Patient and health system determinants of experiences of care at primary health care clinics in eThekwini, KwaZulu-Natal, 2018

Abstract

Background: Respect for persons includes three sub-elements: dignity, autonomy and confidentiality, whilst client orientation has four sub-elements: prompt attention, quality of basic amenities, access to social support for hospitalised individuals and choice of health providers.

Aim: This study sought to determine patient and health system determinants of experiences of care.

Setting: Study was conducted at primary health care clinics in eThekwini, KwaZula-Natal.

Methods: A self-administered questionnaire was used to collect data from 384 patients who received ambulatory care at six primary health care facilities (three community healthcare centres and three clinics) between June 2018 and November 2018.

Results: Three hundred and sixty nine respondents were included in the study. Eighty one percent (299) of the respondents were female, 67.2% (248) were single and 89.7% (331) were black Africans. Fifty (13.6%) respondents reported their health status to be poor, whilst 47 (12.5%) reported excellent health, with the majority (72.0%) reporting ‘good’ or ‘fair’ health. The patients’ experience score for the study population was 89.0% (IQR 81% – 98%). Patients who attended clinics had a 6.53 (p < 0.001) times increased odds of reporting good patients’ experience score compared with patients who attended community healthcare centres. Although ideal clinic status had a positive association with patients’ experience score (odds ration [OR]: 1.75; p > 0.05) this was not significant.

Conclusion: Patients attending clinics had a better experience compared with community health centres. Ideal clinic status showed a positive but not statistical significant association with good patient experiences. This may suggest that factors other than structural improvements play an important role in patients’ experience.