Fomicheva M.L., MD, Professor Fomichev V. A., SD Zacharova M.A.

THE OPINION OF CONSUMERS ABOUT THE QUALITY OF MEDICAL SERVICES. RENDERED IN HEALTH CENTERS IN THE NOVOSIBIRSK REGION

Novosibirsk State Medical University

Abstract

Quality indicators are presented in the delivery of health services in health centers for adults and the city of Novosibirsk region in the year 2016, obtained by survey. Defined performance factors of satisfaction with loyalty options.

It concludes that satisfaction with the quality of medical services provided in health centers, significantly above the average loyalty factor close to the maximum.

Keywords:

Health centers, the quality of medical services, quality indicators.

Introduction

Primary health prevention activities currently conducted mainly in health centers [5, 6]. In this regard, there is a need for a review of their activities in order to enhance the effectiveness of their work and interaction with the health care system [1, 2, 3]. Works by evaluating the opinion of consumers about the quality of medical services in health centers in the domestic literature a bit [3, 4]. But the problem is acute and significant.

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.

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
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;
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".

Bibliography

1. Zhukova Т.V. Optimization of preventive programs to assess the level of public health / Т.В. Zhukova, N.A. Gorbachev, OA Svintukhovsky, M.L. Verevina, I.M. Haragurgieva, N.A. Kononenko, A.Yu. Polonenko. // Health of the population and habitat, 2014. - № 6 (255). - S. 6-10.ã.
2. Kochetovskaya E.A. Organizational and methodical measures to optimize the health of the population of the region on the basis of an analysis of lifestyle factors and interaction with the health care system. / E.A. Kochetovskaya. // Bulletin of New Medical Technologies, 2013. - T. Kh., No. 1. - P. 134-136.
3. Polhovskaya N.M. The current state of methods for assessing the quality of care. / NM. Polhovskaya, Yu.L. Minaev. // Bulletin of the Medical Institute "REAVIZ", 2012. - № 3-4. - P. 82-89.
4. Karpova O.V. Sociological research in the quality management system of medical care. / O.V. Karpova, M.A. Tatarnikov, E.B. Marochkina. // Sociology of Medicine, 2013. - № 1 (22). - P. 11-15.
5. Starodubov V.I. Healthcare in Russia: problems and solutions. / V. I. Starodubov, G.E. Ulumbekova. // Public health: News, Opinions, Training, 2015. - № 1 (1). - P. 12-27.
6. Starodubov V.I. Healthcare in Russia: scenarios of development. / V. I. Starodubov, G.E. Ulumbekova. // Public health: News, Opinions, Training, 2015. - № 2 (2). - P. 34-47.