Comparison of objective measures and patients' perceptions of quality of services in government health facilities in the Democratic Republic of Congo

Janna M. Wisniewski, Mark L. Diana, Valerie Yeager, David R. Hotchkiss

Research output: Contribution to journalArticle

Abstract

Objective: Examine the relationship between patients' perceptions of quality and the objective level of quality at government health facilities, and determine whether the pre-existing attitudes and beliefs of patients regarding health services interfere with their ability to accurately assess quality of care. Design: Cross-sectional, visit-level analysis. Setting: Three regions (Nord-Ubangi, Kasai/Kasai-Central and Maniema/Tshopo) of the Democratic Republic of Congo. Participants: Data related to the inpatient and outpatient visits to government health facilities made by all household members who were included in the survey was used for the analysis. Data were collected from patients and the facilities they visited. Main Outcome Measures: Patients' perceptions of the level of quality related to availability of drugs and equipment; patient-centeredness and safety serve compared with objective measures of quality. Results: Objective measures and patient perceptions of the drug supply were positively associated (ß = 0.16, 95% CI = 0.03, 0.28) and of safety were negatively associated (ß = -0.12, 95% CI = -0.23, -0.01). Several environmental factors including facility type, region and rural/peri-urban setting were found to be significantly associated with respondents' perceptions of quality across multiple outcomes. Conclusions: Overall, patients are not particularly accurate in their assessments of quality because their perceptions are impacted by their expectations and prior experience. Future research should examine whether improving patients' knowledge of what they should expect from health services, and the transparency of the facility's quality data can be a strategy for improving the accuracy of patients' assessments of the quality of the health services, particularly in low-resourced settings.

Original languageEnglish (US)
Pages (from-to)472-479
Number of pages8
JournalInternational Journal for Quality in Health Care
Volume30
Issue number6
DOIs
StatePublished - Jan 1 2018
Externally publishedYes

Fingerprint

Democratic Republic of the Congo
Health Facilities
Health Services
Aptitude
Quality of Health Care
Patient Safety
Pharmaceutical Preparations
Inpatients
Outpatients
Outcome Assessment (Health Care)
Safety
Equipment and Supplies

Keywords

  • Access
  • Developing countries
  • External quality assurance
  • Patient safety
  • Patient-centered care
  • Surveys

ASJC Scopus subject areas

  • Health Policy
  • Public Health, Environmental and Occupational Health

Cite this

Comparison of objective measures and patients' perceptions of quality of services in government health facilities in the Democratic Republic of Congo. / Wisniewski, Janna M.; Diana, Mark L.; Yeager, Valerie; Hotchkiss, David R.

In: International Journal for Quality in Health Care, Vol. 30, No. 6, 01.01.2018, p. 472-479.

Research output: Contribution to journalArticle

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