Dergacheva E.N., MD, professor Fomichev V.A., SD Zacharova M.A.

Novosibirsk State Medical Institute

SATISFACTION WITH THE QUALITY OF MEDICAL SERVICES, PROVIDED HEALTH CENTERS FOR ADULTS IN THE NOVOSIBIRSK REGION

Measures on primary medical prevention are currently being carried out, mainly in the centers of public health. In this regard, there is a need to analyze their activities, in order to improve the effectiveness of their work and interaction with the health care system of the population.
Purpose of the study. Evaluate the satisfaction with the work of health centers for adults in the city of Novosibirsk and the region in 1916.
Material and method. Method of research: questioning (continuous, correspondence, individual, distributing, semi-closed).
A total of 1,798 correctly filled questionnaires were assessed: 573 questionnaires were filled out by men (31.3%), 1,225 questionnaires were filled by women (68.7%). The age varied from 18 to 86 years, on average 44.1 ± 4.1 years. The urban and rural population is represented almost equally.
The indicator of customer satisfaction (CS) was calculated using the formula:

СS__ (I-2) x B²__
                50 . B - importance.
I- the fulfillment of the factors of satisfaction.
50 - the maximum value of the product of the performance and importance.
Execution of satisfaction factors (the degree of justification of expectations). Are assessed in points on the scale: 4 b. - expectations are more than justified; 3 b. - expectations are justified; 2 b. - unjustified expectations; 1 b.- no answer (latent dissatisfaction or indifference). The total number of scores is divided by the number of respondents.
Importance. (qualitative assessment of services, the importance of information). It is estimated in points on the scale: 1 B. - no answer, 2 b. - complete discrepancy with the expected quality, 3 b. - some dissatisfaction with quality, 4 b. - average satisfaction, 5 b. - high satisfaction.
Interpretation. 1 - 0.75 - CS high, 0.74-0.51 - CS above average, 0.49-0.25 - CS below average, 0.24-0 - CS low. Negative values in these ranges will indicate the degree of customer dissatisfaction.
A special value is attached to the consumer's "loyalty" criterion. Loyalty is the consumer's preference for a certain type of service. A loyal consumer regularly visits an institution, uses the full range of services, attracts the attention of other people, reacts with disbelief to the offer of competitors. Willingness to pay a second visit to the institution (question 4, table 1) - the type of loyalty commitment / habit. Visit on recommendation - type of loyalty is an interest.
Results. Table 1 shows a set of questions, the answers to which help determine the quality of health services provided by health centers for adults. (Page 3).
The main criterion of loyalty to the service provider is trust in the information received and the consumer's readiness to apply again to the same institution for receiving the same services (see Table 1).
In the rating of the importance of the information received at the health information center, the indicators of the population's interest in risk factors, parameters of their development and health (46%) ( Table 1) are on the first places.
It should be noted that the majority of respondents (98.5%) were satisfied with the quality of medical services ("fully satisfied", "rather satisfied", section 2, table 1) provided to them in adult health centers.

3.6 per cent of respondents reported inconveniences in the work of health centers for the adult population, and 0.8 per cent refrained from responding.
The calculation of the indicators of satisfaction of health centers for adults showed:
Satisfaction factors (max 5, min 1) - 3.39 ± 0.21;
Importance (max 5, min 1) - 4.71 ± 0.14;

                                                                                                         Table 1
Survey results of visitors to health centers for adults

№	Questions	Variants of answers	Σ	%	М	%*	F	%*
1	What shortcomings in the work of the health center can be noted?	No shortcomings Inconvenient appointment Availability of queue for reception Long waiting for reception Inattentive attitude of medical staff No answer	1704 21 33 8 3 14	94,8 1,2 1,8 0,4 0,2 0,8	537 11 13 3 0 5	93,7 1,9 2,3 0,5 0 0,9	1167 10 20 5 3 9	95,1 0,8 1,7 0,4 0,2 0,7
2	Are you satisfied with the quality of the services provided?	Completely satisfied Rather satisfied Rather not satisfied   Dissatisfied No answer	1324 451 11 0 14	73,6 25,1 0,6 0 0,8	412 159 0 0 3	71,9 27,8 0 0 0,5	912 292 11 0 11	74,5 23,8 0,9 0 0,9
3	After the survey, did you get new information about some body system?	Cardiovascular Respiratory Endocrine Anthropometric data About risk factors Not received No answer	729 505 162 829 829 99 26	40,6 28,1 9,0 46,1 46,1 5,5 1,5	241 177 41 274283 27 3	42,1 30,9 7,2 47,8 49,4 4,7 0,5	488 328 121 555 546 72 23	39,8 26,8 9,9 45,3 44,6 5,9 1,9
4	Do you plan to contact the health center?	Yes, for health information Yes, to identify risk factors No, that's enough No, I will turn to another place No answer	1119 729 137 4 21	66,7 40,6 7,6 0,2 1,2	362 209 74 0 5	63,2 36,5 12,9 0 0,9	837 520 63 4 16	68,3 42,5 5,1 0,3 1,3
5	Your expectations from visiting the health center	More than justified Justified Did not materialize No answer	791 963 9 33	44,0 53,6 0,5 1,8	252 294 2 25	44,0 51,3 0,4 4,4	539 669 7 8	44,0 54,6 0,6 0,7

• in the tender sample

Customer satisfaction (max +1, min -1) - 0.62 ± 0.1;
Loyalty 1 (commitment / habit) is 0.91 ± 0.1, i.e. Every 13 patients are not ready to visit the institution again;
Loyalty 2 (interest) - 0.72 ± 0.1, i.e. 72 people out of 100 (± 1 person) went to the health center on the recommendation.
Conclusion. Data on satisfaction with the quality of services provided by adult health centers in the city of Novosibirsk and the region indicate a degree of satisfaction "above average" with a "high loyalty rate".

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