DETERMINANTS OF PATIENTS’ DISSATISFACTION AT THE ROYAL COMMISSION HOSPITAL IN JUBAIL- SAUDI ARABIA

Abstract

In the last few decades, series of conflicts and violence have taken place between patients and healthcare professionals. These have been noticed by workers in healthcare facilities and some of these have been reported in media. Patients who visit healthcare facility engage in communications with healthcare professionals, introducing to healthcare facilities’ rules, regulations, and procedures, exposed to a new environment. And receive medical treatment and procedures. which in all possess the possibility of miscommunication, misperception, misconduct. the impacts: financial, morals of both patients and staff and in some cases injuries that required legal actions. It is indicating the quality of healthcare and alarm safety concerns. The reasons for these incidents are embodied in patients' dissatisfaction which is the topic of this research; to explore, analyze and determine its origins.The primary reason behind the researcher’s choice of patients' complaints for indicating patients' dissatisfaction is simply because patient complaints represent advanced status of patients' dissatisfaction, “They are often formal letters written to a healthcare organization (or regulator) after a threshold of dissatisfaction with care has been crossed.” (Reader, Gillespie, Roberts, 2014). AimsThe study aims to: determine the characteristics of complaints and complainants, find the association between the complaint's variables, and determine meaningful groupings of the complaint's variables. Material and methodsThe study was conducted in Royal Commission Healthcare Special Program-Jubail (RCHSP-J), which consist of community secondary hospital that consists of 150 beds and five Family Medicine Centers (FMC) distributed over the city districts. This is a retrospective study of secondary data from patients’ complaints registration records and patients’ medical record. full population study all 2019 patients’ complaints. The data source used in this study is: patients’ complaints registered and submitted by patients themselves or their families and relatives. Results:396 complaints were registered, 22 variables for each complaint were traced and collected. Variables were grouped into five categories: Demographic characteristics, Patient characteristics, Hospital factors, Circumstances factors, and Complaints characteristics.The result had three parts (levels): descriptive statistics (univariate and bivariate tables, frequencies, percentages) and analytic statistics (chi square measure of association and p-values for test of significance). Further, Multiple Correspondence Analysis (MCA) is carried out to explore patterns among categorical variables as most of the variables are categorical.The univariate tables described the body of the patient complaints in 2019 in RCHSP-J using 22 variables.The bivariate crosstabulations: revealed 28 significant associations between variables and showed trends and patterns represented were 44 of these associations found to be insignificant.Multiple Correspondence Analysis (MCA): visualized and revealed that the variables’ categorizations used in the study to Patient characteristics, Hospital factors, Circumstances factors, and Complaints characteristics was viable. Conclusion: The study succeeded in shedding light on patients' dissatisfaction as an indicator or alert of urgent need to correct safety, managerial and clinical concerns, has shown that patients' dissatisfaction has both features and determinants that are clearly distinct.Regarding the role of the facility in addressing the issue of patients' dissatisfaction, the following recommendations are made:Firstly, the patient complaint system should be linked with risk management as many of the complaints revealed patient safety concerns which need to be systematically fixed to prevent them from rehappening again. And that patient complaints are not less importance than the occurrence variance reports issued by staff.Secondly, periodic (monthly or quarterly) reports should be issued to show the main concerns in patients’ complaints and follow up on the actions and outcome after actions had been taken.Thirdly, consider the main patient complaints’ concerns as outcome indicator as they reflect the receiver evaluation and opinion in the services which had been delivered.Finally, develop national benchmark for the patient complaints’ concerns as an outcome indicator to evaluate the healthcare facility accordingly and be able to compare different healthcare facilities.One main limitation of the study is the inability to compare the determinants of patients' dissatisfaction with those belonging to the satisfied patients, another limitation is the nature of the data used. Secondary data analysis is limited to the variables collected in the system.