The nurse did not even greet me : how informed versus non-informed patients evaluate health systems responsiveness in South Africa

dc.contributor.authorHompashe, Dumisani MacDonalden_ZA
dc.contributor.authorGerdtham, Ulf G.en_ZA
dc.contributor.authorChristian, Carmen S.en_ZA
dc.contributor.authorSmith, Anjaen_ZA
dc.contributor.authorBurger, Ronelleen_ZA
dc.date.accessioned2021-09-15T13:27:26Z
dc.date.available2021-09-15T13:27:26Z
dc.date.issued2021
dc.descriptionCITATION: Hompashe, D. M., et al. 2021. The nurse did not even greet me : how informed versus non-informed patients evaluate health systems responsiveness in South Africa. BMJ Global Health, 6:e004360, doi:10.1136/bmjgh-2020-004360.
dc.descriptionThe original publication is available at https://gh.bmj.com
dc.description.abstractIntroduction: Universal Health Coverage is not only about access to health services but also about access to high-quality care, since poor experiences may deter patients from accessing care. Evidence shows that quality of care drives health outcomes, yet little is known about non-clinical dimensions of care, and patients’ experience thereof relative to satisfaction with visits. This paper investigates the role of non-clinical dimensions of care in patient satisfaction. Methods: Our study describes the interactions of informed and non-informed patients with primary healthcare workers at 39 public healthcare facilities in two metropolitan centres in two South African provinces. Our analysis included 1357 interactions using standardised patients (for informed patients) and patients’ exit interviews (for non-informed patients). The data were combined for three types of visits: contraception, hypertension and tuberculosis. We describe how satisfaction with care was related to patients’ experiences of non-clinical dimensions. Results: We show that when real patients (RPs) reported being satisfied (vs dissatisfied) with a visit, it was associated with a 30% increase in the probability that a patient is greeted at the facilities. Likewise, when the RPs reported being satisfied (vs dissatisfied) with the visit, it was correlated with a 15% increase in the prospect that patients are pleased with healthcare workers’ explanations of health conditions. Conclusion: Informed patients are better equipped to assess health-systems responsiveness in healthcare provision. Insights into responsiveness could guide broader efforts aimed at targeted education and empowerment of primary healthcare users to strengthen health systems and shape expectations for appropriate care and conduct.en_ZA
dc.description.urihttps://gh.bmj.com/content/6/4/e004360
dc.description.versionPublisher's version
dc.format.extent9 pages ; illustrations
dc.identifier.citationHompashe, D. M., et al. 2021. The nurse did not even greet me : how informed versus non-informed patients evaluate health systems responsiveness in South Africa. BMJ Global Health, 6:e004360, doi:10.1136/bmjgh-2020-004360
dc.identifier.issn2059-7908 (online)
dc.identifier.otherdoi:10.1136/bmjgh-2020-004360
dc.identifier.urihttp://hdl.handle.net/10019.1/123031
dc.language.isoen_ZAen_ZA
dc.publisherBMJ Publishing Group
dc.rights.holderAuthors retain copyright
dc.subjectMedical protocols -- South Africaen_ZA
dc.subjectPrimary health care -- Planning -- South Africaen_ZA
dc.subjectMedical care -- Quality -- South Africaen_ZA
dc.subjectPatient satisfaction -- South Africaen_ZA
dc.titleThe nurse did not even greet me : how informed versus non-informed patients evaluate health systems responsiveness in South Africaen_ZA
dc.typeArticleen_ZA
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