Why are people dissatisfied with medical care services in Lithuania? A qualitative study using responses to open-ended questions.

OBJECTIVES To identify and describe the main sources of dissatisfaction with medical services among the population in Lithuania. DESIGN Analysis of written responses to an open-ended question as a part of a questionnaire survey. PARTICIPANTS A randomly selected group of 25--64-year-old men and women from the Utena and the Kaisiadorys regions of Lithuania. Of the 1395 survey respondents, 357 persons (25.6%) answered the question regarding the dissatisfaction with health care services. MAIN OUTCOME MEASURES Identification of the sources of dissatisfaction with medical care services among study participants. RESULTS Twelve categories of dissatisfaction were identified that were related to three levels: shortcomings in the health care system (systemic level), deficiencies in provision and quality of services (institutional level) and deficiencies in physicians' attitudes, skills and work (individual level). CONCLUSION Consumers' perceptions of medical care quality can be analysed by using information obtained from simple survey material and can be used to improve the quality of service. The causes of dissatisfaction with medical service can be traced to the development of the health care delivery system and patients' rights in a country.

[1]  J. R. Lewis,et al.  Patient views on quality care in general practice: literature review. , 1994, Social science & medicine.

[2]  Diane P. Martin,et al.  Issues in the measurement of satisfaction with treatment. , 1997, The American journal of managed care.

[3]  J. Coyle.  Understanding dissatisfied users: developing a framework for comprehending criticisms of health care work. , 1999, Journal of advanced nursing.

[4]  Michel Wensing,et al.  Patient Priorities with respect to general practice care: an international comparison , 1999 .

[5]  M. Field,et al.  The position of the Soviet physician: the bureaucratic professional. , 1988, The Milbank quarterly.

[6]  M. Avis,et al.  Questioning patient satisfaction: An empirical investigation in two outpatient clinics , 1997 .

[7]  R. Baker,et al.  Measuring patient satisfaction for audit in general practice. , 1992, Quality in health care : QHC.

[8]  B. Williams.  Patient satisfaction: a valid concept? , 1994, Social science & medicine.

[9]  R. Friele,et al.  Quality of Care and Patient Satisfaction: A Review of Measuring Instruments , 1995, Medical care research and review : MCRR.

[10]  Changing perceptions of general practitioner care , 1994 .

[11]  C F Federspiel,et al.  What health professionals can do to identify and resolve patient dissatisfaction. , 1998, The Joint Commission journal on quality improvement.

[12]  J. Sitzia,et al.  Patient satisfaction: a review of issues and concepts. , 1997, Social science & medicine.

[13]  R. Tesch.  Qualitative Research: Analysis Types and Software , 1990 .

[14]  J. Sitzia.  How valid and reliable are patient satisfaction data? An analysis of 195 studies. , 1999, International journal for quality in health care : journal of the International Society for Quality in Health Care.