Gap analysis in Access and Quality of healthcare services :Patients and Providers perspective

1. Harishankar Sahu & Adil Refai
School of Pharmaceutical Management, The IIHMR University
Gap analysis in
Access and Quality of healthcare services :
Patients and Providers perspective
Paper presentation
on
21th Annual International conference

2. Agenda
*Introduction
*Problem statement
*Objectives
*Significance of the study
*Methodology
*Findings
*Conclusion
*Limitations of the study
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3. *The quality of Healthcare services depends on patient’s expectations and
perceptions of services provided by the healthcare professionals.
*Stakeholders of Healthcare department are realizing the significance of
customer centered philosophies and are interested in understanding
perspective of patients in healthcare services.
*This paper seeks to assess the gap between patient’s perceptions and
expectation from the healthcare services delivery and the extent of match
between the patient’s and provider‘s perspectives.
Introduction
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4. * The differences in expectation and perception of patients and healthcare providers
in terms of Access and Quality dimensions in provision of healthcare services
delivery.
Problem statement
Objectives
* To identify the Gap between expectation and perception of patients (beneficiary)
in access and quality of healthcare services provided to patients.
* To identify the Gap between patient’s perception and physician’s perception in
access and quality in healthcare services provided to patients.
Significance of Study
* This study will facilitate in identification of Gaps in the different dimensions
(Access and Quality), which will aid in developing an effective and oriented patient
centric approach in provision of healthcare services.
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5. *The study was descriptive, In which total 60 samples were taken randomly
from different PHC’s of Mungeli District among them 30 were physicians and
30 were diagnosed patients.
*The Access and Quality dimensions of healthcare services were extracted from
secondary sources (i.e. Articles, Journals,) and the pretested structured
questionnaire was used as a tool for collecting data from patients and
physicians.
*rating scale from 1-5 was used to measure the perceptions and priorities of
patients and physicians.
Methodology
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6. Findings
Graph 1: Gap between patient’s priorities and perception in
Access of health care services .
1
Table 1: Gap between patient’s priorities and
perception in Access of health care services .
2.5
3
3.5
4
4.5
5
Service location
Transportation cost
Waiting time
Drugs and other
consumables
EducationHousehold resources
Cost and price of services
Staff interpersonal skills
and trust
Community and cultural
preferences
Mean patient's priorities Mean patient's perception
Access Dimension Gap score
Geographical
Accessibility
Service location 0.13
Transportation cost -0.09
Availability
Waiting time 0.4
Drugs and other consumables -0.33
Education 0
Affordability
Household resources 0.25
Cost and price of services -0.68
Acceptability
Staff interpersonal skills and trust 0.97
Community and cultural preferences -0.43
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7. Findings
3.8
4
4.2
4.4
4.6
4.8
5
Cleanliness
Comfort
Functionality
Care
Understanding
CompetenceCourteous & Polite
Service Information
Equipment function
Prompt service
will to help
Mean patient priorities Mean patients perception
Graph 2: Gap between patient’s priorities and perception in
Quality of health care services .
2
Quality Dimension Gap
Tangibility
Cleanliness -0.202
Comfort -0.61
Functionality -0.43
Empathy
Care -0.6
Understanding -0.03
Assurance
Competence -0.38
Courteous & Polite 0.1
Reliability
Service Information -0.21
Equipment function -0.07
Responsiveness
Prompt service -0.65
will to help 0.08
Table 2: Gap between patient’s priorities and
perception in Quality of health care services .
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8. Findings
Graph 3: Gap between patient’s and Physician perception in
Quality of health care services.
3
Quality Dimension Gap
Tangibility
Cleanliness 0.102
Comfort -0.05
Functionality 0.43
Empathy
Care 0.13
Understanding -0.21
Assurance
Competence 0.45
Courteous & Polite 0.17
Reliability
Service Information 0.1
Equipment function -0.5
Responsiveness
Prompt service 0.57
will to help -0.16
Table 3: Gap between patient’s and
Physician perception in Quality of health
care services.
3
3.5
4
4.5
5
Cleanliness
Comfort
Functionality
Care
Understanding
CompetenceCourteous & Polite
Service Information
Equipment function
Prompt service
will to help
patient's perception physician's perception
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9. Conclusion
* Gap Analysis reveals that there is mismatch in patient’s priorities/ Expectations and patient’s
perception in most of the barriers to access and its dimensions. Also negative gap score in
accessibility dimensions signifies that patients are not considering these barriers (e.g.
Transportation cost, Drugs availability, Cost of services, staff skills and trust and community
preference) as an important barriers in accessing the healthcare services in context to their
priority levels.
* So it is necessary to focus on the dimensions of concern which will help to reduce over or
under utilization and allocation of resources to particular dimensions. Equivalent are quality
dimensions where mismatch of gap exists in priorities and perception of patients and even
patient’s perception and physician’s perception over these attributes or dimensions of quality.
Negative Gap score in perception and priorities of patients itself indicates patients are
dissatisfied and vice a versa.
* Hence it is important to allocate the resources where required and dislocate the resources
where positive gap score exists. For patient and physician perceptions in quality dimensions it
is necessary to reduce Gap score in areas like prompt services by adopting patient centric
approach which will take a lead to develop a plan and strategies which are up to patients
expectations, medically correct and in ethical concerns with society.
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10. Limitations of study
*Study was conducted in one district of Chhattisgarh, hence cannot be
generalized to every state except Chhattisgarh.
*Perceptions and priorities are qualitative in nature and it differs along with
person to person.
*Dimensions of Quality are based on SERVQUAL model and only selected
factors/ attributes are considered from it based on researcher’s convenience
and applicability in study.
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11. Thank you