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III Biannual International Conference on the Future of Primary Care in Europe

Patients’ rights thruogh their eyes in public health institutions in Serbia

Institute of Public Health of Serbia

Mirjana Živković-Šulović, MD

Pisa, Italy, 30.-31. August 2010

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Institute of Public Health of Serbia “Dr Milan Jovanovic Batut” http://www.batut.org.rs

HIFProviders (All levels)

MoH

PHI + PHI network

Center for Analysis, Planing and Center for Analysis, Planing and Organization of Health CareOrganization of Health Care

Main activitesMain activites

Health analysis and planning,Health analysis and planning, health health monitoring and reporting, planning monitoring and reporting, planning of health services, analysis of of health services, analysis of health risks in the communityhealth risks in the communityand quality assurance of health care.and quality assurance of health care.

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Purpose and Method

To check implementation of some patients’ right five years after legislation in Low of Health (2005) and to research correlation with patients satisfaction.

National patients' survey in December 2009. A structured questionnaire was completed by patients, after receiving the health care service in 87 hospitals (five day population) and 163 primary health care facilities (one day population).

Overall patient satisfaction was measured using a five point ordinal scale.

Statistics’ method: frequency distribution, Chi-squared test and multiple linear regression.

Significance level (p) less than 0.05 was considered as statistically significant.

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Legislation and regulation

Important aspects of patients’ rights have been addressed in the Law on Health Care Protection (2005), including the following topics:

Availability of health care according to health needs, resources and equal access

Rights and obligations related to compulsory health insurance Information to the patient + inform to duties Free choice for patients (including choice of doctor) Privacy and confidentiality of information and data Self-determination and informed consent Access to medical documentation Dissatisfaction and complaints Liability and compensation in case of health damage or harm Public information on health protection (e.g. in work or in the event

of epidemics).

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Patient satisfaction survey with hospital care (1)

07.-12.12.2009.; 10.394 respondents; 87 hospitals

Did you give written or oral consent to the procedures and treatment?

Yes 89.3% No 10,7% χ2 =112,976, df=3, p≤0.000 0

10

20

30

40

50

60

70

80

90

100

M S G&O R

Yes

No

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Patient satisfaction survey with hospital care (2)

Did staff informe you about your duties in hospital?

Yes 87,8% No 12,2% χ2 =126,922, df=3, p≤0.000

0

10

20

30

40

50

60

70

80

90

100

M S G&O R

Yes

No

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Patient satisfaction survey with hospital care (3)

Do you aware of the appeals and complaints mechanism?

Yes 76,4% No 23,6% χ2 =298,939, df=3, p≤0.000

0

10

20

30

40

50

60

70

80

90

M S G&O R

Yes

No

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Patient satisfaction survey with hospital care (4)

How much are you satisfide with given informatin about tests, procedures, tretman and results? (five ordinal scale from very dissetisfide to very setisfide)

Dissetisfide Nurses 2,2% Doctors 2,2%

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Patient satisfaction survey with PHC servicies general practis, pedijatrics & gynecologist (1)

07.12.2009.; 57.527 respondents, 171 PHC facilities

How did you choose your doctor? I chose my doctor 81,4% Member of my family chose insted of me 6,6% Did not choose, I get it 3,8% I do not have chosen doctor 5,5% Do not rememmber 2,7% χ2 =597,487, df=8, p≤0.000

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Patient satisfaction survey with PHC servicies general practis, pedijatrics & gynecologist (2)

Do you awere how to make new choise of doctor if you wont?

Yes, I can do it when ever I wish 40,2%

Yes, but I can do it ones per year 32,1%

I think it is not possible 3,7%

Do not know 23,9%

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Patient satisfaction survey with PHC servicies general practis, pedijatrics & gynecologist (3)

My chosen doctor give me clear information of diseases and drugs.

Yes, I agree 84,8% Partly agree 12,6% Do not agree 2.6% χ2 = 16.087, df = 4, p <

0.03

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Patient satisfaction survey with PHC servicies general practis, pedijatrics & gynecologist (4)

There is a box/book for complaints and appeals in PHC servise

Yes, I agree 73% Partly agree 5,7% Do not agree 3,7% Do not know 17,6% χ2 =209,775, df=6,

p≤0.000

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Conclusion (1)

Multiple regression test confirmed that all the variables related to patients’ rights are statistically highly significant on overall satisfaction with health care (p <0.000).

4,00

4,05

4,10

4,15

4,20

4,25

4,30

4,35

4,40

4,45

2005 2006 2007 2008 2009

MW

SW

G&O

RW

Total

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Conclusion (2) Almost 50% patients are not completely

aware about their rights after two campaigns. We need beter strategy.

There is a statistically significant difference on patient awareness about the rights to the various hospital departments or PHC servicies.

These results show that there is need for special research of this issue. We should check medical staff also.

Patients’ rights is an efficient tool for quality control, risk management, conflict resolution and prevention of litigation.

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