BINH DINH PROVINCIAL GENERAL HOSPITAL 40

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5.1 Improving facilities in the hospital 40

5.2 Investing more in medical equipment and information technology to improve service quality 40

5.3 Simplifying complicated administrative procedures 41

5.4 Improving medical staff’s communication skills 41

5.5 Limitations of the thesis 41

CONCLUSIONS 42

LIST OF REFERENCES 43

APPENDIX 1 46

APPENDIX 2 50

APPENDIX 3 52

APPENDIX 4 53

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LIST OF FIGURES

Figure 1 Research process 17

Figure 2 Research model 22

Figure 3 Patient satisfaction by age 24

Figure 4 Summary of inpatient satisfaction on Accessibility 26

Figure 5 Summary of inpatient satisfaction on Transparency on information, examination and treatment procedures 28

Figure 6 Summary of inpatient satisfaction on Facilities and equipment 31

Figure 7 Summary of inpatient satisfaction on Medical staff’s behavior and professional capacity 33

Figure 8 Summary of inpatient satisfaction on Results of service provision 35

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LIST OF TABLES

Table 4.1 Patient classification by sex 23

Table 4.2 The total number of days of hospitalization 24

Table 4.3 Patients using of health insurance card for this treatment 24

Table 4.4 Classification of inpatient satisfaction by accessibility 25

Table 4.5 Classification of inpatient satisfaction by Transparency on information, examination and treatment procedures 27

Table 4.6 Classification of inpatient satisfaction by Facilities and equipment 29

Table 4.7 Classification of inpatient satisfaction by Medical staff’s behavior and professional capacity 31

Table 4.8 Classification of inpatient satisfaction by Results of service provision 33

Table 4.9 Inpatient satisfaction in general and classified by factors 35

Table 4.10 Percentage of overall assessment of inpatient satisfaction 36

Table 4.11 Classification of patients who will return or introduce to other patients 36

Table 4.12 The relation between related factors and inpatient satisfaction 37

Table 4.13 The relation between related factors and patient return 38

For public hospitals, assessment of patient satisfaction will help improve quality of services and reputation, so that hospitals can increase revenue and have effects on other hospitals Pollack (2008) there is a relationship between service quality and patient satisfaction, level of satisfaction is a measurement for the suitability between medical services provided with expectation from patients Satisfied patients will lead

to improved financial outcomes, reduce management claims, retain patients and succeed in a competitive environment

In current circumstance, there is a difference of medical services between public and private hospitals, services at private hospitals are considered better than at public hospitals Nowadays, patients do not only pay attention on quality of medical treatment but also the services that they would receive from medical staff With the development of modern technology in medical treatment, medical services have been highly focused on to increase the competitiveness

Raising patient satisfaction in public health will play an important role for public healthcare providers because patient satisfaction determines the survival and development of public hospitals, according to Decree No 55/2012/ND-CP public healthcare providers will be dissolved if the task is not completed in three consecutive years

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With current situation and desire to contribute to improve the quality of medical services and patient satisfaction in Binh Dinh provincial general hospital, the author decided to choose the topic “Assessment of inpatient satisfaction in Binh Dinh provincial general hospital in 2018”

- What is the relation between related factors and inpatient satisfaction?

1.4 Introduction of Binh Dinh provincial general hospital

1.4.1 Policies of Vietnam healthcare system towards patient satisfaction

Satisfaction of patient is the result of medical services provided The level of satisfaction is a tool to assess the quality of healthcare services Some studies have indicated the relationship between quality of service and satisfaction, the higher the quality of health services, the higher the level of satisfaction Satisfaction plays an important role deciding the choices of patients using medical services at health facilities that helps increase revenue for hospitals When patients are satisfied with the services received, they will return in the future and become regular customers Besides that, they may also introduce the positive remarks about the service quality

to other patients that will help hospitals attract more patients therefore improving satisfaction not only helps retain existing patients but also attracts new patients and enhances the reputation for hospitals

Some studies have also indicated that there is a relationship between patient satisfaction and the profit of hospital The satisfaction will help increase profit for hospitals and competition with other healthcare facilities

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Patient satisfaction is also an important factor determining the survival and development of public hospitals that is indicated in Decree No 55/2012/ND-CP: public healthcare providers will be dissolved if the task is not completed in three consecutive years Patient satisfaction has been identified as a significant evidence reflecting the completion of the task

Improving patient satisfaction will have a good effect on healthcare sector because it brings not only benefits to service users but also benefits to healthcare facilities

In the current context of Vietnam healthcare system, central hospitals are overloading therefore the measurement of patient satisfaction is necessary, it will provide useful evidence for reorganizing the process of delivering services that meets the demand of service users

Raising the quality of medical services and reforming administrative procedures in the whole healthcare sector will make a contribution to implement the Resolution No 30/NQ-CP of the Government on protection, caring, and improvement of people’s health The Resolution No 30/NQ-CP regulating the program of administrative reform on the period 2011-2020 with 5 objectives:

- Building and completing the institutional system of market economy towards social orientation

- Creating a fair and ventilated business environment

- Developing a system of administrative procedures that is smooth, clean, and strong from the central government to the local authorities

- Ensuring protection of democratic rights and human rights

- Building a team of officials and civil servants with quality, capacity and qualifications

The program is divided into two phases with the following tasks:

- Phase I (2011 - 2015): ensuring personal satisfaction with services provided

by public facilities in the field of education and health care reaches more than 60% in 2015

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- Phase II (2016 - 2020): ensuring personal satisfaction with services provided

by public facilities in the field of education and health care reaches more than 80% in 2020

1.4.2 Establishment and development process of the hospital

From the first infirmary of 20 beds with less than 10 staff, established in April 1961

in the highland of Vinh Thanh (Ha Tien village) In 1969, the infirmary had an outstanding growth and was eligible for being a hospital Implementing the direction

of the Provincial Department of Health, hospital staff and local people build a new 100-bed provincial hospital, completed in October 1969, at O village - Vinh Thanh The hospital is made of bamboo, but it is tall and spacious in the dense forest with 20 large and small houses

After the liberation of the South, on April 1975, the provincial health officer took over the medical facility, repaired and brought the hospital back to normal operation and transferred the hospital to the current Binh Dinh General Hospital

Provincial General Hospital with a total area of more than 5 hectares is the highest treatment level of the provincial health sector From 1975 until now, the hospital has experienced many historical periods and has always received investment in construction and development, meeting the need of caring and protecting people's health Currently, Binh Dinh General Hospital is one of the large-scale provincial hospitals in the Central Region, Central Highlands, with 1050 inpatient beds; the total number of officials, employees nearly 1300 people; The hospital currently has 07 functional rooms, 33 clinical and subclinical departments Many modern equipment and facilities for diagnosis and treatment have been procured; officials and employees are regularly trained with knowledge, professional and management skills that is the basis for implementing the goal of constantly improving the quality of medical examination and treatment at the hospital, facilitating officials and people in the province have access to high quality of healthcare services

Being a leading facility in the field of medical examination and treatment With a long tradition and a team of highly qualified professional staff in many specialized

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areas For many years, Binh Dinh General Hospital has affirmed its role in implementing the functions and tasks of a provincial general hospital The hospital is planned by the Prime Minister to be a Regional Hospital under Decision No 153/2006 / QD-TTg dated June 30, 2006 " approving the master plan for development of Vietnam's health in the period up to 2010 and vision to 2020 ” On September 19, 2007, the Hospital was recognized by the Provincial People's Committee of level I Hospital according to Circular No 23/2005 / TT-BYT dated August 25, 2005 of the Minister of Health

Along with promoting the strength of the hospital in examination, treatment, caring, protection and improvement of people's health in the province and the region The hospital has actively implemented social activities such as free medical examination for people in remote and disadvantaged areas; coordination with charity organizations to giving meals to serve the poor, participation in disease prevention, humanitarian blood donation etc The Hospital always sets priority target to improve constantly the quality of medical examination and treatment In order to accomplish this goal, hospital leaders appreciate and focus on people as a key factor Therefore, even in difficult times, lack of human and budget, the hospital still tries to prioritize investment in training and human resource development

With a team of highly qualified professional and technical staff, and some modern equipment, Binh Dinh General Hospital is always a reliable medical examination and treatment place for patients and their relatives in the province and nearby provinces

1.5 Structure of research

Chapter 1: Introduction

Chapter 2: Literature review on patient satisfaction

Chapter 3: Research methodology

Chapter 4: Results of inpatient satisfaction in Binh Dinh provincial general hospital Chapter 5: Recommendations to improve patient satisfaction in Binh Dinh provincial general hospital

or training and research for major medical school centers to services designed by an industry-owned network of such institutions as health maintenance organizations (HMOs) The mix of services that a hospital may offer depends almost entirely upon its basic missions or objectives

Hospital services define the core features of a hospital's organization The range of services may be limited in such specialty hospitals as cardiovascular centers, or cancer treatment centers, or very broad to meet the needs of the community, or patient base, as in full service health maintenance organizations (HMOs), rural charity centers, urban health centers, or medical research centers Hospital services are usually the most general in large urban areas or underserved rural areas, broadly encompassing many services ordinarily offered by other providers

2.2 Service quality

Gronroos (1984) argues that customer perceived quality is influenced by a technical and functional dimension The functional quality is more important as long as the technical quality is at a satisfactory level, a high level of functional quality may compensate for temporary matters in technical quality in overall assessments of service quality Technical quality in the healthcare sector based on the basis of the technical accuracy of the diagnoses and procedures Functional quality refers to the way in which the healthcare services delivered to the patients and it is usually the main determinant of patients’ quality perceptions

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Quality is a term that we usually think of an excellent product or service that meets our expectations Quality is based on perceptions of individuals on products and services, these perceptions have been created through past experience of customers Parasuraman, Ziethml, Barry (1985) Service quality is a type of attitude related to satisfaction described as the difference between the customer’s expectations and perception of services

Javetz and Stem (1996) were the first to observe the growing attention to improvement of quality as a result of three important trends characterizing the healthcare sector

- The market has become more competitive, healthcare insurers and providers compete based on economic considerations

- There has been a consumption growth of private healthcare services

- A marked growth of customers’ awareness with their rights in healthcare sector

Hollis (2006) agreed that financial impact is a significant consideration but stressed that the management of consumer perceptions of healthcare quality is also significant with the following reasons:

- Evaluation of quality is related to satisfaction and service re-use intent

- Quality improvement methods require the identification and meeting of patient expectations

Zineldin (2006) Patient satisfaction is an important health outcome and quality measurement and he suggested reasons for the improvement of quality as followings:

- Patient dissatisfaction with high costs and poor quality

- Quality methods give managers ways to solve problems, influence the work, improve relations with health workers, provide ways to reduce waste and save Money

- Unnecessary drugs, surgery and laboratory wastes resources, and harms patients

From the previous authors, quality is a crucial determinant of competitiveness and long-term profitability in both service and manufacturing organizations However, he

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concluded that quality methods used in developed countries were not appropriate for developing countries therefore the different reasons given for quality improvement comparing to those of previous authors

Raja, Deshmukh and Wadhwa (2007) supported the argument that quality management has emerged not only as the most important and long-term strategy for ensuring the survival of organizations, but also leads to business excellence The authors concluded that declining reimbursement, new incentive structures, and increasing competition are placing pressure on providers to deliver healthcare services effectively and efficiently The authors also stated that most healthcare organizations are beginning to realize that quality is necessary for survival

James (2005) argued that the healthcare industry is moving from competition based

on price to competition based on quality and performance

It is obvious from all of the authors mentioned above that high quality of service is vitally important for the survival of healthcare facilities

2.3 Customer satisfaction

Wilson et al (2008) Customer satisfaction has been a great topic for organizations and researchers because customer satisfaction will be an important factor to increase sales, maximize profits, minimize costs, and lead to customer loyalty

Customers play a significant role in the organizational process and are the first aspect

to be considered by managers Customers are always trying to get maximum satisfaction from products and services Winning in today’s severe competition market, it is necessary to build not only the products but also customer relationship that means delivering superior value to the targeted customers Most companies adopts quality management programs which improves the quality of products and marketing processes because quality has a direct impact on product performance and

on customer satisfaction, Kotler et al (2002)

Kotler & Keller (2009) it is termed satisfaction when a customer is contented with products or services, satisfaction can be a person’ feelings of pleasure or disappointment comparing a product’s perceived outcome with their expectations

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Levy (2009) suggested three ways of measuring customer satisfaction

- A survey that customer feedback could be transformed into measureable data

- Focus group where discussions arranged by a trained moderator reveal what customers think

- Informal measures like talking to customers or reading blocs

The National Business Research Institute suggested possible dimensions that can be used in measuring customer satisfaction

- Trust in your employees

- The closeness of the relationship with contacts in your firm

- Other types of services needed

- Your positioning in clients’ mind

2.4 Customer satisfaction and service quality

Cronin & Taylor (1992) customer satisfaction has been considered to be based on the customer’s experience on a particular service encounter, the fact that service quality

is a determinant of customer satisfaction because service quality comes from results

of the services from providers

Oliver (1993) suggested that service quality would be antecedent to customer satisfaction regardless of whether these constructs were cumulative or transaction-specific

Wilson et al (2008) have been more precise about the meaning and measurement of service quality and satisfaction Service quality and satisfaction have certain things

in common; however, satisfaction is a broader term whereas service quality focuses

on dimensions of service