Un modelo estructural para medir la efectividad de los servicios hospitalarios: aplicación en hospitales públicos del sur de Chile / A structural model to measure effectiveness of hospital services

Background: One of the main determinants of quality in the public health care services is the perceived user satisfaction. Aim: To analyze the relationship between supply (User Orientation of Management) (UO), demand (User Satisfaction with service components) (US) and subjective indicators of effectiveness, such as Perceived Global Quality (PGQ) and Global Satisfaction (GS) among hospital service users. Material and Methods: A survey was applied to users of hospital services, asking about management and quality of hospital services and satisfaction with the service provided. Data was analyzed with exploratory and confirmatory factorial analyses. Structural Equation Models were used to test the hypotheses implied in the theoretical model of effectiveness. Results: The cause-effect relationship between UO and US was confirmed. There was also a direct relationship between PGQ and GS. Conclusions: Efficient nursing and administrative personnel are of highest importance to improve user satisfaction. The hospital management must pay extreme attention to this kind of staff in order to be effective from the point of view of their patients.

Gestión y satisfacción en servicios de salud de Chile: contraste entre las percepciones de los funcionarios y los usuarios / Perceptions of providers and clients about management and satisfaction with services in two public hospitals

Background: Clients and providers of health care can have contrasting perceptions about the quality of service. Provider perceptions are mostly devoted to design and delivery of services while those of clients are focused in the attention received. Aim: To assess perceptions of health care providers and clients about client management and satisfaction with services provided. Material and Methods: Two public hospitals were surveyed. A qualitative analysis was performed first, reviewing reports and patient data bases and through informal meetings with providers and clients. In a second phase, an enquiry with Likert type questions was devised and answered by a total of 377 providers and 400 clients from both hospitals. Results: The median perception of clients about the quality of service was better than that of providers in both hospitals. The communication of hospitals with clients to offer timely information received a poor evaluation both from providers and clients. However the concern of hospitals about health care of the community was considered adequate. The degree of satisfaction with concrete issues such as information panels and physical infrastructure received similar evaluation both by providers and clients. Conclusions: This analysis can be useful for management decision making, identifying strengths and weaknesses of health care provided by these two public hospitals. This type of assessment can be replicated in other public and private health care facilities.

Análisis de la opinión de usuarios sobre calidad percibida y satisfacción con hospitales públicos: Estudio de caso desde la perspectiva de la aplicación del marketing / An enquiry on client opinions about quality of care in a public hospital

Background: The level of satisfaction of patients with the services provided by public hospitals is becoming an important issue for health authorities. Aim: To analyze an enquiry applied to patients, about the level of satisfaction with the service provided by a public regional hospital in Chile. Material and methods: An enquiry was applied to 150 ambulatory (76 percent women) and 50 hospitalized patients (56 percent women). It included 28 questions about management aspects of health care and 20 questions about client satisfaction. Data was analyzed using factorial analysis and multiple regressions. Results: The manners of hospital personnel were the factor with the highest impact on the perception of patients about global quality of services. Attention timing was the most influential aspect on global satisfaction. Conclusions: There results confirm those from abroad and can orient an adequate management of public hospital.

La aplicación del marketing en hospitales públicos desde la perspectiva de los funcionarios: El caso de un hospital del sur de Chile / Application of marketing strategies for the management of public hospitals from the viewpoint of the staff members

Background: The implementation of the marketing strategies in public hospitals provides management advantages and improves the relationship between customers and staff. Aim: To analyze the application of marketing strategies in a public hospital, from the perspective of the staff. Material and methods: A structured survey that asked about perceptions in 50 items about communication between personnel and customers/users, customer satisfaction, participation in the development of new policies and incentives for efficiency was applied to a stratified sample of the staff. Factorial and regression analyses were performed to define the impact of marketing strategies on the degree of preoccupation and orientation of the organization towards the satisfaction of customer needs. Results: The survey was applied to 74 males and 122 females. The survey showed that the orientation of the hospital towards the satisfaction of its beneficiaries basically depends on the generation of an organizational culture oriented towards them and the implementation of adequate policies in staff management and quality of service. These basic aspects can be accompanied with practices associated to the new marketing approaches such as a market orientation, customer orientation and relational marketing. All these factors presented positive and significant relations. Conclusions: New marketing strategies should be applied, to achieve an efficient and customer oriented hospital management.