Patient Satisfaction Compared in 5 Rural and 5 Urban Hospitals in Illinois - Research Paper Example

Patient satisfaction compared in 5 rural and 5 urban hospitals in Illinois Full of Number and Name Date Introduction This study examines the levels of patients’ satisfaction in both rural and urban hospitals in the state of Illinois. Rural hospitals provide basic medical care to people in rural areas. These hospitals are usually smaller compared to their counterparts in urban areas. Basically, rural hospitals are predominantly owned by the local authorities, non-governmental organizations or private practitioners (Amyx, Mowen & Hamm, 2000). Majority concentrates on delivery of primary health care services. As portrayed by recent research, most rural patients’ by-pass rural hospitals to seek medical attention from urban- based hospitals. Due to under utilization of rural hospitals, these hospitals continue facing financial challenges due to reduced occupancy rates and declining government assistance (Dent & Haslam, 2006). The issue of lower occupancy rates has substantially increased costs, hindering efforts to introduce new services and technology. As such, the rural population continue to raise alarm of limited access to quality health care while at the same time they under- utilize rural hospitals leading to their closure The survey conducted in regard to satisfaction derived by patients generally rated the quality of rural care lower than that of urban care. In the figure below, the study was centered on two samples each consisting five hospitals selected from both rural and urban settings. The study found that, most patients were satisfied with services rendered by urban hospitals than those offered by their rural counter parts. Many patients from the rural setting either expressed dissatisfaction or were not sure of the quality of local services. Graphs Fig 1.0 Patients response on level of service satisfaction at rural hospitals Source: UnitedHealth Group/Harris Interactive Survey of patient response to quality of services in rural hospitals, May 2011 Results From the research carried out, it was learnt that 15% were strongly satisfied, 33% satisfied, 9% were not sure, 28% dissatisfied while 15% were strongly dissatisfied. Patient’s response on level of service satisfaction at urban hospitals Source: UnitedHealth Group/Harris Interactive Survey of patient response to quality of services in urban hospitals, May 2011 Results From the research undertaken, it was learnt that 37% of all the patients examined were strongly satisfied, 47% satisfied, 5% was not sure, 9% was dissatisfied while 2% expressed strong dissatisfaction. Discussion Patients perceive rural hospital care to be more personal as they can identify themselves with the caregivers. There may be a chance of caregivers to interact with their patients after discharge. Therefore, they tend to be more attentive and courteous in their job (Chern & Wan, 2000). On the other hand, the anonymity of urban areas endangers the staff attitude of “who cares,” “I’ll never see the patient again.” Patients may have lower expectations of rural hospitals when they know that they lack necessary technology or experience high patient to staff ratio. As such, they may evaluate their preferred care against a lower set of expectations. In rural setting, there could be lesser chances of error due to the simpler care processes and simple technology being in use. From the previous studies, it was established that patients discharged from teaching hospitals derived more satisfaction. More so, patients want to receive care from hospitals with cutting -edge care, physicians who are the best in their field or those using state of art technology. Perhaps, patients viewed Medicare derived from such modern urban hospitals to be worth the cost associated rather than being prodded and poked by trainees in institutions that train practitioners and conducts research. Patient’s hospital choice between the rural and urban was found to depend on the ability of the patient to evaluate available options and their decision to act accordingly. Adams, Porell and Robbins (1996) observed that hospital size and the nursing staff forms an important factor in assessing satisfaction. Rural hospitals are quite small compared to their urban counterparts, and their small size allows them to provide quieter and friendlier environment for their clients. In most cases, physicians in rural hospitals attend to elder people and those with lower levels of education, who tend to give better assessment compared to the educated population that demands value for their money and better services. Another factor about rural hospitals is that there were high chances that most of the hospital staff is relatives to the patients, which contributed to better services. The close relationship between the patient and the hospital staff enhanced a sense of responsibility by the staff. To most patients, nursing care, which is basically more communal, was found to be more important. Notably, there was marked difference between rural and urban community nurses. Patients reported much more satisfaction from care given by rural community nurses. In rural communities, trust is key aspect of business unlike urban dwellers that are less likely to trust each other. They argued that, rural social life is based on face -to- face encounters unlike urban life which brings isolation and lacks moral support. According to Dranove (1998), in the rural area, patients reported great difficulties accessing wellness and health programs, for instance smoking cessation, disease management and health education that is nowadays increasingly becoming a health challenge everywhere. These services are well available to their colleagues in urban areas and thus, in most cases, a patient is forced to travel longer distances to seek healthcare. Patients from the rural areas were on record complaining of poor services from hospital staff. This was due to huge numbers of patients mainly composed of elderly class and the poor, seeking Medicare from few caregivers at from the local hospitals. The patients to staff ratio is too high, therefore, the available staff becomes overwhelmed by the swelling numbers of both inpatients and outpatients. In addition, some of the patients complained of the services provided at some rural hospitals as they still followed old procedures and medicines exposing the patients to greater suffering as a result of pain. Hygiene was another major issue at rural hospitals which, despite new inventions were found to be using old means in maintaining cleanliness in the hospital environment (Ellis, 1998). Despite being small in size, rural hospitals were found to suffer shortages in bed capacity, nurses, physicians and other specialists as compared to their urban counterparts. Another major challenge was lack of transport as it became a bigger challenge when it came to referral of emergency cases. Hospital location was another factor that the patients were found to derive satisfaction. Urban hospitals were centrally located, making the services readily accessible to the patients unlike their rural counterparts where patients had to travel thousands of miles to access a hospital. This factor saw many patient by-passing rural hospitals for urban ones to avoid inconveniences of non availability of the required services. The study established that hospitals with religious affiliation from rural and urban areas are more appealing. Patients from both rural and urban centers seemed to favor these particular hospitals as most of them thought that the staffs who are members of their church tend to follow religious doctrines. Therefore, they were kind to them on delivery of services. The study further established that most patients who sought services at these hospitals felt much safer and placed a lot of trust on the medical staff. Donabedian (1988) suggested that urban hospitals were run more efficiently compared to their rural counterparts. However, efficiency was found to be compromised as it had an inverse relationship to patient satisfaction. The hospital management tried to cut on hospitals operating expenses. As such, the management ensured that the available staff, though well remunerated served as many patients as they could. This factor saw one medic handling a bigger number of patients and for this reason, many patients were not contented with service delivery as they kept complaining of slowness. Conclusion Generally, most patients favored urban hospitals as compared to their rural counterparts. In spite of large urban population, urban hospitals were found to be well equipped and had the best professionals who could offer quality services. Therefore, the research learnt that, some of the patients from the rural areas were seeking medical attention at the urban based hospitals by- passing those in the rural areas since they considered them to be more superior in terms of service delivery. References Adams, E.K., Porell, F.W., & Robbins, J.D. (1996). Estimating the Utilization Impacts of Hospital Closures through Hospital Choice Models: a Comparison of Disaggregate and Aggregate Models. Socio-Economic Planning Science, 30(2), 139-153. Amyx, D., Mowen, J.C., & Hamm, R. (2000). Who really wants health-care choice? Journal of Management in Medicine, 14 (5/6), 272-290. Chern, JY., & Wan, TTH. (2000). The impact of the prospective payment system on the technical efficiency of hospitals. Journal of Medical Systems, 24(3), 159-172. Dent, M., & Haslam, C. (2006). Delivering patient choice in American acute hospital trusts. Accounting Forum, 30, 359-376. Donabedian, A. (1988). The quality of care: how can it be assessed? Journal of the American Medical Association, 260, 1743-1748. Dranove, D. (1998). Economies of scale in non-revenue producing cost centers: implications for hospital mergers. Journal of Health Economics, 17, 69-83. Ellis, R.P. (1998). Creaming, skimping and dumping: provider competition on the intensive and extensive margins. Journal of Health Economics, 17, 537–555. Read More