Perceptions of health care providers and patients on quality of care in maternal and neonatal health in fourteen Bangladesh government healthcare facilities: a mixed-method study.
Perceptions of health care providers and patients on quality of care in maternal and neonatal health in fourteen Bangladesh government healthcare facilities: a mixed-method study.
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DOI：
10.1186/s12913-015-0918-9
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发表时间：
2015-06-19
影响因子：
2.8
通讯作者：
Dalal K
中科院分区：
文献类型：
--
作者：
Islam F;Rahman A;Halim A;Eriksson C;Rahman F;Dalal K
孟加拉国在医疗保健方面取得了显著进展，孕产妇和5岁以下儿童死亡率稳步下降，努力实现千年发展目标4和5。然而，与高收入国家相比，孟加拉国的死亡率仍然很高。医疗保健的质量需要提高，以进一步降低死亡率。在实施任何干预措施之前，调查当前的医疗质量是至关重要的。这项研究是为了探索医疗保健提供者对孕产妇和新生儿保健(MNH)护理质量的看法。这项研究还调查了患者对从地区和次地区医院接受的MNH护理的满意度。本研究采用定性与定量相结合的研究方法。研究地点为孟加拉国塔库尔冈和贾马尔普尔的两家区医院和12家分区医院。在医疗保健提供者中进行了14次小组讨论和56次深入访谈。在出院前，对112名来自产科、产房和新生儿病房的患者和他们的服务人员进行了客户离职访谈。八名医生和四名人类学家使用预先测试的指南收集了2011年11月至12月的数据。医院工作人员确定了影响病人护理质量的几个关键因素：工作人员和后勤短缺；缺乏实验室支持；未充分使用病人管理规程；缺乏培训；监督不足。由于病人数量太多，医生无法提供最佳护理。离职访谈显示，85%的受访者对所接受的医院服务感到满意。14名受访者中有7名对医院设施的清洁情况感到满意。超过一半的受访者对他们接受的药物感到满意。在一半的设施中，患者没有机会向医疗保健提供者询问他们的健康状况和治疗情况。由于缺乏医疗人员和后勤支持，孟加拉国的地区和次地区医院的医疗质量很差。需要一种综合质量改进方法来改善孟加拉国地区和次地区医院的卫生保健服务。
Bangladesh has achieved remarkable progress in healthcare with a steady decline in maternal and under-5 child mortality rates in efforts to achieve Millennium Development Goals 4 and 5. However, the mortality rates are still very high compared with high-income countries. The quality of healthcare needs improve to reduce mortality rates further. It is essential to investigate the current quality of healthcare before implementing any interventions. The study was conducted to explore the perception of healthcare providers about the quality of maternal and neonatal health (MNH) care. The study also investigated patient satisfaction with the MNH care received from district and sub-district hospitals. Both qualitative and quantitative methods were used in the study. Two district and 12 sub-district hospitals in Thakurgaon and Jamalpur in Bangladesh were the study settings. Fourteen group discussions and 56 in-depth interviews were conducted among the healthcare providers. Client exit interviews were conducted with 112 patients and their attendants from maternity, labor, and neonatal wards before being discharged from the hospitals. Eight physicians and four anthropologists collected data between November and December 2011 using pretested guidelines. The hospital staff identified several key factors that affected the quality of patient care: shortage of staff and logistics; lack of laboratory support; under use of patient-management protocols; a lack of training; and insufficient supervision. Doctors were unable to provide optimal care because of the high volume of patients. The exit interviews revealed that 85 % of respondents were satisfied with the hospital services received. Seven out of 14 respondents were satisfied with the cleanliness of the hospital facilities. More than half of the respondents were satisfied with the drugs they received. In half of the facilities, patients did not get an opportunity to ask the healthcare providers questions about their health conditions and treatments. The quality of healthcare is poor in district and sub-district hospitals in Bangladesh because of the lack of healthcare personnel and logistic support. An integrated quality improvement approach is needed to improve MNH care service in district and sub-district hospitals in Bangladesh.
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影响因子：
168.9
作者：
Koblinsky, Marge;Matthews, Zoe;van Lerberghe, Wim
通讯作者：
van Lerberghe, Wim
影响因子：
2.4
作者：
Hoque DM;Rahman M;Billah SM;Savic M;Karim AQ;Chowdhury EK;Hossain A;Musa SA;Kumar H;Malhotra S;Matin Z;Raina N;Weber MW;El Arifeen S
通讯作者：
El Arifeen S
影响因子：
6.2
作者：
Fee, Christopher;Weber, Ellen J.;Bacchetti, Peter
通讯作者：
Bacchetti, Peter
DOI：
10.1111/j.1553-2712.2008.00267.x
发表时间：
2008-12
期刊：
Academic emergency medicine : official journal of the Society for Academic Emergency Medicine
影响因子：
--
作者：
Hwang U;Richardson L;Livote E;Harris B;Spencer N;Sean Morrison R
通讯作者：
Sean Morrison R
影响因子：
2.9
作者：
Brainin, M;Olsen, TS;Sivenius, J
通讯作者：
Sivenius, J